Table of Content

20 November 2023, Volume 26 Issue 33

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Review & Perspectives

Research Progress on Comprehensive Assessment Tools for the Elderly with Dementia

XIN Gongkai, CONG Xin, YUAN Lei, CHENG Yuetong, NI Cuiping, ZHANG Weiwei, ZHANG Pingping, LIU Yu

2023, 26(33):  4103-4109.  DOI: 10.12114/j.issn.1007-9572.2023.0138

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There are many types of assessment tools for dementia patients both domestically and internationally. However, assessments using single-dimensional measurement tools often have limitations, and there is still a lack of reports on comprehensive assessment tools specifically for dementia patients in current. Based on this, the comprehensive assessment tools for the elderly with dementia are reviewed both domestically and internationally, 8 assessment tools from the perspectives of demand and function for the elderly with dementia are summarized, and the content, reliability and validity, application of each tool are discussed in this paper, in order to provide reference for the use and development of assessment tools for the elderly with dementia in China.

Advances in Duration of Untreated Psychosis and Its Early Intervention

ZHANG Siyu, ZHOU Yuqiu, DU Xiaohui, WANG Zhengjun

2023, 26(33):  4110-4117.  DOI: 10.12114/j.issn.1007-9572.2023.0200

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Mental illness usually involves a range of cognitive, behavioral, and affective symptoms associated with impaired occupational or social functioning. Duration of untreated psychosis (DUP) is considered as an important predictor and independent risk factor for the prognosis of patients with mental disorders, a longer DUP is associated with poor prognosis. Meanwhile, early intervention measures to shorten DUP have gradually attracted increasing attention from both domestic and international researchers. In this paper, the related studies on DUP were reviewed and analyzed, the concept, measurement tools, neurobiological mechanisms of DUP, the relationship between DUP and prognosis, and early intervention measures to shorten DUP were described, in order to provide ideas and reference for developing clinical intervention strategies for DUP.

Research Ideas of the Efficacy Mechanism and Prospect Analysis of Traditional Chinese Manipulative Therapy on Treating Spinal Degenerative Diseases with Combination of Medicine and Industry

WANG Xu, WEI Xu, ZHU Liguo, FENG Tianxiao, WANG Zhipeng, SHI Bin

2023, 26(33):  4118-4124.  DOI: 10.12114/j.issn.1007-9572.2023.0182

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Spinal degenerative diseases are currently most common clinical conditions and also dominant diseases in the field of traumatology and orthopedics. Traditional Chinese manipulative therapy is a common approach for spinal degenerative diseases in traumatology and orthopedics of Chinese medicine. However, the current researches on the efficacy mechanism of traditional Chinese manipulative therapy is still not deep enough, which hinders the modernization and internationalization of the study on the manipulative therapy. Combination of medicine and industry is a novel research idea generated by the combination of relevant scientific and technological progress and the modernization of traditional Chinese medicine in recent years, which is helpful to realize the modernization of the research on the efficacy mechanism of traditional Chinese manipulative therapy and promote the internationalization of traditional Chinese manipulative therapy. Using the application status of modern engineering technologies such as mechanical engineering technology, software engineering technology, neural engineering technology and artificial intelligence technology in the research of traditional Chinese manipulative therapy as research ideas, this paper sorts out the researches on the modernization on the efficacy mechanism of traditional Chinese manipulation under the "combination of medicine and industry" research model in recent years, in order to provide reference ideas for the subsequent researches of the efficacy mechanism of manipulation in the treatment of spinal degenerative diseases.

Original Research

Relationship between Serum Thyroid Hormone Levels and Prognosis during Hospitalization in Heart Failure Patients

ZHANG Jin, DING Zhiguo, QI Shuo, LI Ying, LI Weiqiang, ZHANG Yuanyuan, ZHOU Tong

2023, 26(33):  4125-4129.  DOI: 10.12114/j.issn.1007-9572.2023.0184

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Background

The serum reverse triiodothyronine (rT₃) values of heart failure patients who died during hospitalization were found significantly higher than the upper limit of the biological reference interval in the clinical work of the author. The prediction of thyroid hormones, especially rT₃, on death during hospitalization of heart failure patients was rare reported in the previous studies, it is of great clinical significance to explore the indicators with predictive value for death during hospitalization in patients with heart failure.

Objective

To investigate the relationship between serum thyroid hormones and prognosis during hospitalization in patients with heart failure.

Methods

A total of 197 patients with heart failure admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from April 2019 to April 2022 were included in the study. Baseline data of the study subjects were collected by the electronic medical record system. Fasting venous blood of all subjects was collected within 24 h after admission for total triiodothyronine (TT₃), total thyroxine (TT₄), free triiodothyronine (FT₃), free thyroxine (FT₄), thyroid stimulating hormone (TSH), rT₃ and N-terminal brain natriuretic peptide precursor (NT-pro-BNP). Subjects were divided into death group (n=18) and non-death group (n=179) according to the occurrence of death during hospitalization. Multivariate Logistic regression analysis was used to investigate the influencing factors of death during hospitalization in patients with heart failure. Receiver operating curve (ROC curve) was plotted to evaluate the predictive value of related indicators on death during hospitalization in patients with heart failure, and the area under curve (AUC) of each indicator was calculated and compared by Delong test.

Results

The age and rT₃ of death group were higher than those of non-death group, while FT₃, TT₃ and TSH of death group were lower than those of non-death group, with statistically significant differences (P<0.05). In the non-death group, 66 patients had normal thyroid function, 87 patients had low T₃ syndrome, 15 patients had high FT₄ alone, 3 patients had high TT₄ alone, 5 patients had both high TT₄ and FT₄, 1 patient had low TT₄ alone, 1 patient had high TT₃ alone, and 1 patient had high FT₃ alone. In the death group, 1 patient had normal thyroid function, 14 patients had low T₃ syndrome, and 3 patients had high FT₄ alone. There was significant difference in the incidence of low T₃ syndrome between the two groups (P<0.05). The results of multivariate Logistic regression analysis showed that rT₃ was an influencing factor for death during hospitalization in patients with heart failure〔OR=5.245, 95%CI (2.283, 12.050), P<0.05〕. ROC curve results showed that the AUC of rT₃ was 0.914〔95%CI (0.865, 0.962) 〕, which was higher than that of age (Z=3.137, P=0.002), FT₃ (Z=2.389, P=0.017), TT₃ (Z=2.123, P=0.034) and TSH (Z=3.056, P=0.002) .

Conclusion

Low T₃ syndrome may be a risk factor for death during hospitalization in patients with heart failure. Serum rT₃ is of high predictive value for the prognostic evaluation of patients with heart failure during hospitalization, which need more attention in clinical work.

The Predictive Value of CHA₂DS₂-VASc Score on Major Adverse Cardiovascular Events in Patients with Three Vessels or Left Main Diseases of Coronary Heart Disease

WANG Qiushi, LI Hongwei

2023, 26(33):  4130-4136.  DOI: 10.12114/j.issn.1007-9572.2023.0109

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Background

SYNTAX score is the most common system for predicting the prognosis of patients with coronary heart disease based on coronary anatomy and lesions, and an evaluation method based on general clinical data is needed to improve the effectiveness of prediction.

Objective

To investigate the relationship between CHA₂DS₂-VASc scores and major adverse cardiovascular events in patients with three-vessel disease (TVD) or left main coronary artery disease (LMD) .

Methods

A total of 630 TVD/LMD patients were enrolled, and 276 patients were divided into the mild lesion group (0—22 points), 249 cases in the moderate lesion group (23—32 points) and 105 cases in the severe lesion group (≥33 points) according to SYNTAX score. Pearson correlation analysis and partial correlation analysis were used to explore the correlation between quantitative data, and univariate and multivariate Logistic regression analysis were used to investigate whether CHA₂DS₂-VASc and SYNTAX scores were risk factors for the incidence of MACEs within 3 years. The receiver operating characteristic (ROC) curve was plotted to evaluate the CHA₂DS₂-VASc score in predicting the occurrence of MACEs within 3 years. The ROC curves for predicting MACEs of CHA₂DS₂-VASc score, SYNTAX score, and the combination of the two scoring systems were compared using the Delong method.

Results

There were statistically significant differences in age, congestive heart failure, eGFR, LVEF, SYNTAX score, CHA₂DS₂-VASc score, MACEs within 3 years, death and non-fatal myocardial infarction among the groups with diferent degree of coronary stenosis (P<0.05), and CHA₂DS₂-VASc score was positively correlated with SYNTAX score (r=0.109, P=0.003). Multivariate Logistic regression analysis showed that hypertension〔OR=1.753, 95%CI (1.047, 2.938) 〕, LVEF 〔OR=0.962, 95%CI (0.942, 0.982) 〕, SYNTAX score 〔OR=1.028, 95%CI (1.002, 1.055) 〕, and CHA₂DS₂-VASc score 〔OR=1.210, 95%CI (1.070, 1.369) 〕 were independent influencing factors of MACEs of TVD/LMD patients within 3 years (P<0.05). ROC curve analysis showed that AUC of SYNTAX score predicting MACEs is 0.638, and AUC of CHA₂DS₂-VASc score predicting MACEs is 0.619. The AUC of combined SYNTAX and CHA₂DS₂-VASc score predicting MACEs was 0.685. The AUC difference between SYNTAX and CHA₂DS₂-VASc score was 0.019 (P=0.587) by Delong method, indicating that both SYNTAX and CHA₂DS₂-VASc scores had a predictive effect on MACEs, but the AUC difference was not statistically significant. The AUC difference between the combined two kind of score and SYNTAX score alone was 0.046 9 (P=0.046), and the AUC difference between the combined two kind of scores and CHA₂DS₂-VASc score oalone was 0.065 9 (P=0.043) .

Conclusion

The CHA₂DS₂-VASc score can be used to predict coronary artery severity and MACEs within 3 years in patients with three-vessel disease/left main coronary artery disease. Combined CHA₂DS₂-VASc and SYNTAX scoring system can effectively improved the predictive value of MACEs within 3 years.

Platelet-lymphocyte Ratio Predicts In-hospital Mortality in Elderly Patients with Acute Myocardial Infarction

WANG Yu, CHEN Yan, HAN Yuanyuan, XU Qing, CHEN Shengyue, LYU Zhibo, LU Chuan, ZHENG Mingxin, ZHAO Xin

2023, 26(33):  4137-4142.  DOI: 10.12114/j.issn.1007-9572.2023.0116

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Background

Important predictive value of platelet-lymphocyte ratio (PLR) for adverse outcomes of cardiovascular disease has been proved in previous studies, however, the predictive value of PLR for short-term prognosis in elderly patients with acute myocardial infarction (AMI) remains to be explored.

Objective

To determine the predictive ability of PLR for mortality risk during hospitalization in elderly patients with AMI.

Methods

The medical history data of 1 423 elderly patients with AMI treated in the Department of Cardiology of the Second Hospital of Dalian Medical University from December 2015 to December 2021 was retrospectively collected, mainly including gender, age, BMI, blood pressure classification, glycated hemoglobin, platelet count, neutrophil count, lymphocyte count, estimated glomerular filtration rate, lipid related indices, the combination of heart failure and diabetes, the use of statins and antiplatelet agents during hospitalization, with the final outcome defined as all-cause death during hospitalization. The included patients were divided into the non-death group (n=1 315) and death group (n=108) according to the occurrence of death. ROC curve was used to determine the predictive ability of PLR for in-hospital mortality risk in elderly patients with AMI, and the clinical application value of PLR and its combined indicators by decision curve analysis (DCA) .

Results

There were significant differences in age, BMI, PLR, white blood cell count, neutrophil count, lymphocyte count, red blood cell count, hemoglobin, fasting blood glucose level, AST, TG, CTNI, eGFR grade, proportion of heart failure, proportion of antiplatelet drugs, and proportion of lipid-lowering drugs between the death group and the non-death group (P<0.05). The area under the ROC curve of PLR for predicting the risk of in-hospital mortality in elderly AMI patients was 0.661 (P<0.001) ; AUC when PLR was combined with CK-MB or CTNI was 0.705 and 0.779 (P<0.001), respectively. The results of decision curve analysis based on Bootstrap method showed that the risk threshold of PLR between 6% and 82% and the risk threshold of PLR combined with CTNI between 2% and 86% could produce large net benefits and have clinical application value.

Conclusion

PLR can effectively predict the risk of in-hospital death in elderly patients with AMI, and this predictive ability is significantly improved after combined CTNI.

Analysis of the Prevalence and Influencing Factors of Non-alcoholic Fatty Liver Disease in Different Gender Groups

WANG Lina, GAO Pengfei, CAO Fan, GE Ying, YAN Wei, HE Daikun

2023, 26(33):  4143-4151.  DOI: 10.12114/j.issn.1007-9572.2023.0107

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Background

Fatty liver disease is a common frequently-occurring disease in daily life, and the number of non-alcoholic fatty liver disease (NAFLD) patients has been gradually increasing in recent years with an important impact on people's health. The differences in lifestyle and basal metabolism in different gender groups may lead to differences in the prevalence of NAFLD. However, few studies have been conducted to investigate the prevalence of NAFLD in different gender populations.

Objective

To explore the prevalence and influencing factors of NAFLD in different gender groups, so as to provide reference for the prevention and treatment of NAFLD.

Methods

A total of 29 271 subjects received physical examination in the Physical Examination Center of Jinshan Hospital of Fudan University were selected in the retrospective case-control study from August 2020 to August 2021. General data, physical examination data, laboratory indexes, combination of underlying diseases, and imaging findings of the subjects were collected. The included subjects were divided into the NAFLD group and control group according to the diagnostic criteria of NAFLD, and the prevalence and characteristics of NAFLD in different gender groups were analyzed. Multivariate Logistic regression analysis was used to explore the influencing factors of NAFLD by gender; the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of related indicators for NAFLD in different gender groups, and the area under the ROC curve (AUC), sensitivity and specificity were calculated.

Results

There were 10 524 cases of NAFLD among 29 271 subjects with an overall prevalence of 35.95%, including 7 854 NAFLD patients in the 18 322 male subjects with a prevalence of 42.87%, 2 670 NAFLD patients in the 10 949 male subjects with a prevalence of 24.39%. There was a statistically significant difference in the prevalence of NAFLD among subjects with different genders (χ²=1 016.505, P<0.001). Multivariate Logistic regression analysis showed that waist circumference, BMI, age, alanine aminotransferase, uric acid, total cholesterol, triglyceride, fasting blood glucose and electrocardiogram results were the influencing factors of NAFLD in the subjects by gender (P<0.05). Waist circumference, BMI, and the combination of waist circumference and BMI had a high predictive value for NAFLD in different gender populations. The sensitivity and specificity of waist circumference in predicting NAFLD risk in male subjects were 0.778 and 0.613, respectively, with the optimal cut-off value of 85.5 cm, the sensitivity and specificity of BMI in predicting the NAFLD risk in male subjects were 0.720 and 0.711, with the optimal cut-off value of 24.6 kg/m², the sensitivity and specificity of the combination of waist circumference and BMI were 0.744 and 0.692, with the AUC of 0.789, the optimal cutoff value is 0.394. The sensitivity and specificity of waist circumference in predicting the risk of NAFLD in female subjects were 0.815 and 0.754, respectively, with the optimal cut-off value of 78.5 cm, the sensitivity and specificity of BMI in predicting the risk of NAFLD in female subjects were 0.797 and 0.759, respectively, with the optimal cut-off value of 23.6 kg/m², the sensitivity and specificity of the combination of waist circumference and BMI were 0.853 and 0.734, with the AUC of 0.872, the optimal cutoff value is 0.202.

Conclusion

The influencing factors of NAFLD in male and female are slightly different. Age, alanine transaminase, uric acid, triacylglycerol, total cholesterol, fasting blood glucose, electrocardiogram results, waist circumference and BMI were all influencing factors of NAFLD in different gender groups. Waist circumference, BMI and waist circumference combined with BMI have a high predictive value for NAFLD risk in both males and females, which can be applied to the screening of NAFLD in physical examination.

A Study on the Relationship of Vitamin A and E Levels in Umbilical Cord Blood with Respiratory Distress Syndrome in Preterm Infants

LIU Weina, GE Haiyan, MA Jing, CAO Qinying, BAI Xingyu, CUI Shifang, QIAO Yanxia

2023, 26(33):  4152-4158.  DOI: 10.12114/j.issn.1007-9572.2023.0273

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Background

Respiratory distress syndrome (RDS) is an important cause of death in preterm infants, which needs to be constantly strengthened in clinical prevention and treatment, but the relationship of umbilical cord blood vitamin A and E levels with the development of RDS in preterm infants has been rarely reported.

Objective

To investigate the relationship of vitamin A and E levels in umbilical cord blood with RDS in preterm infants.

Methods

A total of 304 preterm infants in the Fourth Hospital of Shijiazhuang from January 2021 to January 2022 were selected and divided into the RDS group (n=120) and non-RDS group (n=184) according to the incidence of RDS. Clinical features that may be related to the occurrence of RDS in preterm infants were collected, vitamin A and E levels in umbilical cord blood were detected. Multivariate Logistic regression analysis was used to analyze the influencing factors of the occurrence and severity of RDS in preterm infants.

Results

The gestational age, birth weight, vitamin A and E levels in umbilical cord blood of preterm infants in the RDS group were lower than those in the non-RDS group, the proportions of newborn's Apgar score in one-minute≤7, newborn's Apgar score in five-minute≤7, and incidence of vitamin A deficiency were higher in the RDS group than those in the non-RDS group (P<0.05). There were 86 cases with mild RDS and 34 cases with severe RDS in the RDS group; the vitamin A level in umbilical cord blood in cases with severe RDS was significantly lower than cases with mild RDS, while the incidence of vitamin A deficiency was significantly higher than cases with mild RDS (P<0.05). Multivariate Logistic regression analysis showed that vitamin A level in umbilical cord blood was the influencing factor of the occurrence of RDS in preterm infants〔OR=2.208, 95%CI (1.156, 4.218), P<0.05〕, and vitamin A deficiency was the influencing factor of the occurrence of severe RDS〔OR=6.835, 95%CI (2.537, 18.416), P<0.05〕.

Conclusion

Vitamin A and E levels in umbilical cord blood are relatively lower in preterm infants with RDS, vitamin A level is the influencing factor of the occurrence and severity of RDS in preterm infants, suggesting that vitamin A supplementation should be applied during pregnancy to reduce the occurrence or severity of RDS in preterm infants.

Chain Mediating Effects of Stressful Life Events and the Time Taken to Fall Asleep in the Relationship between Yin-deficiency Constitution and Depressed Mood in Junior High School Students

YU Xinlian, DAI Xinyue, ZHAO Xicun, XU Ying

2023, 26(33):  4159-4166.  DOI: 10.12114/j.issn.1007-9572.2023.0071

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Background

The period of junior high school age is a key development stage of adolescent mental health, during which mental maturity and physical and mental development imbalance may greatly increase the susceptibility of the students to depressed mood. Previous studies have shown that yin-deficiency constitution is a risk factor for depressed mood in adolescents, which has also been reported to be impacted by stressful life events and the time taken to fall asleep, but there is no systematic discussion about the mechanism of action in the relationships between the four factors.

Objective

To explore the relationship between yin-deficiency constitution and depressed mood in junior high school students, as well as the mediating effect of stressful life events and the time taken to fall asleep.

Methods

On March 2022, a convenient sample of junior high school students from a middle school in Meishan City, Sichuan Province were surveyed on their general data (gender, ethnicity, region of origin, grade), prevalence of yin-deficiency constitution assessed using the yin-deficiency Constitution subscale of the Traditional Chinese Medicine Constitution Scale for 7-14-year-olds, prevalence of stressful life events assessed using the Adolescent Self-Rating Life Events Checklist (ASLEC), and the time taken to fall asleep assessed using the items assessing how long it takes to fall asleep in the Munich Chronotype Questionnaire (MCTQ), and prevalence of depressed mood assessed using the Center for Epidemiologic Studies Depression (CES-D). The scores of yin-deficiency constitution, ASLEC and CES-D as well as the time taken to fall asleep were compared across the students by demographic characteristics. Spearman correlation analysis was used to explore the correlation between the variables. A multiple-mediator model was constructed to examine the mediating effect of stressful life events and the time taken to fall asleep on yin-deficiency constitution and depressed mood, and the significance of chain mediating effect was tested using bootstrap method.

Results

The survey achieved a response rate of 98.1% (2 570/2 620) in the 2 620 surveyed students. The detection rate of depressed mood in the respondents was 32.8% (844/2 570). Female students had higher scores of yin-deficiency constitution, ASLEC and CES-D than male students (P<0.05). The yin-deficiency score, ASLEC score and CES-D score in grade 2 and grade 3 students was higher than that of grade 1 students (P<0.05). The ASLEC score in non-Han students was longer than that of Han students (P<0.05). The time taken to fall asleep in Han students was longer than that of non-Han students (P<0.05). The yin-deficiency constitution score, ASLEC score and CED-S score of students from rural areas was higher than that of those from towns (P<0.05). The average yin-deficiency constitution score, ASLEC score, the time taken to fall asleep and CES-D score in all respondents were 25.0 (15.0, 40.0) points, 36.0 (30.0, 44.0) points, 15.0 (8.6, 25.7) min and 11.0 (6.0, 18.0) points, respectively. The yin-deficiency constitution score was positively correlated with ASLEC score, the time taken to fall asleep and CES-D score (r_s=0.538, 0.151, 0.470, P<0.05). The ASLEC score was positively correlated with the time taken to fall asleep and CES-D score (r_s=0.224, 0.684, P<0.05). The time taken to fall asleep was positively correlated with CES-D score (r_s=0.289, P<0.05). Multiple mediator model-based analysis showed that yin-deficiency constitution positively predicted depressed mood (β=0.465, P<0.001). And it also positively predicted the level of stressful life events (β=0.511, P<0.001) and the time taken to fall asleep (β=0.066, P=0.004). The level of stressful life events positively predicted the time taken to fall asleep (β=0.228, P<0.001) and depressed mood (β=0.591, P<0.001). The time taken to fall asleep positively predicted depressed mood (β=0.139, P<0.001). The final results of Bootstrap test showed that significant effect of path dependence was found in the path of yin-deficiency constitution→stressful life events→the time taken to fall asleep→depressed mood〔mediating effect value =0.009, 95%CI (0.006, 0.012), P<0.001〕, indicating that the chain mediating effect of stressful life events and the time taken to fall asleep on yin-deficiency constitution and depressed mood was valid.

Conclusion

Yin-deficiency constitution can be used as a direct predictor of depressed mood in junior high school students, but it also can directly affect their depressed mood through its role played between stressful life events and the time taken to fall asleep as an independent mediator or a chain mediator. To reduce the incidence of depressed mood and improve mental health in this population, measures can be taken to improve the yin-deficiency constitution, improve the ability to cope with stressful life events and shorten the time taken to fall asleep.

Application of Mobile Smart Healthcare in the Prevention and Control of Cardiovascular Diseases in Elderly Patients with Chronic Diseases in Primary Care

YU Xinyan, ZHAO Jun, ZHAO Xiaoye, JIANG Qingru, CHEN Yatian, WANG Yan, ZHANG Haicheng

2023, 26(33):  4167-4172.  DOI: 10.12114/j.issn.1007-9572.2023.0206

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Background

The advantages of mobile smart healthcare in screening, intervention, treatment, and management of cardiovascular diseases have become increasingly prominent in recent years. The application value of wearable single lead electrocardiogram equipment in the early screening and diagnosis of arrhythmia patients out of the hospital has been recognized by scholars and clinical workers. However, its application in risk screening and long-term follow-up management of chronic disease patients in primary care is limited by the single function of the cloud platform led and matched by it.

Objective

To explore the application value of mobile smart healthcare in the prevention and control of cardiovascular disease risk in elderly patients with chronic disease in primary care from the perspective of chronic disease prevention and control and using wearable single lead electrocardiogram equipment as carriers, based on hierarchical medical system.

Methods

A total of 3 000 patients with chronic disease aged above 65 years admitted to primary care institutions in Ningxia from January 2022 to August 2022 were selected as research subjects, including 1 202 males and 1 798 females with an average age of (71.3±5.0) years. The baseline data were recorded by primary care physicians through mobile phone APP and cloud platform of patient management, 72-hour ECG data collected by wearable single lead electrocardiogram equipment were also uploaded to cloud platform of patient management. Analysis of data and risk stratification for arrhythmia, heart rate variability (HRV) and obstructive sleep apnea hypopnea syndrome (OSAHS) were performed by professional electrocardiographers, and the corresponding marks on the cloud platform for the data with low, medium and high risk of cardiovascular disease were ticked according to the stratification results of the three analysis methods. The cloud platform notifies primary care physicians of high and medium risk data in the form of SMS for the management of different processes of patients. The number of detected cases with different risk stratification, the number of detected cases and rates of management according to the process among patients with low, medium and high risk of cardiovascular disease were counted.

Results

Arrhythmias were detected in 1 526 (50.87%), 1 349 (44.97%), and 125 (4.17%) cases consistent with negativity, positivity, and significant positivity, respectively; HRV was mildly, moderately, and severely reduced in 2 330 (78.50%), 630 (21.23%), and 8 (0.27%) cases, respectively; OSAHS was consistent with mild, moderate, and severe abnormalities in 1 769 (59.60%), 573 (19.31%), and 626 (21.09%) cases, respectively. The comprehensive risk of cardiovascular disease was low, moderate, and high in 744 (24.80%), 1 640 (54.67%), and 616 (20.53%) patients, respectively. The rates of management according to the process in patients with high, medium and low comprehensive risk of cardiovascular disease were 94.49% (703 cases), 88.10% (1 445 cases) and 100% (616 cases), respectively.

Conclusion

The elderly patients with chronic disease in primary care with combined application of mobile smart healthcare technology and arrhythmia, HRV, OSAHS analysis methods to the prevention and control of cardiovascular diseases have higher detection rate of cardiovascular disease risk and management rate, which is conducive to the establishment of a cardiovascular disease prevention and control system for them.

Demand and Influencing Factors for Community Health Services during Chemotherapy of Patients with Advanced Cancer

LI Qianqian, CHEN Xunrui, ZHANG Wenying, YUAN Haihua, ZHANG Yanjie, JIANG Bin, LIU Feng

2023, 26(33):  4173-4180.  DOI: 10.12114/j.issn.1007-9572.2023.0025

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Background

How to implement effective and reasonable support and comprehensive services for patients with advanced cancer during chemotherapy is an issue worthy of attention in community health services at present. According to the latest data, the mortality rate of malignant tumors among residents in Shanghai has become the second place after cardiovascular and cerebrovascular diseases. The current attention to patients with advanced cancer during chemotherapy is also gradually increasing. Therefore, this study tries to understand the demand for primary care among such patients and the influencing factors.

Objective

To investigate the demand and influencing factors for community health services during chemotherapy of partial patients with advanced cancer in Shanghai, and to explore how to develop community interventions and services to address the demand of such patients.

Methods

Patients with advanced cancer during chemotherapy who regularly visited or hospitalized at Shanghai Ninth People's Hospital, Wusong Hospital and Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine from December 2021 to March 2022 were selected as the study subjects. Based on previous relevant questionnaires, government specifications and interview results, the final version of the demand for community health services of partial patients with advanced cancer during chemotherapy in Shanghai was formed, with a total of 3 demand dimensions (psychological, medical care, social support) and 38 demand items. The contents include patients' general information (demographic and sociological information: gender, age, religious beliefs, education level, marital status, source of medical expenses, disposable monthly household income, whether to participate in a patient group; tumor diagnosis: type and time of diagnosis, pain score, combining with other diseases), 6 items of psychological and psychological demand, 24 items of medical care demand, and 8 items of social support demand. A 3-point scale was adopted: 1 was unnecessary, 2 was necessary, and 3 was very necessary. The higher the score, the higher the degree of patients' demand, which was ranked according to the average score of each demand item. Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of the demand for community health services of patients with advanced cancer during chemotherapy.

Results

The average scores of each demand dimension were ranked in order of psychological demand (2.31 points), medical care demand (2.27 points) and social support demand (2.18 points). The top five average scores of all demand items were "preparation of biochemical tests such as routine blood, liver and kidney functions before chemotherapy" (2.48 points), "education on chemotherapy knowledge" (2.48 points), "care of PICC catheterization during chemotherapy" (2.45 points), "management of myelosuppression after chemotherapy" (2.43 points) " and "providing of updated information on treatment, examination and rehabilitation" (2.42 points), mainly focus on the medical care demand dimension. Multivariate Logistic regression analysis showed that education level and disposable monthly household income were influencing factors of psychological demand of patients with advanced cancer during chemotherapy (P<0.05) ; age and medical expenses were influencing factors of medical care of patients with advanced cancer during chemotherapy (P<0.05) ; age and whether to join a patient group were influencing factors of social support of patients with advanced cancer during chemotherapy (P<0.05) .

Conclusion

Patients with advanced cancer during chemotherapy have specific demand for community health services, with different levels of demand in psychological, medical care and social support dimensions, which are influenced by various factors such as age, education level, and household income. This study provides references for community health service centers to carry out relevant medical services. In the future, new service items with high level of demand can be piloted, community interventions such as psychological and medical care for patients with advanced cancer during chemotherapy, and their quality of survival should be followed up.

Influencing Factors of Shared Decision Making between Doctors and Patients in Menopausal Hormone Therapy in Patients with Menopausal Syndrome

ZHOU Yuyu, GAO Chuan, CUI Puan, WANG Yaping, HE Zhong

2023, 26(33):  4181-4186.  DOI: 10.12114/j.issn.1007-9572.2023.0219

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Background

Menopausal hormone therapy (MHT) can effectively relieve menopausal symptoms, but its treatment options are diverse, and it is essential to make treatment decisions meeting women's needs. However, the current investigation on the quality of shared decision making between doctors and patients (SDM) in menopausal hormone therapy needs to be supplemented.

Objective

To analyze the quality of SDM in MHT among menopausal syndrome patients and explore its influencing factors, so as to provide a theoretical basis for achieving quality clinical care for menopausal population.

Methods

A total of 101 patients with menopausal syndrome from Center for Gynecological Endocrinology and Reproduction in Peking Union Medical College Hospital from October 2022 to January 2023 were selected as study subjects. The study was conducted using the questionnaire method, which consisted of general demographic information, treatment-related information and SDM quality survey. The Chinese version of 9-items shared decision making questionnaire (SDM-Q-9) was used to assess the SDM quality of patients. Multiple linear regression analysis was used to explore the influencing factors of SDM quality in MHT among patients with menopausal syndrome. Multiple linear regression analysis was used to explore the influencing factors of the quality of SDM in MHT among patients with menopausal syndrome.

Results

The average score of SDM quality was 89.75. Patients with children, considered MHT to be very effective, with symptoms of hot flushes and sweating, insomnia and mood fluctuations, advised by doctors to receive MHT had better degree of participation in SDM (P<0.05). Multiple linear regression analysis showed that patients with children (β=0.26, P=0.005), hot flushes and sweating (β=0.19, P=0.044), insomnia (β=0.23, P=0.017) and recommendation by doctors (β=0.21, P=0.025) are influencing factors of SDM quality in MHT of patients with menopausal syndrome, which could explain 23.7% of the variation in SDM quality.

Conclusion

SDM quality is relatively good in MHT among menopausal syndrome patients. Patients with children, hot flashes and sweating, insomnia, and recommendation for use by doctors are influencing factors of SDM quality in MHT among menopausal syndrome patients. Doctors should take the initiative to include patients in SDM, so that patients can realize that they are the principal leader of their health and make SDM consistent with their needs and values in conjunction with doctors.

Effect of Electroacupuncture on BDNF/TrkB/PI3K/Akt Pathway and Hippocampal Neuronal Protection in Rats with Learning and Memory Impairment after Ischemia Reperfusion

SU Kaiqi, LYU Zhuan, WU Mingli, LUO Meng, GAO Jing, NIE Chenchen, LIU Hao, FENG Xiaodong

2023, 26(33):  4187-4193.  DOI: 10.12114/j.issn.1007-9572.2023.0115

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Background

Learning and memory impairment is a common dysfunction after stroke, which seriously affects the overall recovery of patients. Electroacupuncture at Shenting and Baihui has definite efficacy in patients with cognitive dysfunction after stroke, but its mechanism of action remains uncertain.

Objective

To observe the effect of electroacupuncture on hippocampal neuronal protection and brain-derived nerve growth factor (BDNF) /tyrosine receptor kinase B (TrkB) /phosphatidylinositol-3-hydroxykinase (PI3K) /protein kinase B (Akt) signaling pathway in rats with learning and memory impairment after middle cerebral artery occlusion reperfusion (MCAO/R) .

Methods

A total of 60 8-week-old healthy male SD rats were selected from May 2021 to March 2022, and 24 rats were divided into the blank group (n=12) and sham operation group (n=12), and the other 36 rats were constructed as MCAO/R model. The 24 rats with successful modeling were randomly divided into the model group (n=12) and electroacupuncture group (n=12). The electroacupuncture treatment was performed at Shenting and Baihui points in the electroacupuncture group. Zea-Longa score was used to observe the degree of neurological impairment in each group. Spatial probe test was used to evaluate the spatial learning and memory ability of the rats. TTC staining was used to observe the volume of brain infarction in rats. RT-PCR was used to measure the mRNA levels of BDNF, TrkB, PI3K and Akt, Western blotting was used to detect the protein levels of BDNF and TrkB and the levels of p-PI3K/PI3K and p-Akt/Akt.

Results

Zea-Longa score of the model group and electroacupuncture group was significantly different from the blank group and sham operation group at 2 h after surgery (P<0.05), and Zea-Longa score of the model group was significantly different from the blank group, sham operation group and electroacupuncture group at 7 and 14 days after treatment (P<0.05). During the 9th to 13th day of treatment, the escape latency in the model group was higher than the sham operation group (P<0.05), and lower in the electroacupuncture group than the model group (P<0.05). The frequency of crossing the effective region of the platform in the model group was lower than the blank group and sham operation group (P<0.05), and higher in the electroacupuncture group than the model group (P<0.05). The volume of cerebral infarction in blank group, sham operation group, model group and electroacupuncture group was 0, 0, (36.7±6.3) % and (24.0±2.2) %, respectively, and the volume of cerebral infarction in the electroacupuncture group was lower than the model group (P<0.05). The mRNA levels of BDNF, TrkB, PI3K and Akt in the model group were lower than the blank group and sham operation group (P<0.05), and higher in the electroacupuncture group than the model group (P<0.05). Compared with sham operation group, the protein levels of BDNF and TrkB (P<0.01, P<0.001), the levels of p-PI3K/PI3K and p-Akt/Akt (P<0.01, P<0.05) in model group were decreased; compared with the model group, the protein levels of BDNF and TrkB and the levels of p-PI3K/PI3K and p-Akt/Akt in electroacupuncture group were increased (P<0.05) .

Conclusion

Electroacupuncture may reduce the symptom of neurological function deficits and improve the learning and memory ability of rats after cerebral ischemia reperfusion by upregulating the expression of BDNF/TrkB/PI3K/Akt pathway related proteins.

Mechanism of Artesunate Regulating NLRP3/ASC/Caspase-1 Signaling Pathway to Reduce Inflammation and Protect Neurological Function in Mice with Intracerebral Hemorrhage

LI Yuan, MU Yanling, XUE Mengzhou

2023, 26(33):  4194-4202.  DOI: 10.12114/j.issn.1007-9572.2023.0160

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Background

The inflammatory response is a major factor in the progression of intracerebral hemorrhage (ICH). Artesunate (ART) has antibacterial and anti-inflammatory pharmacological activity with high concentrations in the brain, but its neuroprotective effect on cerebral hemorrhage injury remains unclear.

Objective

To observe the effect of ART on inflammatory response after intracerebral hemorrhage and explore its mechanism.

Methods

From March 2022 to February 2023, 108 male C57BL/6 mice aged 8 to 10 weeks were selected and randomly divided into the sham-operated group (Sham group, n=36), ICH control group (ICH+Vehicle group, n=36) and ART treatment group (ICH+ART group, n=36). ICH model was established. The mice in the ICH+ART group were intraperitoneally injected with 150 mg·kg^-1·d^-1 2 h after modeling, and the mice in the ICH+Vehicle group were intraperitoneally injected with 5% sodium bicarbonate solution for 3 consecutive days. The behavioral indicators of mice were observed. The brain tissue damage of mice in each group was observed by HE staining; the number of positive cells per unit area of interleukin (IL) 6, IL-1β and myeloperoxidase (MPO) were detected by immunohistochemical staining; the activation of microglia/macrophages was observed by IBA1 immunofluorescence staining. TUNEL/NeuN immunofluorescence double staining was performed to observe neuronal death. The levels of MPO, IL-1β, tumor necrosis factor α (TNF-α), Nod-like receptor protein 3 (NLRP3), apoptosis-related granuloid protein (ASC) and cysteine aspartic protease 1 (Caspase-1) were compared by western blotting.

Results

The modified neurological severity scores and percentages of right turn of mice were higher in the ICH+Vehicle group than the Sham group, and lower in the ICH+ART group than the ICH+Vehicle group (P<0.05). HE staining results showed that there was a small amount of blood around the striatum in the Sham group and negligible edema. In the ICH+Vehicle group, brain tissue was seriously damaged, with increased intercellular space, perivascular hematoma and inflammatory cell infiltration. All of the above symptoms were significantly improved in the ICH+ART group. The numbers of IL-6, IL-1β and MPO positive cells in the ICH+Vehicle group were higher than the Sham group, the numbers of IL-6, IL-1β and MPO positive cells in the ICH+ART group were lower than the ICH+Vehicle group (P<0.05). The number of activated microglia/macrophages in the ICH+Vehicle group was higher than the Sham group, the number of activated microglia/macrophages in the ICH+ART group was lower than the ICH+Vehicle group (P<0.05). The number of neuron death in the ICH+Vehicle group was higher than the Sham group, and lower in the ICH+ART group than the ICH+Vehicle group (P<0.05). The levels of MPO, IL-1β, TNF-α, NLRP3, ASC and Caspase-1 in the ICH+Vehicle group were higher than the Sham group, the levels of MPO, IL-1β, TNF-α, NLRP3, ASC and Caspase-1 in the ICH+ART group were lower than the ICH+Vehicle group (P<0.05) .

Conclusion

ART therapy after ICH attenuates the inflammatory response of striatum and the activation of microglia in mice through targeted regulation of NLRP3/ASC/Caspase-1 signaling pathway, and ultimately reduces striatal neuronal apoptosis and improves brain edema.

Effectiveness of Backward Walking Based on Anti-gravity Treadmill Training System Combined with Conventional Low Back Core Training on Patients with Non-specific Low Back Pain

TU Jinkang, LI Fangfang, WU Xiaoqiong, XI Chong, QI Shaohua, CHEN Jun

2023, 26(33):  4203-4206.  DOI: 10.12114/j.issn.1007-9572.2023.0189

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Background

In recent years, the incidence of non-specific low back pain has been increasing. The duration of conventional treatment is short, and the symptoms tend to rebound, which has a great impact on the body and mind of patients.

Objective

To investigate the effectiveness of backward walking based on anti-gravity treadmill training system combined with conventional low back core training on patients with non-specific low back pain.

Methods

A total of 40 patients with non-specific low back pain admitted to the Rehabilitation Department of Zhongshan Hospital, Fudan University from July to December 2022 were divided into the experimental group (20 cases) and control group (20 cases) according to the random number table method. The control group received conventional low back core training, and the experimental group received backward walking based on anti-gravity treadmill training system on the basis of the control group. The Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) and Back Pain Classification Scale (BPS) of the 2 groups were evaluated before and 4 weeks after treatment, respectively.

Results

There was no significant difference in ODI, VAS and BPS scores between the two groups before treatment (P>0.05) ; after 4 weeks of treatment, ODI, VAS and BPS scores of the 2 groups were decreased, and ODI, VAS and BPS scores of the experimental group were significantly lower than those of the control group (P<0.05) ; the difference in the change of each score before and after treatment between the two groups was statistically significant (P<0.05) .

Conclusion

The backward walking based on anti-gravity treadmill training system is effective in improving the pain level and overall status of the low back in patients with non-specific low back pain, which is worthy of clinical promotion.

Effect of Dual Task on Walking Ability in Posterior Circulation Ischemic Stroke Patients with Vestibular Symptoms

YIN Miaomiao, CUI Liling, LI Yaqing, WANG Liqun, ZHANG Yue, WU Jialing

2023, 26(33):  4207-4212.  DOI: 10.12114/j.issn.1007-9572.2023.0229

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Background

Posterior circulation ischemic stroke patients with vestibular symptoms usually do not present with obvious limb paralysis with certain walking ability after improvement of dizziness and vertigo symptoms, however, their fall risk is high and clinical attention to walking ability is lacking. Functional assessment using dual-task paradigms can better detect potential gait abnormalities in patients and provide a basis for early rehabilitation intervention.

Objective

To investigate the effect of dual task on walking ability of posterior circulation ischemic stroke patients with vestibular symptoms.

Methods

Forty patients diagnosed with posterior circulation ischemic stroke accompanied by vestibular symptoms and treated at Tianjin Huanhu Hospital from 2021 to 2022 were selected as the study subjects. Gait parameters including gait speed, step frequency, step size, proportion of double support phase time, step duration, trunk coronal plane and sagittal plane swing angles were collected using single-task walking, motor-motor dual-task walking, and cognitive-motor dual-task walking paradigms. The differences in gait parameters among the three task conditions and the differences in dual-task costs between the two dual-task walking.

Results

Compared to single-task walking, the trunk coronal plane and sagittal plane swing angles were decreased in patients during motor-motor dual-task walking (P<0.05) ; the gait speed was increased, proportion of double support phase time and trunk coronal plane swing angle were increased in patients during cognitive-motor dual-task walking (P<0.05). Compared to motor-motor dual-task walking, the dual-task costs of cognitive-motor dual-task walking in terms of gait speed, step size and the proportion of double support phase time were increased (P<0.05) .

Conclusion

Dual task leads to decreased gait stability in posterior circulation ischemic stroke patients with vestibular symptoms. Additionally, cognitive-motor dual-task walking requires more attentional resources and is more likely to result in gait disturbances compared to motor-motor dual-task walking.

Vulnerable Groups Research·Children Health Problems

Importance of the Role of Primary Care in Myopia Prevention and Control Behavioral Intervention among Children

WANG Jie, LI Shiming, WEI Shifei, WANG Ningli

2023, 26(33):  4213-4217.  DOI: 10.12114/j.issn.1007-9572.2023.0271

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Myopia is a major risk factor for vision health in children, it is important for the prevention and control of occurrence and development of myopia in children to standardize the screening of myopia and achieve early detection and intervention of myopia. At present, myopia screening, the establishment, management and application of refractive development profile in China are still in the initial stage. In particular, the follow-up measures after refractive development profile establishment still face many problems and challenges. In this paper, the role of primary care in myopia prevention and control behavioral intervention among Children was analyzed in depth according to the current status and characteristics of myopia screening and after refractive development profile establishment, combining with the requirements of hierarchical diagnosis and treatment, in order to provide recommendations on myopia screening, refractive development profile establishment and community behavioral interventions in China, balance medical resources for its development in a regulated, healthy and sustainable manner.

Spectrum of Outpatient Illnesses in Children Contracting Family Doctor Services in Shenzhen's Community Settings and Related Implications for Standardized Residency Training of General Practitioners

YIN Zhaoxia, MAO Lidong, ZHANG Baoshuang, HUANG Yin, FENG Yang, WANG Yunfei

2023, 26(33):  4218-4224.  DOI: 10.12114/j.issn.1007-9572.2023.0047

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Background

The difficulty of getting pediatric services still exists in China. It is a general trend that community health centers (CHCs) provide pediatric services. There are rare studies on the spectrum of pediatric illnesses in CHCs.

Objective

To understand the current status of pediatric diagnosis and treatment in Shenzhen's CHCs by analyzing the spectrum of pediatric illnesses treated in clinics, and to analyze the gap between actual practical status with the training contents based on Spectrum of Diseases for Resident Rotation in Pediatric Medicine (hereinafter referred to as Pediatric Training Rules) specified in General Residency Training Rules in the Standardized Training Contents and Standards for Residents (2022 Edition) .

Methods

Through checking the outpatient medical records in CHCs in Shenzhen's 10 districts during April to September 2021, pediatric care expenditure data of children〔including babies (<1 year old), toddlers (1-3 years old), preschoolers (4-6 years old), gradeschoolers (7-12 years old) and teens (13-18 years old) stratified by age〕 contracting family doctor services were collected. The actual spectrum of diseases and diagnosis and treatment behaviors were analyzed, and compared with the Pediatric Training Rules to assess the practical application of the contents required to be mastered in the Pediatric Training Rules.

Results

A total of 961 605 children were included, among whom preschoolers accounted for the highest percentage (38.22%, 367 486/961 605), followed by gradeschoolers (27.57%, 265 151/961 605), toddlers (21.90%, 210 621/961 605), teens (8.49%, 81 594/961 605), and babies (3.82%, 36 753/961 605). The top five diseases in the spectrum and diagnosis and treatment behaviors were respiratory diseases, calcium and vitamin supplements, pediatric physical examination and health care, trauma and postoperative dressing change, and skin diseases, accounting for 67.92% of the total diagnostic and therapeutic workload. Younger age was associated with increased concentrated diagnosis and treatment behaviors. Physical examination and health care (27.60%, 10 142/36 753), calcium and vitamin supplements (25.48%, 9 364/36 753) were the main diagnosis and treatment behaviors in babies. Five diseases in the spectrum and diagnosis and treatment behaviors accounting for ≥80% of the total diagnostic and therapeutic workload in babies, while in teens, 13 diseases in the spectrum and diagnosis and treatment behaviors accounting for ≥80% of the total diagnostic and therapeutic workload. Except for babies, respiratory diseases were the primary reason for seeking treatment in children of other age groups. The proportion of workload of trauma treatment and postoperative dressing change was the highest in teens. Except neonatal asphyxia, neonatal pneumonia, poliomyelitis, infantile tetany and viral myocarditis, the pediatric diseases encountered in these CHCs were covered by the disease spectrum required to be mastered in the Pediatric Training Rules, and the top five healthcare & treatments were respiratory disease treatment〔333 172 (34.65%) 〕, pediatric physical examination and health care〔70 703 (7.35%) 〕, acute infectious diseases treatment〔20 893 (2.17%) 〕, infantile diarrhea〔13 622 (1.42%) 〕, and pediatric abdominal pain〔12 526 (1.30%) 〕. The amount of diagnosis and treatment workload for pediatric anemia, pediatric leukemia, rickets, infantile diabetes, malnutrition, neonatal jaundice, nephritis and nephrotic syndrome, infantile epilepsy, simple obesity, and infantile convulsion accounted for less than 1.00% of the total amount, among which pediatric anemia, pediatric leukemia, neonatal jaundice, nephritis and nephrotic syndrome, infantile epilepsy and simple obesity were mainly transferred for treatment or prescribed a laboratory test.

Conclusion

In general, the CHCs provide a large number of pediatric diagnosis and treatment services, but the services for younger children are still insufficient. Pediatric Training Rules focus on internal diseases, and relevant trainings have some differences with the actual diagnosis and treatment services. The treatments for some diseases in the spectrum in the rules are too specialized, and the diseases are less frequently encountered in community settings, and such patients mainly are transferred for treatment or examined using a laboratory test. Therefore, the pediatric rotation in standardized general residency training should be planned as a whole since the disease spectrum includes many diseases rather than only internal diseases, and actions should be made to expand the training content, improve outpatient teaching, and strengthen the training for physicians to improve their abilities in diagnosis and treatment of young children.

Clinical Characteristics and Influencing Factors of Bronchial Asthma Combined with Obstructive Sleep Apnea-hypopnea Syndrome in Children

LIANG Xuan, NA Feiyang, QIN Mengyao, YANG Hui, GUO Li, GUO Qi, REN Lei, CHEN De, LIU Donghai, ZHANG Rongfang

2023, 26(33):  4225-4230.  DOI: 10.12114/j.issn.1007-9572.2023.0032

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Background

Bronchial asthma (BA) and obstructive sleep apnea-hypopnea syndrome (OSAHS) are two major chronic diseases affecting the health of children. OSAHS may aggravate BA, adding to the difficulties in BA control, and BA can lead to the occurrence or progression of OSAHS through various mechanisms, such a relationship between them has attracted increasing attention.

Objective

To explore the clinical features and influencing factors of children with BA complicated with OSAHS.

Methods

One hundred and nine children with BA who were admitted to Children's Asthma Center, Gansu Provincial Maternity and Child Health Care Hospital from September 2021 to August 2022 were selected, including 49 with OSAHS (BA with OSAHS group) and 60 without (simple BA group). The general clinical data, pulmonary function test results, and serum levels of inflammatory cytokines, 25-hydroxyvitamin D 〔25 (OH) D〕 and C-reactive protein (CRP) were collected. The clinical features were analyzed, and factors associated with OSAHS in BA were analyzed by multivariate Logistic regression.

Results

Multivariate Logistic regression analysis showed that obesity〔OR=4.803, 95%CI (1.011, 2.822) 〕, enlarged neck circumference〔OR=1.318, 95%CI (1.003, 1.732) 〕 and gastroesophageal reflux disease (GERD) 〔OR=7.756, 95%CI (1.398, 43.045) 〕 were independent risk factors for OSAHS in BA children (P<0.05), while elevated 25- (OH) D〔OR=0.830, 95%CI (0.757, 0.910) 〕 was a protective factor for OSAHS in BA children (P<0.05) .

Conclusion

The values of pulmonary function indices of children with BA complicated with OSAHS were lower than those of children with simple BA. Obesity, enlarged neck circumference, GERD and 25- (OH) D level were the influencing factors of OSAHS in BA children.