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Zhou T, Guan Y, Lin X, Zhou X, Mao L, Ma Y, Fan B, Li J, Liu S, Fan L. CT-based whole lung radiomics nomogram for identification of PRISm from non-COPD subjects. Respir Res 2024; 25:329. [PMID: 39227894 PMCID: PMC11373438 DOI: 10.1186/s12931-024-02964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 08/28/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Preserved Ratio Impaired Spirometry (PRISm) is considered to be a precursor of chronic obstructive pulmonary disease. Radiomics nomogram can effectively identify the PRISm subjects from non-COPD subjects, especially when during large-scale CT lung cancer screening. METHODS Totally 1481 participants (864, 370 and 247 in training, internal validation, and external validation cohorts, respectively) were included. Whole lung on thin-section computed tomography (CT) was segmented with a fully automated segmentation algorithm. PyRadiomics was adopted for extracting radiomics features. Clinical features were also obtained. Moreover, Spearman correlation analysis, minimum redundancy maximum relevance (mRMR) feature ranking and least absolute shrinkage and selection operator (LASSO) classifier were adopted to analyze whether radiomics features could be used to build radiomics signatures. A nomogram that incorporated clinical features and radiomics signature was constructed through multivariable logistic regression. Last, calibration, discrimination and clinical usefulness were analyzed using validation cohorts. RESULTS The radiomics signature, which included 14 stable features, was related to PRISm of training and validation cohorts (p < 0.001). The radiomics nomogram incorporating independent predicting factors (radiomics signature, age, BMI, and gender) well discriminated PRISm from non-COPD subjects compared with clinical model or radiomics signature alone for training cohort (AUC 0.787 vs. 0.675 vs. 0.778), internal (AUC 0.773 vs. 0.682 vs. 0.767) and external validation cohorts (AUC 0.702 vs. 0.610 vs. 0.699). Decision curve analysis suggested that our constructed radiomics nomogram outperformed clinical model. CONCLUSIONS The CT-based whole lung radiomics nomogram could identify PRISm to help decision-making in clinic.
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Affiliation(s)
- TaoHu Zhou
- Department of Radiology, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, China
- School of Medical Imaging, Shandong Second Medical University, Weifang, 261053, Shandong, China
| | - Yu Guan
- Department of Radiology, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, China
| | - XiaoQing Lin
- Department of Radiology, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, China
- College of Health Sciences and Engineering, University of Shanghai for Science and Technology, No.516 Jungong Road, Shanghai, 200093, China
| | - XiuXiu Zhou
- Department of Radiology, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, China
| | - Liang Mao
- Department of Medical Imaging, Affiliated Hospital of Ji Ning Medical University, Ji Ning, 272000, China
| | - YanQing Ma
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, ZJ, China
| | - Bing Fan
- Department of Radiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jie Li
- Department of Radiology, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, China
- College of Health Sciences and Engineering, University of Shanghai for Science and Technology, No.516 Jungong Road, Shanghai, 200093, China
| | - ShiYuan Liu
- Department of Radiology, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, China
| | - Li Fan
- Department of Radiology, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, China.
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Jiang S, Tong X, Yu K, Yin P, Shi S, Meng X, Chen R, Zhou M, Kan H, Niu Y, Li Y. Ambient particulate matter and chronic obstructive pulmonary disease mortality: a nationwide, individual-level, case-crossover study in China. EBioMedicine 2024; 107:105270. [PMID: 39137570 PMCID: PMC11367568 DOI: 10.1016/j.ebiom.2024.105270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 07/25/2024] [Accepted: 07/25/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Short-term exposure to particulate matter air pollution has been associated with the exacerbations of COPD, but its association with COPD mortality was not fully elucidated. We aimed to assess the association between short-term particulate matter exposure and the risk of COPD mortality in China using individual-level data. METHODS We derived 2.26 million COPD deaths from a national death registry database in Chinese mainland between 2013 and 2019. Exposures to fine particulate matter (PM2.5) and coarse particulate matter (PM2.5-10) were assessed by satellite-based models of a 1 × 1 km resolution and assigned to each individual based on residential address. The associations of PM2.5 and PM2.5-10 with COPD mortality were examined using a time-stratified case-crossover design and conditional logistic regressions with distributed lag models. We further conducted stratified analyses by age, sex, education level, and season. FINDINGS Short-term exposures to both PM2.5 and PM2.5-10 were associated with increased risks of COPD mortality. These associations appeared and peaked on the concurrent day, attenuated and became nonsignificant after 5 or 7 days, respectively. The exposure-response curves were approximately linear without discernible thresholds. An interquartile range increase in PM2.5 and PM2.5-10 concentrations was associated with 4.23% (95% CI: 3.75%, 4.72%) and 2.67% (95% CI: 2.18%, 3.16%) higher risks of COPD mortality over lag 0-7 d, respectively. The associations of PM2.5 and PM2.5-10 attenuated slightly but were still significant in the mutual-adjustment models. A larger association of PM2.5-10 was observed in the warm season. INTERPRETATION This individual-level, nationwide, case-crossover study suggests that short-term exposure to PM2.5 and PM2.5-10 might act as one of the environmental risk factors for COPD mortality. FUNDING This study is supported by the National Key Research and Development Program of China (2023YFC3708304 and 2022YFC3702701), the National Natural Science Foundation of China (82304090 and 82030103), the 3-year Action Plan for Strengthening the Construction of the Public Health System in Shanghai (GWVI-11.2-YQ31), and the Science and Technology Commission of Shanghai Municipality (21TQ015).
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Affiliation(s)
- Shuo Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xunliang Tong
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kexin Yu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Yanming Li
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical, Beijing, China.
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Zhang F, Cui Y, Zhang T, Yin W. Epigenetic regulation of macrophage activation in chronic obstructive pulmonary disease. Front Immunol 2024; 15:1445372. [PMID: 39206196 PMCID: PMC11349576 DOI: 10.3389/fimmu.2024.1445372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Macrophages in the innate immune system play a vital role in various lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), acute lung injury and pulmonary fibrosis. Macrophages involved in the process of immunity need to go through a process of activation, including changes in gene expression and cell metabolism. Epigenetic modifications are key factors of macrophage activation including DNA methylation, histone modification and non-coding RNA regulation. Understanding the role and mechanisms of epigenetic regulation of macrophage activation can provide insights into the function of macrophages in lung diseases and help identification of potential therapeutic targets. This review summarizes the latest progress in the epigenetic changes and regulation of macrophages in their development process and in normal physiological states, and the epigenetic regulation of macrophages in COPD as well as the influence of macrophage activation on COPD development.
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Affiliation(s)
- Feng Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University (GMU) - Guangzhou Institutes of Biomedicine and Health (GIBH) Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou National Laboratory, Guangzhou International Bio Island, Guangzhou, Guangdong, China
| | - Yachao Cui
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University (GMU) - Guangzhou Institutes of Biomedicine and Health (GIBH) Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou National Laboratory, Guangzhou International Bio Island, Guangzhou, Guangdong, China
| | - Tiejun Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University (GMU) - Guangzhou Institutes of Biomedicine and Health (GIBH) Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
- The Guangdong-Hong Kong-Macau Joint Laboratory for Cell Fate Regulation and Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Medical University Affiliated Qingyuan Hospital, Qingyuan People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wenguang Yin
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University (GMU) - Guangzhou Institutes of Biomedicine and Health (GIBH) Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou National Laboratory, Guangzhou International Bio Island, Guangzhou, Guangdong, China
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Hua Y, Fan X, Yang M, Su J, Guo J, Jin J, Sun D, Pei P, Yu C, Lyu J, Tao R, Zhou J, Lu Y. Association between socioeconomic status and risk of chronic obstructive pulmonary disease in China: a prospective cohort study. BMC Public Health 2024; 24:2077. [PMID: 39085848 PMCID: PMC11292937 DOI: 10.1186/s12889-024-19490-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE Socioeconomic status (SES) has been proven to be associated with chronic obstructive pulmonary disease (COPD) in Western populations, but the evidence is very limited in China. This study aimed to investigate the association between SES and the risk of COPD incident. METHODS This study was based on the China Kadoorie Biobank (CKB) project in Wuzhong District, Suzhou. A total of 45,484 adults aged 30-79 were included in the analysis during 2004-2008. We used Cox proportional hazard models to investigate the association between SES and the risk of COPD. Household income, education, private property and consumption potential was used to measure SES. Incident COPD cases were ascertained using hospitalization records, death certificates, and active follow-up. RESULTS A total of 524 COPD cases were identified during a median follow-up of 11.2 years. Household income was inversely associated with the risk of COPD (Ptrend<0.005). The adjusted hazard ratios (95% confidence intervals) for incident COPD were 0.88 (0.69-1.14), 0.77 (0.60-0.99), and 0.42 (0.31-0.57) for participants with annual household income of 10,000 ~ 19,999 yuan, 20,000 ~ 34,999 yuan and ≥ 35,000 yuan respectively, in comparison to participants with an annual household income < 10,000 yuan. Furthermore, we found that education level, refrigerator use, private toilet, private phone, and motor vehicle were adversely associated with COPD risk, while ownership of newly renovated flats was positively correlated with COPD incident. CONCLUSIONS This prospective study suggests that SES is associated with the risk of COPD in Chinese adults. Population-based COPD prevention strategies tailored for people with different SES could help reduce the burden of COPD in Chinese.
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Affiliation(s)
- Yujie Hua
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, 215004, China
| | - Xikang Fan
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Mengshi Yang
- Department of Epidemiology and Health Statistics, Southeast University, Nanjing, 210009, China
| | - Jian Su
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Jia Guo
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, 215004, China
| | - Jianrong Jin
- Wuzhong District Disease Control and Prevention Centre, Suzhou, 215000, China
| | - Dianjianyi Sun
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Jun Lyu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Ran Tao
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Jinyi Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China.
| | - Yan Lu
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, 215004, China.
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Huang W, Xu H, Wu J, Ren M, Ke Y, Qiao J. Toward cleaner air and better health: Current state, challenges, and priorities. Science 2024; 385:386-390. [PMID: 39052781 DOI: 10.1126/science.adp7832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/17/2024] [Indexed: 07/27/2024]
Abstract
The most up-to-date estimate of the global burden of disease indicates that ambient air pollution, including fine particulate matter and ozone, contributes to an estimated 5.2 million deaths each year. In this review, we highlight the challenges in estimating population exposure to air pollution and attributable health risks, particularly in low- and middle-income countries and among vulnerable populations. To protect public health, the evidence so far confirms urgent needs to prioritize interdisciplinary research on air pollution exposure and risk assessment and to develop evidence-based intervention policies and risk communication strategies. Here, we synthesize the emerging evidence supporting the monitoring and evaluation of the progress in implementation of the Global Air Quality Guidelines prepared by the World Health Organization.
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Affiliation(s)
- Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
- Peking University Institute for Global Health, Beijing, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Minghui Ren
- Peking University Institute for Global Health, Beijing, China
- Department of Global Health, Peking University School of Public Health, and China Center for Health Development Studies, Peking University, Beijing, China
| | - Yang Ke
- Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital and Institute, Beijing, China
| | - Jie Qiao
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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Wen G, Meng J, Peng P, Xu Y, Wang R, Cui W, Wen A, Luo G, Zhang Y, Tang S. Prevalence of Chronic Obstructive Pulmonary Disease and Its Associated Risk Factors in Yunnan Province, China: A Population Based Cross-Sectional Study. Int J Chron Obstruct Pulmon Dis 2024; 19:1531-1545. [PMID: 38974816 PMCID: PMC11227295 DOI: 10.2147/copd.s459267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/07/2024] [Indexed: 07/09/2024] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) is a significant disease impacting health and quality of life. Yunnan Province, a major tobacco producer, lacks comprehensive COPD studies. The purpose of this study is to describe the epidemic situation of COPD in Yunnan province and explore its influencing factors. Methods This study is a cross-sectional research conducted in a representative sample of adults aged 20 and older from 13 prefectures and cities in Yunnan Province, China. COPD was diagnosed using post-bronchodilator pulmonary function tests. Demographics were analyzed with descriptive statistics. The influencing factors of COPD were examined by using the multivariate logistic regression models. Results Our study found that high-risk individuals for COPD accounted for 20.30% of the screened population aged 20 and above, with a COPD prevalence of 27.18% among this high-risk group. Male had a higher prevalence (33.01%) than did female (16.35%; p<0.001 for sex difference). Additionally, the proportion of severe and extremely severe COPD cases in Yunnan Province was higher than the national average and other provinces. After considering the potential confounding variables, male (OR=2.291, 95% CI: 1.584-3.313), age (OR=1.501, 95% CI: 1.338-1.685), underweight (OR=1.747, 95% CI: 1.225-2.491), previous smoking (OR=1.712, 95% CI: 1.182-2.478), passive smoking (OR=1.444, 95% CI: 1.159-1.800), and a history of respiratory system diseases in childhood (OR=2.010, 95% CI: 1.346-3.001) were significantly associated with an increased risk of COPD. Conversely, being overweight (OR=0.636, 95% CI: 0.489-0.828), and residing in high-altitude counties (OR=0.445, 95% CI: 0.263-0.754) were negatively correlated with the risk of COPD. Conclusion There is significant prevalence of COPD (27.18%) among high-risk population aged 20 and above in Yunnan Province, China. Apart from male, smoking, BMI and other known risk factors for COPD. We found that high-altitude residence had a lower prevalence of COPD. There is no significant difference in COPD prevalence between Han and ethnic minority populations.
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Affiliation(s)
- Geyi Wen
- Department of Pulmonary and Critical Care Medicine, the First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China
| | - Jinliang Meng
- Department of Pulmonary and Critical Care Medicine, the First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China
| | - Puxian Peng
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Yanyan Xu
- Department of Pulmonary and Critical Care Medicine, the First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China
| | - Ruiqi Wang
- Department of Pulmonary and Critical Care Medicine, the First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China
| | - Wenlong Cui
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Aihan Wen
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Guohong Luo
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Yunhui Zhang
- Department of Pulmonary and Critical Care Medicine, the First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China
| | - Songyuan Tang
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
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Su Y, He H, Yang J, Liu Y, Jiang W, Li C, Wei Y, Cheng J, Chen Y. Trends by age and sex and projections of disease prevalence from studying hypertensive heart disease in China over the past three decades. Int J Health Plann Manage 2024; 39:1113-1130. [PMID: 38383980 DOI: 10.1002/hpm.3786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Hypertensive heart disease (HHD) is a common cause of cardiovascular disease and mortality worldwide, and its burden is increasing with aging populations. OBJECTIVES This study aimed to estimate the prevalence and mortality rates of HHD in mainland China and Taiwan Province using data from the Global Burden of Disease Study 2019 (GBD 2019), and forecast the development trend of HHD from 2020 to 2024. METHODS We obtained data on number of cases, deaths, crude prevalence rate, crude death rate, age-standardized prevalence rate (ASPR), and age-standardized death rate (ASDR) for mainland China and Taiwan Province from 1990 to 2019 from the GBD 2019. Joinpoint software was used to estimate average annual percentage change (AAPC) with 95% confidence intervals, and the number of HHD cases in China from 2022 to 2024 was predicted by the exponential smoothing method. RESULTS Between 1990 and 2019, HHD cases and deaths increased in mainland China, but the ASPR and ASDR decreased by 5.96% and 48.72%, respectively. In Taiwan Province, ASPR and ASDR decreased by 7.66% and 52.14%, respectively. The number of HHD cases and death rates varied by region, age, and sex, with a higher number of cases in mainland China than in Taiwan Province. By 2024, the number of HHD cases in mainland China was projected to be over 9.6 million cases, and in Taiwan Province, it was projected to surpass 120,000 cases. CONCLUSION The differences in HHD cases between mainland China and Taiwan Province in terms of age and sex indicated the need for effective prevention and control measures, especially targeting the elderly population. These findings can inform policymakers and health professionals in the development of targeted prevention and treatment strategies and resource allocation for HHD in China.
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Affiliation(s)
- Yao Su
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Honghong He
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Jingtao Yang
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Ya Liu
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Weiwei Jiang
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Chen Li
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Yang Wei
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Jun Cheng
- Department of Cardiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Yiguo Chen
- Department of Orthopedics, The People's Hospital of Yubei District of Chongqing, Chongqing, China
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Guo X, Ren H, Sun P, Ding E, Fang J, Fang K, Ma X, Li C, Li C, Xu Y, Cao K, Lin EZ, Guo P, Pollitt KJG, Tong S, Tang S, Shi X. Personal exposure to airborne organic pollutants and lung function changes among healthy older adults. ENVIRONMENTAL RESEARCH 2024; 258:119411. [PMID: 38876423 DOI: 10.1016/j.envres.2024.119411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024]
Abstract
Epidemiological evidence on the impact of airborne organic pollutants on lung function among the elderly is limited, and their underlying biological mechanisms remain largely unexplored. Herein, a longitudinal panel study was conducted in Jinan, Shandong Province, China, involving 76 healthy older adults monitored over a span of five months repetitively. We systematically evaluated personal exposure to a diverse range of airborne organic pollutants using a wearable passive sampler and their effects on lung function. Participants' pulmonary function indicators were assessed, complemented by comprehensive multi-omics analyses of blood and urine samples. Leveraging the power of interaction analysis, causal inference test (CIT), and integrative pathway analysis (IPA), we explored intricate relationships between specific organic pollutants, biomolecules, and lung function deterioration, elucidating the biological mechanisms underpinning the adverse impacts of these pollutants. We observed that bis (2-chloro-1-methylethyl) ether (BCIE) was significantly associated with negative changes in the forced vital capacity (FVC), with glycerolipids mitigating this adverse effect. Additionally, 31 canonical pathways [e.g., high mobility group box 1 (HMGB1) signaling, phosphatidylinositol 3-kinase (PI3K)/AKT pathway, epithelial mesenchymal transition, and heme and nicotinamide adenine dinucleotide (NAD) biosynthesis] were identified as potential mechanisms. These findings may hold significant implications for developing effective strategies to prevent and mitigate respiratory health risks arising from exposure to such airborne pollutants. However, due to certain limitations of the study, our results should be interpreted with caution.
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Affiliation(s)
- Xiaojie Guo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Huimin Ren
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, China Medical University, Shenyang, Liaoning 110001, China
| | - Peijie Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, China Medical University, Shenyang, Liaoning 110001, China
| | - Enmin Ding
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jianlong Fang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Ke Fang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Xiao Ma
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, Shandong University, Jinan, Shandong 250100, China
| | - Chenfeng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Chenlong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, Shandong University, Jinan, Shandong 250100, China
| | - Yibo Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, China Medical University, Shenyang, Liaoning 110001, China
| | - Kangning Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Elizabeth Z Lin
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Pengfei Guo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Shilu Tong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane 4001, Australia
| | - Song Tang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
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9
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Wang J, Zhao Z, Yang J, Ng M, Zhou M. The association between education and premature mortality in the Chinese population: a 10-year cohort study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101085. [PMID: 38751727 PMCID: PMC11091532 DOI: 10.1016/j.lanwpc.2024.101085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/23/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024]
Abstract
Background Recent studies have shown significant associations between education and premature mortality. However, the relationship differs across countries. We aimed to present the latest evidence on the educational inequalities in premature mortality in the Chinese population. Methods We linked two databases, to establish a population-based, ten-year cohort spanning 2010 to 2020. Cox proportional hazard regression analyses adjusting for age, sex and urbanicity were conducted for all-cause mortality, and competing risk models were fitted for cause-specific mortality. We calculated population attributable fraction (PAF) using the hazard ratios (HRs) obtained by regression analyses. Additionally, we fitted models adjusting for risk factors and investigated the mediating effect of income, smoking, alcohol consumption and diets. Findings Compared with individuals with upper secondary and above education, the HR for premature all-cause mortality for those with less than primary education was 1.93 (95% CI: 1.72-2.19). The HRs were the highest for deaths from respiratory diseases (HR = 3.09, 95% CI 1.82-5.27). The excess risk of premature mortality associated with low education was higher among women and urban population. The association of education remained significant after accounting for risk factors, and income was the main mediator, which accounted for 23.0% of mediation in men and 11.1% in women. Interpretation The study's findings support the increased risk of premature mortality associated with low education, particularly in women and urban populations. The considerable number of deaths attributed to educational inequality underscores the necessity for more effective and targeted public health interventions. Funding Chinese Central Government.
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Affiliation(s)
- Jifei Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenping Zhao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Yang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Marie Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Maigeng Zhou
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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10
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Ying Y, Khunthason S, Apidechkul T, Nilvarangkul K. Influencing factors of good quality of life among chronic obstructive pulmonary disease patients living in Zhejiang Province, China. Sci Rep 2024; 14:8687. [PMID: 38622219 PMCID: PMC11018838 DOI: 10.1038/s41598-024-59289-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/09/2024] [Indexed: 04/17/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic, progressive and debilitating disease that affects quality of life (QOL), especially among patients living in poor environments. This study aimed to determine the influencing factors of good QOL among COPD patients living in Zhejiang, China. A cross-sectional study was conducted to collect data from participants in six tertiary hospitals in Zhejiang Province by a simple random sampling method. A validated questionnaire was used to collect general information, environmental factors, and COPD stage. The standardized St. George's Respiratory Questionnaire (SGRQ) was used to assess QOL. Logistic regression was used to determine influencing factors of good QOL among COPD patients at a significance level of α = 0.05. A total of 420 participants were recruited for analysis. The overall prevalence of patients with good QOL was 25.7%. Six variables were found to be associated with good QOL in the multivariable analysis. Patients who were employed had 2.35 times (95% CI 1.03-5.34) greater odds of having good QOL than those who were unemployed. Those whose family income was higher than 100,000 CNY had 2.49 times (95% CI 1.15-5.39) greater odds of having good QOL than those whose family income was lower than 100,000 CNY. Those who had treatment expenses less than 5,000 CNY had 4.57 (95% CI 1.57-13.30) times greater odds of having good QOL than those who had treatment expenses of 5,000 CNY or higher. Those who had mild or moderate airflow limitation were 5.27 times (95% CI 1.61-17.26) more likely to have good QOL than those who were in a severe or very severe stage of COPD. Those who had a duration of illness less than 60 months had 5.57 times (95% CI 1.40-22.12) greater odds of having good QOL than those who had a duration of illness of 120 months or more. Those who were not hospitalized within the past 3 months had 9.39 times (95% CI 1.62-54.43) greater odds of having good QOL than those who were hospitalized more than twice over the past 3 months. Socioeconomic status, disease stage and accessibility were associated with good QOL among COPD patients in Zhejiang Province, China. Increasing family income and implementing measures to improve the accessibility of medical care, including developing a proper system to decrease the cost of treatment for COPD patients, can improve patients' QOL.
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Affiliation(s)
- Yubing Ying
- School of Health Science, Mae Fah Luang University, 333 Moo 1, Ta Sud Subdistrict, Muang District, 57100, Chiang Rai Province, Thailand
| | - Siriyaporn Khunthason
- School of Health Science, Mae Fah Luang University, 333 Moo 1, Ta Sud Subdistrict, Muang District, 57100, Chiang Rai Province, Thailand.
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, 333 Moo 1, Ta Sud Subdistrict, Muang District, 57100, Chiang Rai Province, Thailand
| | - Kessarawan Nilvarangkul
- Chiang Rai Rajabhat University, 80 Moo 9 Phaholyothin Road, Muang District, 57100, Chiang Rai, Thailand
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11
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Rao B, Xie D, Deng Y, Ye J, Zeng X, Lin A, Chen J, Huang D, Xie C, Chen C, Luo Y, Lu X, Wang X, Lu J. Robust positive association between serum urate and the risk of chronic obstructive pulmonary disease: hospital-based cohort and Mendelian randomisation study. BMJ Open Respir Res 2024; 11:e002203. [PMID: 38479817 PMCID: PMC10941131 DOI: 10.1136/bmjresp-2023-002203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and hyperuricaemia are both characterised by systemic inflammation. Preventing chronic diseases among the population with common metabolic abnormality is an effective strategy. However, the association of hyperuricaemia with the higher incidence and risk of COPD remains controversial. Therefore, replicated researches in populations with distinct characteristics or demographics are compellingly warranted. METHODS This cohort study adopted a design of ambispective hospital-based cohort. We used propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) to minimise the effects of potential confounding factors. A Cox regression model and restricted cubic spline (RCS) model were applied further to assess the effect of serum urate on the risk of developing COPD. Finally, we conducted a two-sample Mendelian randomisation (MR) analysis to explore evidence of causal association. RESULTS There is a higher incidence in the population with hyperuricaemia compared with the population with normal serum urate (22.29/1000 person-years vs 8.89/1000 person-years, p=0.009). This result is robust after performing PSM (p=0.013) and IPTW (p<0.001). The Cox model confirms that hyperuricaemia is associated with higher risk of developing COPD (adjusted HR=3.35 and 95% CI=1.61 to 6.96). Moreover, RCS shows that the risk of developing COPD rapidly increases with the concentration of serum urate when it is higher than the reference (420 µmol/L). Finally, in MR analysis, the inverse variance weighted method evidences that a significant causal effect of serum urate on COPD (OR=1.153, 95% CI=1.034 to 1.289) is likely to be true. The finding of MR is robust in the repeated analysis using different methods and sensitivity analysis. CONCLUSIONS Our study provides convincing evidence suggesting a robust positive association between serum urate and the risk of developing COPD, and indicates that the population with hyperuricaemia is at high risk of COPD in the Chinese population who seek medical advice or treatment in the hospital.
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Affiliation(s)
- Boqi Rao
- Emergency Department, The Second Affiliated Hospital, The State Key Lab of Respiratory Disease, Institute of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dongming Xie
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, The Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yibin Deng
- Centre for Medical Laboratory Science, the Afliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, Guangxi, China
- Key Laboratory of Research on Clinical Molecular Diagnosis for High Incidence Diseases in Western Guangxi, Baise, Guangxi, China
| | - Junyi Ye
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, The Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaobin Zeng
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, The Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ao Lin
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, The Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jinbin Chen
- KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dongsheng Huang
- Department of Respiratory and Critical Care Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, China
| | - Chenli Xie
- Department of Respiratory and Critical Care Medicine, Binhaiwan Central Hospital of Dongguan, Dongguan, Guangdong, China
- Dongguan Key Laboratory of Precision, Dongguan, Guangdong, China
| | - Cuiyi Chen
- Department of Respiratory and Critical Care Medicine, Songshan Lake Central Hospital of Dongguan, Dongguan, Guangdong, China
| | - Yixuan Luo
- Guangzhou Panyu District Central Hospital, Guangzhou, Guangdong, China
| | - Xiaoxiao Lu
- Department of English and American Studies, Ludwig Maximilian University of Munich Faculty of Languages and Literatures, Munich, Germany
| | - Xinhua Wang
- Institute of Basic Medicine, Institute of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jiachun Lu
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, The Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
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12
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Sang L, Gong X, Huang Y, Sun J. Proportions and risk factors of chronic obstructive pulmonary disease and preserved ratio impaired spirometry, and association with small airway disease, in the positive screening older population from China: a cross-sectional study. BMC Pulm Med 2024; 24:114. [PMID: 38443893 PMCID: PMC10916211 DOI: 10.1186/s12890-024-02920-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Early diagnosing Chronic Obstructive Pulmonary Disease (COPD) is relatively difficult. Therefore, the concepts of preserved ratio impaired spirometry (PRISm) and small airway disease (SAD) were proposed to achieve early diagnosis for COPD. Besides, the occurrence of COPD is positively related to age. However, the relationship among COPD, PRISm, and SAD still requires clarification. Thus, we estimated the proportions and risk factors of COPD and PRISm in the positive screening participants, and searched the methods of early diagnosing COPD via the SAD indicators. METHODS A total of 53,641 residents aged more than 60 years old from Shaoxing City, Zhejiang Province, China, completed a series of screening projects. And 2327 of positive screening participants ultimately finished bronchodilator tests. The data were statistically analyzed to figure out the proportions and risk factors of COPD and PRISm, and the efficacy of early diagnosing COPD by the SAD indicators. RESULTS Totally 2229 positive screening participants were included, the proportion of PRISm was 6.3% (141/2229), and of COPD was 78.2% (1743/2229). Statistical analyses showed that COPD patients were more likely to be smokers, males, and older. And COPD patients had higher questionnaire scores, meaning that they were more prone to have family history of respiratory diseases and more severe respiratory symptoms. Additionally, COPD patients had lower maximal mid-expiratory flow (MMEF) pred, forced expiratory flow (FEF) 75pred, and FEF50pred. And we found that male sex and presence of respiratory symptoms might lead to COPD and PRISm. Also, the methods of early diagnosing COPD through the SAD indicators might be acceptable. CONCLUSION There is a close association between COPD and decreased small airway function (SAF) among the participants included. Age, smoking, male sex, worse SAF, and respiratory symptoms might cause the progressing from normal people to PRISm, then to COPD patients. Besides, the SAD indicators such as MMEFpred, FEF75pred, and FEF50pred were included in lung function tests and bronchodilator tests. Intriguingly, it was found that early diagnosing COPD via the SAD indicators might be feasible. In the future, early diagnosis for COPD requires further research.
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Affiliation(s)
- Le Sang
- Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Xia Gong
- Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Yunlei Huang
- Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Jian Sun
- Shaoxing People's Hospital, Zhejiang Province, Shaoxing City, China.
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13
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Fu Y, Zhao J, Chen J, Zheng Y, Mo R, Zhang L, Zhang B, Lin Q, He C, Li S, Lin L, Xie T, Ding Y. miR‑186‑5p regulates the inflammatory response of chronic obstructive pulmonary disorder by targeting HIF‑1α. Mol Med Rep 2024; 29:34. [PMID: 38214374 PMCID: PMC10804437 DOI: 10.3892/mmr.2024.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/14/2023] [Indexed: 01/13/2024] Open
Abstract
Chronic obstructive pulmonary disorder (COPD) is a chronic respiratory disease that is a major cause of morbidity and mortality worldwide. Previous studies have shown that miR‑186‑5p expression is significantly increased in COPD and is involved in multiple physiological and pathological processes. However, the role of miRNA‑186‑5p in the inflammatory response of COPD remains unclear. In this study, an in vitro model of COPD was established using lipopolysaccharide (LPS)‑induced human bronchial epithelial cells (BEAS‑2B). CCK‑8 assays, flow cytometry, and a Muse cell analyzer were used to determine cell viability, cell cycle distribution, and apoptosis, respectively. The production of TNF‑α and IL‑6 were measured by ELISA. Reverse‑transcription‑quantitative PCR and western blotting were used to analyze mRNA and protein expression levels. The targeting relation between miR‑186‑5p and HIF‑1α was discovered using dual‑luciferase reporter assays. The results showed that transfection of miR‑186‑5p inhibitor inhibited cell proliferation and promoted cell apoptosis in the LPS‑induced BEAS‑2B cells. Inhibition of miR‑186‑5p markedly increased the levels of TNF‑α and IL‑6. miR‑186‑5p directly targeted and negatively regulated HIF‑1α expression. In addition, inhibition of miR‑186‑5p increased the expression of the NF‑κB pathway protein p‑p65. In conclusion, it was found that inhibiting miR‑186‑5p may improve inflammation of COPD through HIF‑1α in LPS‑induced BEAS‑2B cells, possibly by regulating NF‑κB signaling. These findings provide a novel potential avenue for the clinical management of COPD. Future research is required to determine the mechanism of the interaction between miR‑186‑5p and HIF‑1α in COPD.
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Affiliation(s)
- Yihui Fu
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Jie Zhao
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Jie Chen
- Department of General Practice, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Yamei Zheng
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Rubing Mo
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Lei Zhang
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Bingli Zhang
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Qi Lin
- Department of General Practice, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Chanyi He
- Department of General Practice, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Siguang Li
- Department of General Practice, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Lingsang Lin
- Department of General Practice, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Tian Xie
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
| | - Yipeng Ding
- Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
- Department of General Practice, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, P.R. China
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王 子, 莫 佳, 张 蒙, 廖 纪. [Epidemiology and hospitalization costs analysis of female inpatients with acute exacerbation of chronic obstructive pulmonary disease in Beijing from 2013 to 2020]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:1074-1081. [PMID: 38101792 PMCID: PMC10723980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE To study epidemiological characteristics and hospitalization costs of female inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing. METHODS A retrospective study was conducted to analyze electronic hospitalization summary reports of female inpatients with AECOPD in Beijing from 2013 to 2020. Clinical characteristics (age distribution and comorbidities), epidemiological characteristics (temporal and spatial distribution characteristics), hospi-talization times and costs of patients were described. RESULTS A total of 57 911 subjects in 166 hospitals were included in this study, with a mean age of (78.84±8.59) years and the highest number of patients aged 80-89 years (49.06%), followed by patients aged 70-79 years (31.08%), and the lowest number of patients under 50 years (0.41%). The proportions of patients with coronary heart disease, hypertension and heart failure were 30.60%, 30.52% and 26.54% respectively. The median number of daily hospitalizations during the study period was 18 (IQR: 16). The number of daily hospitalizations for AECOPD showed an overall growth trend over the eight years from 2013 to 2020, starting to increase significantly in 2015 and continuing to increase until 2019, then followed by a decline in 2020. The proportion of inpatient admissions was higher in winter and spring (54.09%) than that in summer and autumn (45.91%). The top three districts in terms of the proportion of total inpatient admissions were Xicheng district (14.18%), Chaoyang district (14.12%) and Fengtai district (13.47%). The density of inpatients was relatively high in the western regions, central urban areas and northeastern regions of the city, while the density of inpatients was relatively low in the near suburbs. The median number of hospital days for female patients with AECOPD was 12 days, and the median hospital costs was CNY 20 648.37. Patients from urban areas had longer hospitalization times and higher hospitalization costs than those from suburban areas (P < 0.001). Western medicine expenses accounted for the largest proportion of total hospital expenses (33.32%). During the study period, hospitalization costs exhibited an overall pattern of initial growth, followed by subsequent decline, eventually stabilizing. The differences in hospitalization costs among the patients with different comorbidities were significant. CONCLUSION Female hospitalized patients with AECOPD in Beijing were older than 70 years, often complicated by cardiovascular disease. AECOPD occurred mainly in winter and spring, with regional differences. The hospitalization costs were closely associated with the patients' age, comorbidities, and the geographicical region.
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Affiliation(s)
- 子恺 王
- 北京大学第一医院呼吸和危重症医学科,北京 100034Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, China
| | - 佳丽 莫
- 北京大学第一医院儿科,北京 100034Departmant of Pediatrics, Peking University First Hospital, Beijing, 100034, China
| | - 蒙 张
- 北京大学第一医院呼吸和危重症医学科,北京 100034Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, China
| | - 纪萍 廖
- 北京大学第一医院呼吸和危重症医学科,北京 100034Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, China
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Teng Y, Jian Y, Chen X, Li Y, Han B, Wang L. Comparison of Three Prediction Models for Predicting Chronic Obstructive Pulmonary Disease in China. Int J Chron Obstruct Pulmon Dis 2023; 18:2961-2969. [PMID: 38107597 PMCID: PMC10725189 DOI: 10.2147/copd.s431115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose To predict the future number of patients with chronic obstructive pulmonary disease (COPD) in China and compare the three prediction models. Methods A generalized additive model (GAM), autoregressive integrated moving average (ARIMA) model, and curve-fitting method were used to fit and predict the number of patients with COPD in China. Data on the number of patients with COPD in China from 1990 to 2019 were obtained from the Global Burden of Disease (GBD) database. The coefficient of determination (R2), mean absolute error (MAE), mean absolute percentage error (MAPE), root mean squared error (RMSE), relative error of prediction, Akaike Information Criterion (AIC), and Bayesian Information Criterion (BIC) were used to evaluate and compare the fitting effect, prediction effect, and reliability of the three models. Results The GAM, ARIMA, and curve-fitting methods could predict future trends in COPD in China. The performance of the GAM is the best among the three models, whereas the curve fitting method is the worst, and the ARIMA (0,1,2) model is in between. The prediction results of the three models showed that the number of patients with COPD in China is expected to increase from 2020 to 2025. Conclusion GAM and AIRMA models are recommended for predicting the future prevalence of COPD in China. The number of patients with COPD in China is expected to increase in the next few years. The prevention and control of COPD in China still needs to be strengthened. Using appropriate models to predict future trends in COPD will provide support for health policymakers.
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Affiliation(s)
- Yuhan Teng
- Department of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Yining Jian
- Department of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Xinyue Chen
- Department of General Practice, the First Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Yang Li
- Department of General Practice, Hunnan Zhujia Community Health Service Center, Shenyang, Liaoning, People’s Republic of China
| | - Bing Han
- Department of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Lei Wang
- Department of General Practice, the First Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China
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16
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Zhou Z, Yang L, Hu C, Gao R, Zhang X, Shen T. The combination of astragalus injection and ambroxol hydrochloride in the adjuvant treatment of COPD: a systematic review and meta-analysis. Sci Rep 2023; 13:22077. [PMID: 38087032 PMCID: PMC10716149 DOI: 10.1038/s41598-023-49421-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a severe condition that leads to premature mortality and places a significant financial burden on healthcare systems. An adjunctive therapy in COPD includes the simultaneous administration of astragalus injection and ambroxol hydrochloride. Despite its widespread use, the effectiveness of this combined approach in COPD treatment has not been systematically evaluated. Thus, we conducted a systematic review and meta-analysis to assess the efficacy of combining astragalus injection with ambroxol hydrochloride as an adjuvant treatment for COPD. Six electronic databases were used to search for relevant randomized controlled trials, and data analysis was conducted using Review Manager 5.4. A total of 14 randomized controlled trials were included, involving 1070 patients who met the criteria. The results of the meta-analysis indicated that the combination of astragalus injection with ambroxol hydrochloride as an adjuvant treatment can improve various clinical parameters in patients with COPD compared to conventional treatment alone. These parameters include the clinical effective rate (OR = 5.44, 95% CI 3.51-8.43, I2 = 0%), partial pressure of oxygen in artery (MD = 1.12, 95% CI 0.87-1.36, I2 = 5%), partial pressure of carbon dioxide in artery (MD = - 1.43, 95% CI - 1.65 to - 1.21, I2 = 0%), forced expiratory volume in one second (MD = 0.30, 95% CI 0.18-0.42, I2 = 0%), percentage of forced expiratory volume in one second (MD = 16.18, 95% CI 12.60-19.76, I2 = 82%), forced vital capacity (MD = 0.33, 95% CI 0.21-0.45, I2 = 36%), hemoglobin (MD = - 16.17, 95% CI - 20.84 to - 11.51, I2 = 29%), and the ratio of forced expiratory volume in one second to forced vital capacity (MD = 2.51, 95% CI - 0.05 to 5.06, I2 = 0%). The combination of astragalus injection and ambroxol hydrochloride could be a selection of COPD patients as an adjuvant treatment. However, further validation is required to evaluate the effectiveness of combining astragalus injection and ambroxol hydrochloride as an adjunctive treatment for patients with COPD.
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Affiliation(s)
- Zubing Zhou
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Lele Yang
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Chao Hu
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Rui Gao
- Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, 610095, China
| | - Xiaobo Zhang
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
| | - Tao Shen
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
- Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
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Xu Y, Zhao H, Yu C, Wang Y, Xu H, Weng Z, Chen C, Mao H. An investigation of the risk factors of chronic obstructive pulmonary disease in natural population-based cohorts in China - a nested case-control study. Front Public Health 2023; 11:1303097. [PMID: 38145085 PMCID: PMC10739482 DOI: 10.3389/fpubh.2023.1303097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) has become one of the most significant chronic diseases in China. According to conventional wisdom, smoking is the pathogenic factor. However, current research indicates that the pathophysiology of COPD may be associated with prior respiratory system events (e.g., childhood hospitalization for pneumonia, chronic bronchitis) and environmental exposure (e.g., dust from workplace, indoor combustion particles). Dyspnea, persistent wheezing, and other respiratory symptoms further point to the need for pulmonary function tests in this population. Reducing the burden of chronic diseases in China requires a thorough understanding of the various factors that influence the occurrence of COPD. Methods Using a cohort from the natural population, this study used nested case-control analysis. We carried out a number of researches, including questionnaire surveys and pulmonary function testing, in the Northwest and Southeast cohorts of China between 2014 and 2021. After removing any variations in the baseline data between patients and control subjects using propensity score matching analysis, the risk factors were examined using univariate or multivariate regression. Result It was discovered that prior history of chronic bronchitis, long-term wheezing symptoms, and environmental exposure-including smoking and biofuel combustion-were risk factors for COPD. Dyspnea, symptoms of mobility limitation, organic matter, and a history of hospitalization for pneumonia at an early age were not significant in the clinical model but their incidence in COPD group is higher than that in healthy population. Discussion COPD screening effectiveness can be increased by looking for individuals with chronic respiratory symptoms. Smokers should give up as soon as they can, and families that have been exposed to biofuels for a long time should convert to clean energy or upgrade their ventilation. Individuals who have previously been diagnosed with emphysema and chronic bronchitis ought to be extra mindful of the prevention or advancement of COPD.
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Affiliation(s)
- Yixin Xu
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hongjun Zhao
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Pulmonary and Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Chunchun Yu
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuqian Wang
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hao Xu
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Pulmonary and Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Zhe Weng
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chengshui Chen
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Pulmonary and Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Haizhou Mao
- Department of Mathematics, Zhejiang Industry and Trade Vocational College, Wenzhou, Zhejiang, China
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Yu J, Fu Y, Zeng L, Xie P, Li L, Zheng Y. Burden of female infertility in China from 1990 to 2019: a temporal trend analysis and forecasting, and comparison with the global level. Sex Health 2023; 20:577-584. [PMID: 37967574 DOI: 10.1071/sh23029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/13/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Infertility is a common reproductive disease that affects not only individuals and families, but also the growth of the social population. Hence, understanding the burden of female infertility in China and worldwide is of great significance for the development of infertility prevention and treatment strategies. METHODS The Global Burden of Disease Study (GBD 2019) Data Resources were used to collect and collate relevant data on female infertility in China and worldwide from 1990 to 2019. The difference in the number, age-standardised prevalence rate (ASPR), disability-adjusted life years and age-standardised disability-adjusted life years rate (ASDR) of women with infertility in different periods and geographical areas were analysed. The autoregressive integrated moving average method was used to predict the ASPR and ASDR of female infertility in China and worldwide in the next 11years. RESULTS In the past 30years, the number of female infertility cases increased by 7.06million in China and 56.71million worldwide. The corresponding average annual increase of ASPR was 10.10% and 7.28%, respectively, and that of ASDR was 0.08% and 0.79%, respectively. In addition, there are differences in age and time between Chinese and global female infertility. In 1990, the crude prevalence rate of female infertility was the highest in women aged 40-44years and 35-39years in China and worldwide, respectively. In 2019, the crude prevalence rate of female infertility was still the highest in women aged 40-44years in China, whereas that around the world reached the highest in women aged 30-34years, which was significantly earlier. The forecast for the next 11years suggests that the ASPR and ASDR for female infertility in China will first rise and then decline, but the overall magnitude of change is not very significant, whereas the ASPR and ASDR for female infertility globally are still on the rise. The ASPR value of female infertility is expected to be 5025.56 in 100 000 persons in China and 3725.51 in 100 000 persons worldwide by 2030. The ASDR value of female infertility is expected to be 26.16 in 100 000 persons in China and 19.96 in 100 000 persons worldwide by 2030. CONCLUSION The burden of female infertility is still increasing in China and worldwide. Therefore, it is of great significance to pay more attention to infertile women, and advocate a healthy lifestyle to reduce the burden of disease for infertile women.
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Affiliation(s)
- Jingwei Yu
- Gynecology of Traditional Chinese Medicine, Panyu Maternal and Child Care Service Centre (Panyu He Xian Memorial Hospital), Guangzhou City, Guangdong Province 511442, China
| | - Yanhong Fu
- Department of Gynecology, Guangzhou Huadu District Maternal and Child Care Service Centre, Guangzhou City, Guangdong Province 510800, China
| | - Lei Zeng
- Department of Gynecology, First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province 510405, China
| | - Pengpeng Xie
- Department of TCM Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou City, Guangdong Province 510623, China
| | - Limei Li
- Department of Women's Health Care, Guangdong Maternal and Child Health Hospital, Guangzhou City, Guangdong Province 511442, China
| | - Yongxia Zheng
- Gynecology of Traditional Chinese Medicine, Panyu Maternal and Child Care Service Centre (Panyu He Xian Memorial Hospital), Guangzhou City, Guangdong Province 511442, China
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Yan Z, Xu Y, Li K, Liu L. Heavy metal levels and flavonoid intakes are associated with chronic obstructive pulmonary disease: an NHANES analysis (2007-2010 to 2017-2018). BMC Public Health 2023; 23:2335. [PMID: 38001456 PMCID: PMC10675902 DOI: 10.1186/s12889-023-17250-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The association between exposure to environmental metals and chronic obstructive pulmonary disease (COPD) is preventing chronic lung diseases. However, little is currently known about the interaction between heavy metals and flavonoids in relation to the risk of COPD. This study aims to bridge this knowledge gap by leveraging The National Health and Nutrition Examination Survey (NHANES) database to evaluate thecorrelation between blood levels of heavy metals (cadmium, lead, mercury) and the intake of various flavonoid compounds (isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, total flavonoids). Additionally, appropriate dietary recommendations are provided based on the study findings. MATERIALS AND METHODS Cross-sectional analysis was conducted using the 2007-2010 and 2017-2018 NHANES data. Specialized weighted complex survey design analysis software was used for data analysis. Multivariate logistic regression models and restricted cubic splines (RCS) were used to evaluate the relationship between blood heavy metal levels, flavonoids intake, and COPD incidence in all participants, and to explore the effect of different levels of flavonoids intake on COPD caused by heavy metal exposure. RESULTS A total of 7,265 adults aged ≥ 40 years were analyzed. Higher levels of blood cadmium (Cd), blood lead and Anthocyanidin (AC) intake were independently associated with an increased risk of COPD (Cd highest quantile vs. lowest: OR = 1.73, 95% CI, 1.25-2.3; Lead highest quantile vs. lowest quantile: OR = 1.44, 95% CI, 1.11-1.86; AC highest quantile vs. lowest: OR = 0.73, 95% CI, 0.54-0.99). When AC intake exceeded 11.56 mg/d, the effect of Cd exposure on COPD incidence decreased by 27%, and this finding was more significant in smokers. CONCLUSION Higher levels of Cd (≥ 0.45ug/L) and lead (≥ 0.172 ug/L) were positively correlated with the risk of COPD among participants aged 40 years and above, while AC intake (≥ 11.56 mg/d) could reduce the risk related to blood Cd.
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Affiliation(s)
- Zhaoqi Yan
- Jiangxi University of Traditional Chinese Medicine, Graduate school, Yangming Road, Nanchang, Jiangxi, China
| | - Yifeng Xu
- Jiangxi University of Traditional Chinese Medicine, Graduate school, Yangming Road, Nanchang, Jiangxi, China
| | - Keke Li
- Jiangxi University of Traditional Chinese Medicine, Graduate school, Yangming Road, Nanchang, Jiangxi, China
| | - Liangji Liu
- Department of Respiratory and Critical Care Medicine, Hospital of Jiangxi University of Traditional Chinese Medicine, 445 Bayi Dadao, Nanchang, Jiangxi, China.
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20
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Yu XQ, Di JQ, Zhang W, Wei GS, Ma ZP, Wu L, Yu XF, Zhu HZ, Zhou M, Feng CL, Feng JH, Fan P, Li JS, Yang JY. Bu-Fei Yi-Shen Granules Reduce Acute Exacerbations in Patients with GOLD 3-4 COPD: A Randomized Controlled Trial. Int J Chron Obstruct Pulmon Dis 2023; 18:2439-2456. [PMID: 37955027 PMCID: PMC10637367 DOI: 10.2147/copd.s413754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) is a disease characterized by frequent acute exacerbations (AEs), especially in severe and very severe cases. We aimed to evaluate the efficacy and safety of Bu-fei Yi-shen granules (BYGs) for COPD. Patients and Methods We conducted a multicenter, randomized, double-blinded, placebo-controlled trial of 348 COPD patients with GOLD 3-4 COPD. The patients were randomly assigned into experimental or control groups in a 1:1 ratio. Patients in the experimental group were prescribed BYG, while those in the control group were administered a placebo, orally, twice daily, with 5 days on and 2 days off per week for 52 weeks. The outcomes included AEs, pulmonary function, clinical signs and symptoms, dyspnea scores (mMRC), quality of life scores, and a 6-minute walk test (6MWT). Results A total of 280 patients completed the trial, including 135 patients in the experimental group and 145 in the control group. Compared to the control group, significant differences were observed in frequencies of AEs (mean difference: -0.35; 95% CI: -0.61, -0.10; P = 0.006) and AE-related hospitalizations (-0.18; 95% CI: -0.36, -0.01; P = 0.04), 6MWD (40.93 m; 95% CI: 32.03, 49.83; P < 0.001), mMRC (-0.57; 95% CI: -0.76, -0.37; P < 0.001), total symptoms (-2.18; 95% CI: -2.84, -1.53; P < 0.001), SF-36 (11.60; 95% CI: 8.23, 14.97; P < 0.001), and mCOPD-PRO (-0.45; 95% CI: -0.57, -0.33; P < 0.001) after treatment. However, there were no significant differences in mortality, pulmonary function, and mESQ-PRO scores (P > 0.05). No obvious adverse events were observed. Conclusion BYG, as compared to a placebo, could significantly reduce the frequencies of AEs and AE-related hospitalizations for GOLD 3-4 COPD patients. Clinical symptoms, treatment satisfaction, quality of life, and exercise capacity improved. There was no significant improvement in mortality and pulmonary function.
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Affiliation(s)
- Xue-Qing Yu
- Department of Respiratory Disease, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan Province, 450000, People’s Republic of China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, People’s Republic of China
| | - Jia-Qi Di
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, People’s Republic of China
| | - Wei Zhang
- Department of Respiratory Disease, Shanghai Shuguang Hospital, Shanghai University of Chinese Medicine, Shanghai, 200000, People’s Republic of China
| | - Geng-Shu Wei
- Department of Respiratory Disease, the Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi Province, 712000, People’s Republic of China
| | - Zhan-Ping Ma
- Department of Respiratory Disease, Shaanxi Province Hospital of Traditional Chinese Medicine, Xi’an, Shaanxi Province, 710000, People’s Republic of China
| | - Lei Wu
- Department of Respiratory Disease, Hebei Province Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei, 050000, People’s Republic of China
| | - Xue-Feng Yu
- Department of Respiratory Disease, the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, 110000, People’s Republic of China
| | - Hui-Zhi Zhu
- Department of Respiratory Disease, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, 230000, People’s Republic of China
| | - Miao Zhou
- Department of Respiratory Disease, the Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan Province, 450000, People’s Republic of China
| | - Cui-Ling Feng
- Department of Traditional Chinese Medicine, People’s Hospital Affiliated to Peking University, Beijing, 100000, People’s Republic of China
| | - Ji-Hong Feng
- Department of Respiratory Disease, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, People’s Republic of China
| | - Ping Fan
- Department of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, 510000, People’s Republic of China
| | - Jian-Sheng Li
- Department of Respiratory Disease, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan Province, 450000, People’s Republic of China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, People’s Republic of China
| | - Jian-Ya Yang
- Department of Respiratory Disease, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan Province, 450000, People’s Republic of China
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Lin QI, Zhang CF, Chen JY, Guo ZK, Wu SY, Li HY. Targeting Mitochondrial Dysfunction With LncRNAs in a Wistar Rat Model of Chronic Obstructive Pulmonary Disease. In Vivo 2023; 37:2543-2554. [PMID: 37905633 PMCID: PMC10621436 DOI: 10.21873/invivo.13362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM Chronic obstructive pulmonary disease (COPD) has become a prominent healthcare issue in recent years. Cigarette smoking (CS) and fine particulate matter (PM2.5) are important causative factors for COPD. This study assessed the aberrant lncRNA profiles in the tissue of rats with COPD caused by CS or PM2.5 Materials and Methods: A COPD rat model was developed using CS (CSM) or PM2.5 (PMM), and lung tissue RNA was extracted. The Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) were used to investigate the correlations between the distinct lncRNAs and mRNA pathways. A coding-non-coding gene co-expression network (CNC) was constructed by establishing connections between differentially expressed long non-coding RNAs (lncRNAs) and messenger RNAs (mRNAs) associated with mitochondrial dysfunction and the inflammatory response. RESULTS A quantitative real-time reverse transcription PCR (qRT-PCR) experiment was performed to verify the expression of the particular lncRNAs. Microarray analysis of lung tissue from the COPD model revealed that 123 and 444 lncRNAs were substantially raised and reduced in PMM vs. the control group (Ctrl), respectively, as were 621 and 1,178 mRNAs. Meanwhile, 81 and 340 lncRNAs were consistently raised and lowered in CSM vs. Ctrl, respectively, as were 408 and 931 mRNAs. GO enrichment and KEGG pathway analysis indicated that the COPD model was connected to inflammatory responses, mitochondrial dysfunction, and others. CONCLUSION XR_340674, ENSRNOT00000089642, XR_597045, and XR_340651 were decreased, and XR_592469 was elevated. These lncRNAs were shown to be related to mitochondrial dysfunction in the lung tissue of animals exposed to CS or PM2.5.
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Affiliation(s)
- Q I Lin
- Department of Pharmacy, the Affiliated Hospital of Putian University, Putian, P.R. China;
- The School of Public Health, Fujian Medical University, Fuzhou, P.R. China
| | - Chao-Feng Zhang
- Department of Haematology and Rheumatology, The Affiliated Hospital of Putian University, Putian, P.R. China
- School of Basic Medical Sciences, Putian University, Putian, P.R. China
| | - Jing-Yu Chen
- School of Basic Medical Sciences, Putian University, Putian, P.R. China
| | - Zhen-Kun Guo
- The School of Public Health, Fujian Medical University, Fuzhou, P.R. China
| | - Si-Ying Wu
- The School of Public Health, Fujian Medical University, Fuzhou, P.R. China
| | - Huang-Yuan Li
- The School of Public Health, Fujian Medical University, Fuzhou, P.R. China;
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Shen S, Xiao Y. Association Between C-Reactive Protein and Albumin Ratios and Risk of Mortality in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:2289-2303. [PMID: 37873518 PMCID: PMC10590598 DOI: 10.2147/copd.s413912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/14/2023] [Indexed: 10/25/2023] Open
Abstract
Purpose This study was to evaluate the association between C-reactive protein (CRP) to albumin (ALB) ratio (CAR) and the risk of mortality in patients with chronic obstructive pulmonary disease (COPD). Methods In this retrospective cohort study, clinical data were extracted from the National Institutes of Health National Health and Nutrition Examination Survey (NHANES) database between 2007 and 2010. Cox proportional hazard regressions were performed to assess the association between CAR and 5-year mortality in COPD patients. Subgroup analyses were applied to identify the consistency of the association based on the severity of COPD, gender, body mass index (BMI), smoking status, cardiovascular disease (CVD), and chronic kidney disease (CKD), and diabetes. The area under the curve (AUC) of the receiver operator characteristic (ROC) curve analysis was used to evaluate the predictive performance of CAR. Results A total of 1210 COPD patients were included, of which 110 COPD patients (9.09%) had 5-year mortality. The mean follow-up was 57.76 (0.33) months. A higher CAR was associated with an increased risk of 5-year mortality in COPD patients [hazard ratio (HR): 1.94, 95% confidence interval (CI): 1.07 to 3.50, P =0.029)]. Subgroup analysis showed that the association between CAR and mortality was especially suitable for COPD patients with mild COPD, in COPD patients who were still smoking, in COPD patients with BMI <=29.9 kg/m2, in COPD patients who were without CVD, in COPD patients who were without diabetes, and COPD patients who were without CKD. The AUCs of CAR for predicting 1-year, 3-year, and 5-year mortality in COPD patients were 0.735, 0.615, and 0.608, respectively. Conclusion CAR is strongly correlated with mortality in patients with COPD and CAR could be served as a prognostic biomarker for patients with COPD. This study may provide a promising prognostic biomarker for risk stratification and clinical management of patients with COPD.
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Affiliation(s)
- Shenghua Shen
- Department of Pulmonary and Critical Care Medicine, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213004, People’s Republic of China
| | - Yuan Xiao
- Department of Pulmonary and Critical Care Medicine, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213004, People’s Republic of China
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Shen W, Li X, Fang Q, Li G, Xiao W, Wu Y, Liu J, Hu W, Lu H, Huang F. The impact of ambient air pollutants on childhood respiratory system disease and the resulting disease burden: a time-series study. Int Arch Occup Environ Health 2023; 96:1087-1100. [PMID: 37338586 DOI: 10.1007/s00420-023-01991-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE The effects of air pollution on human health have long been a hot topic of research. For respiratory diseases, a large number of studies have proved that air pollution is one of the main causes. The purpose of this study was to investigate the risk of hospitalization of children with respiratory system diseases (CRSD) caused by six pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) in Hefei City, and further calculate the disease burden. METHOD In the first stage, the generalized additive models were combined with the distributed lag non-linear models to evaluate the impact of air pollution on the inpatients for CRSD in Hefei. In the second stage, this study used the cost-of-illness approach to calculate the attributable number of hospitalizations and the extra disease burden. RESULT Overall, all the six kinds of pollutants had the strongest effects on CRSD inpatients within lag10 days. SO2 and CO caused the highest and lowest harm, respectively, and the RR values were SO2 (lag0-5): 1.1 20 (1.053, 1.191), and CO (lag0-6): 1.002 (1.001, 1.003). During the study period (January 1, 2014 to December 30, 2020), the 7-year cumulative burden of disease was 36.19 million CNY under the WHO air pollution standards. CONCLUSION In general, we found that six air pollutants were risk factors for CRSD in Hefei City, and create a huge burden of disease.
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Affiliation(s)
- Wenbin Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Xue Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Qingfeng Fang
- Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Wei Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Yueyang Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Jianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Wenlei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Huanhuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
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Lin Q, Zhang C, Weng H, Lin Y, Lin Y, Ruan Z. The utility of long non-coding RNAs in chronic obstructive pulmonary disease: a comprehensive analysis. BMC Pulm Med 2023; 23:340. [PMID: 37697291 PMCID: PMC10496340 DOI: 10.1186/s12890-023-02635-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES Chronic obstructive pulmonary disease (COPD) is one of the main causes of morbidity and mortality in the world. However, there are some patients who are not diagnosed early and correctly through routine methods because of inconspicuous or serious symptoms. This study aims to assess the diagnostic role of long non-coding RNA (lncRNA) in COPD. METHODS We searched literature from electronic databases, after excluding non-COPD literature, the bibliometric analysis was performed, and VOSviewer software was used to represent the data analyzed. Literature evaluating the diagnostic test accuracy of lncRNA for COPD was eligible, and the QUADAS-2 checklist was used to evaluate the quality. The pooled sensitivity (SEN), specificity (SPE), diagnostic odds ratio (DOR), and summary receiver operating characteristic curve (sROC) were used to analyze the overall diagnostic performance. Subgroup and meta-regression analyses were performed to explore the heterogeneity, and a funnel plot was assessed for publication bias. Also, lncRNAs related to COPD were identified and explored for their potential biological function. RESULTS An increased annual growth rate of literature on this subject from 2016 focused on COPD, humans, RNA, and lncRNA. The meta-analysis enrolled 17 literature indicated that the SEN, SPE, and DOR differentiating COPD patients from normal controls (NCs) were 0.86 (95% CI [0.80, 0.90]), 0.78 (95% CI [0.67, 0.86]), and 21.59 (95% CI [11.39, 40.91]), respectively. Meanwhile, lncRNAs had the ability to distinguish acute exacerbations of COPD (AECOPD) patients from COPD; the SEN, SPE, and DOR were 0.75 (95% CI [0.62, 0.85]), 0.81 (95% CI [0.71, 0.89]), and 13.02 (95% CI [7.76, 21.85]), respectively. The area under the sROC were calculated to be greater than 0.8 at least. Subgroup and meta-regression analysis showed that the types of specimens and dysregulated lncRNAs might affect the diagnostic accuracy. The funnel plot showed there was a certain publication bias. 41 lncRNAs related to COPD were identified and mainly located in the nucleus and cytoplasm, associated with proliferation, invasion, and prognosis. These lncRNA-binding proteins were involved in the spliceosome, Rap1 signaling pathway, MAPK signaling pathway, and so on. CONCLUSION LncRNA suggests potential diagnostic biomarkers and therapeutic targets for COPD patients.
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Affiliation(s)
- Qi Lin
- Department of Pharmacy, The Affiliated Hospital of Putian University, Putian, Fujian Province, China.
- Pharmaceutical and Medical Technology College, Putian University, Putian, Fujian Province, China.
| | - Chaofeng Zhang
- Department of Hematology and Rheumatology, The Affiliated Hospital of Putian University, Putian, Fujian Province, China
- Key Laboratory of Translational Tumor Medicine in Fujian Province, Putian University, Putian, Fujian Province, China
| | - Huixin Weng
- Pharmaceutical and Medical Technology College, Putian University, Putian, Fujian Province, China
| | - Yating Lin
- Pharmaceutical and Medical Technology College, Putian University, Putian, Fujian Province, China
| | - Yucang Lin
- Department of Information, The Affiliated Hospital of Putian University, Putian, Fujian Province, China
| | - Zhipeng Ruan
- Pharmaceutical and Medical Technology College, Putian University, Putian, Fujian Province, China.
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Wang Z, Wu P, Wang L, Li B, Liu Y, Ge Y, Wang R, Wang L, Tan H, Wu CH, Laine M, Salje H, Song H. Marginal effects of public health measures and COVID-19 disease burden in China: A large-scale modelling study. PLoS Comput Biol 2023; 19:e1011492. [PMID: 37721947 PMCID: PMC10538769 DOI: 10.1371/journal.pcbi.1011492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/28/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
China had conducted some of the most stringent public health measures to control the spread of successive SARS-CoV-2 variants. However, the effectiveness of these measures and their impacts on the associated disease burden have rarely been quantitatively assessed at the national level. To address this gap, we developed a stochastic age-stratified metapopulation model that incorporates testing, contact tracing and isolation, based on 419 million travel movements among 366 Chinese cities. The study period for this model began from September 2022. The COVID-19 disease burden was evaluated, considering 8 types of underlying health conditions in the Chinese population. We identified the marginal effects between the testing speed and reduction in the epidemic duration. The findings suggest that assuming a vaccine coverage of 89%, the Omicron-like wave could be suppressed by 3-day interval population-level testing (PLT), while it would become endemic with 4-day interval PLT, and without testing, it would result in an epidemic. PLT conducted every 3 days would not only eliminate infections but also keep hospital bed occupancy at less than 29.46% (95% CI, 22.73-38.68%) of capacity for respiratory illness and ICU bed occupancy at less than 58.94% (95% CI, 45.70-76.90%) during an outbreak. Furthermore, the underlying health conditions would lead to an extra 2.35 (95% CI, 1.89-2.92) million hospital admissions and 0.16 (95% CI, 0.13-0.2) million ICU admissions. Our study provides insights into health preparedness to balance the disease burden and sustainability for a country with a population of billions.
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Affiliation(s)
- Zengmiao Wang
- State Key Laboratory of Remote Sensing Science, Center for Global Change and Public Health, Faculty of Geographical Science, Beijing Normal University, Beijing, China
| | - Peiyi Wu
- State Key Laboratory of Remote Sensing Science, Center for Global Change and Public Health, Faculty of Geographical Science, Beijing Normal University, Beijing, China
| | - Lin Wang
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Bingying Li
- State Key Laboratory of Remote Sensing Science, Center for Global Change and Public Health, Faculty of Geographical Science, Beijing Normal University, Beijing, China
| | - Yonghong Liu
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yuxi Ge
- State Key Laboratory of Remote Sensing Science, Center for Global Change and Public Health, Faculty of Geographical Science, Beijing Normal University, Beijing, China
| | - Ruixue Wang
- State Key Laboratory of Remote Sensing Science, Center for Global Change and Public Health, Faculty of Geographical Science, Beijing Normal University, Beijing, China
| | - Ligui Wang
- Center of Disease Control and Prevention, PLA, Beijing, China
| | - Hua Tan
- Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Chieh-Hsi Wu
- Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Marko Laine
- Finnish Meteorological Institute, Meteorological Research Unit, Helsinki, Finland
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Hongbin Song
- Center of Disease Control and Prevention, PLA, Beijing, China
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Yu C, Xia Q, Li Q, Wu J, Wang X, Wu J. Hospitalization costs of COPD cases and its associated factors: an observational study at two large public tertiary hospitals in Henan Province, China. BMC Geriatr 2023; 23:457. [PMID: 37491188 PMCID: PMC10367229 DOI: 10.1186/s12877-023-04087-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 06/03/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND The increasing prevalence of Chronic Obstructive Pulmonary Disease (COPD) has imposed a considerable economic burden. However, there remains a paucity of relevant evidence regarding the hospitalization costs of COPD cases. Therefore, in this study, we aimed to assess the hospitalization costs among COPD cases and investigate the factors that contribute to their costs in Henan Province, China. METHODS We enrolled a total of 1697 cases who were discharged with a diagnosis of COPD from January 1, 2020 to December 31, 2020, into the study. Demographic and clinical characteristics of the cases were obtained from the hospital information system (HIS) of two large tertiary hospitals in Henan Province, China. The factors associated with hospitalization costs were examined using a multiple linear regression model. RESULTS Total hospitalization costs of 1697 COPD cases were $5,419,011, and the median was $1952 (IQR:2031). Out-of-pocket fees accounted for 43.95% of the total hospitalization costs, and the median was $938 (IQR:956). Multiple linear regression analysis revealed that hospitalization costs were higher among older cases, cases with more comorbidities, and cases with longer length of stay. Furthermore, hospitalization costs were higher in cases who paid through private expenses compared to those covered by Urban Employee Basic Medical Insurance. Additionally, we found that cases admitted through an outpatient clinic had higher hospitalization costs than those admitted through the emergency department. CONCLUSION Hospitalization costs of COPD cases are substantial. Strategies to reduce hospitalization costs, such as shortening LOS, optimizing payment plans, and preventing or managing complications, should be implemented to alleviate the economic burden associated with COPD hospitalizations.
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Affiliation(s)
- Chengcheng Yu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Qingyun Xia
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Juxiao Wu
- School of Journalism and Communication, Wuhan University, Wuhan, 430072, Hubei, China
| | - Xiangyu Wang
- Beijing Chao-Yang Hospital, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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An R, Zhang S, Huang X, Lan Y, Cao T, Wan Q. Physical activity trajectories and their determinants in patients with chronic obstructive pulmonary disease: A cohort study. J Clin Nurs 2023. [PMID: 37243430 DOI: 10.1111/jocn.16771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
AIMS AND OBJECTIVES The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio-ecological model. BACKGROUND PA has been linked to poor long-term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors. DESIGN Cohort study. METHODS We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group-based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow-up. A STROBE checklist was used to guide the reporting of this study. RESULTS Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow-up. CONCLUSIONS This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD. RELEVANCE TO CLINICAL PRACTICE It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA. NO PATIENT OR PUBLIC CONTRIBUTION A national cohort study was used and no patients or the public were involved in the design and implementation of this study.
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Affiliation(s)
- Ran An
- School of Nursing, Peking University, Beijing, China
| | - Shifang Zhang
- School of Nursing, Peking University, Beijing, China
| | - Xiuxiu Huang
- School of Nursing, Peking University, Beijing, China
| | - Yue Lan
- School of Nursing, Peking University, Beijing, China
| | - Ting Cao
- School of Nursing, Peking University, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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Wu DL, Luo CL, Du X, Li PP, Jiang M, Liu T, Sun Y. Current Status and Influencing Factors of Readiness for Discharge of Elderly Patients with Chronic Obstructive Pulmonary Disease. Patient Prefer Adherence 2023; 17:1323-1333. [PMID: 37255947 PMCID: PMC10226539 DOI: 10.2147/ppa.s410725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Abstract
Objective Readiness for hospital discharge is an important indicator of patients' transition from illness to health and can predict rehabilitation and prognosis. Identifying factors that influence readiness for discharge is crucial for developing effective nursing interventions. Therefore, this study aims to investigate the current status of discharge readiness and its influencing factors in elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 311 elderly inpatients diagnosed with COPD were enrolled in this investigation at a tertiary hospital in Chengdu between December 2021 and June 2022. Questionnaires were designed to collect general information, disease-related information, and responses to the Readiness for Hospital Discharge Scale (RHDS) and the Quality of Discharge Teaching Scale (QDTS). Univariate and multivariate linear regression analyses were employed to further analyze factors related to discharge readiness and the correlation between discharge readiness and the quality of discharge guidance. Results The total score of discharge readiness of elderly COPD patients was 77.72 ± 11.86 with a mean score of 6.48 ± 0.19 for each item. The quality of discharge instructions was 110.54 ± 15.66, with a mean score of 6.12 ± 0.15 for each item. Discharge preparation was positively correlated with the quality of discharge guidance. Multivariate analysis showed that marital status, admission mode, length of stay in hospital, Classification of Severity of Airflow Limitation, mMRC classification, number of medications taken with discharge, presence of inhalers in medication orders, mode of home oxygen therapy, and quality of discharge guidance were independent factors of discharge readiness in elderly COPD patients (P < 0.05). Conclusion Both discharge readiness and the quality of discharge guidance for elderly COPD patients in China are currently suboptimal and need further improvement. The survey findings provide valuable insights that can guide future management practices and interventions aimed at improving discharge readiness.
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Affiliation(s)
- Dao-Lin Wu
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
- Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Chun-Li Luo
- School of Nursing, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xu Du
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Pei-Pei Li
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Min Jiang
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Tao Liu
- Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
- Department of Oncology, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Key Clinical Specialty of Sichuan, Chengdu, Sichuan, People’s Republic of China
| | - Yun Sun
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
- Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
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Zhao L, Zhao Q. Knowledge, attitude, and practice toward disease prevention among a high-risk population for chronic obstructive pulmonary disease: A cross-sectional study. Int J Nurs Sci 2023; 10:238-244. [PMID: 37128490 PMCID: PMC10148251 DOI: 10.1016/j.ijnss.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/08/2023] [Accepted: 03/19/2023] [Indexed: 04/07/2023] Open
Abstract
Objective This study aimed to describe the current situation of knowledge, attitude, and practice (KAP) of chronic obstructive pulmonary disease (COPD) prevention among a high-risk population for COPD. Methods A cross-sectional survey was conducted. A total of 241 participants at risk of COPD were selected who visited the respiratory outpatient department of a Class A tertiary hospital in Chongqing, China from January to December 2021. A self-developed COPD prevention KAP assessment was used for evaluation which included knowledge (21 items), attitude (9 items), and practice (9 items) three dimension, 39 items. Results The average overall KAP score was 68.29 ± 12.91, with scores for the knowledge, attitude, and practice dimension was 68.75 ± 18.07, 71.13 ± 15.09 and 65.00 ± 20.93, respectively. Among the people at risk of COPD, 76.8% experienced a moderate level of KAP toward COPD prevention, while 22.0% were at a poor level. Significant differences in the KAP scores were based on gender, educational level, occupation, type of medical insurance, smoking, and passive smoking status (P < 0.05). The male COPD high-risk group has better KAP toward COPD prevention than the female group (P < 0.05). The knowledge and attitude of COPD prevention present worse in people with a high risk of COPD aged 70 or above, primary school and below educational level, and farmers (P < 0.05). Smoking and passive smoking groups have higher recognition of the knowledge but the lower practice of COPD prevention (P < 0.05). Conclusion The participants with a high risk of COPD had a moderate level of KAP for COPD prevention, in which the understanding and action on vaccination and lung function test was weak, but an active attitude for health. It is necessary to implement tailored health education interventions to their characteristics to reduce the incidence and development of COPD.
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Affiliation(s)
- Lulu Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Nursing, The People’s Hospital of Dazu, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Corresponding author.
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Wang H, Liu Q, Liu L, Cao J, Liang Q, Zhang X. High-intensity interval training improves the outcomes of patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials. Respir Med 2023; 208:107128. [PMID: 36717003 DOI: 10.1016/j.rmed.2023.107128] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Pulmonary exercise is an important part in the treatment of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects and safety of high-intensity interval training (HIIT) in patients with COPD, to provide insights to the COPD treatment and care. METHODS Two investigators searched PubMed, Medline, Embase, web of Science, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases up to Sept 15, 2022 for randomized controlled trials (RCTs) on the effects and safety of HIIT for COPD patients. RevMan5.3 software was used for statistical analysis. RESULTS A total of 20 RCTs involving 962 COPD patients were finally included. 514 patients underwent HIIT interventions. Meta-analysis showed that HIIT increased the peak oxygen consumption (SMD = 0.30, 95%CI:0.14-0.46), peak minute ventilation (SMD = 0.26, 95%CI: 0.05-0.47), peak work rate (SMD = 0.34, 95%CI: 0.17-0.51), 6-min walking distance (SMD = 0.39, 95%CI: 0.23-0.55) in COPD patients (all P < 0.05). HIIT improved the quality of life (SMD = 0.30, 95%CI: 0.06-0.54) and reduced the dyspnea (SMD = -0.27, 95%CI: -0.51∼-0.03) in COPD patients (all P < 0.05). There were no significant differences in the forced expiratory volume in 1 s/forced vital capacity (SMD = 0.28, 95%CI: -0.01-0.56) and St. George's Respiratory Questionnaire score (SMD = -0.35, 95%CI: -0.73-0.03) between HIIT and control group (all P > 0.05). There was no publication bias analyzed by the Egger test and funnel plots (all P > 0.05). CONCLUSIONS HIIT may be beneficial to improve the pulmonary function, exercise capacity and quality of life of patients with COPD, which is worthy of clinical promotion for COPD treatment and care.
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Affiliation(s)
- Hongyan Wang
- School of Nursing, Sichuan Nursing Vocational College, China
| | - Qin Liu
- School of Nursing, Chengdu University of TCM, China
| | - Linfeng Liu
- School of Nursing, Sichuan Nursing Vocational College, China
| | - Jun Cao
- School of Nursing, Sichuan Nursing Vocational College, China
| | | | - Xiangeng Zhang
- School of Nursing, Sichuan Nursing Vocational College, China.
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Liu W, Xu Y, Lin Y, Wang L, Zhou M, Yin P, Zhao G. Burden of epilepsy in China and its provinces, 1990 to 2019: findings from the Global Burden of Disease Study 2019. Chin Med J (Engl) 2023; 136:305-312. [PMID: 36752807 PMCID: PMC10106145 DOI: 10.1097/cm9.0000000000002526] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. METHODS We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019. RESULTS In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92-1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33-133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03-98.74%) and 35.72% (95% UI: 0.47-86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43-5.66]/100,000), Qinghai (1.80 [95% UI: 1.15-2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88-1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39-0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44-0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41-0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased. CONCLUSIONS The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.
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Affiliation(s)
- Wei Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yangyang Xu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yicong Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China
| | - Lijun Wang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Guoguang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China
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Zhao SQ, Zhao LP, Xu XP, You H. Individual-Level Health Care Costs Attributable to Noncommunicable Diseases: A Longitudinal Study Based on the Older Adults in China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231214469. [PMID: 38044620 PMCID: PMC10697053 DOI: 10.1177/00469580231214469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023]
Abstract
Noncommunicable chronic diseases among the elderly population represent a significant economic burden in China. However, previous disease-related health cost studies lacked representation of older adults and comparability of the burden of multiple chronic diseases. The objective of this study was to determine the fraction of health care costs attributable to the 6 most prevalent chronic diseases and comorbidities in the sample of older adults. This study employed data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with 3 waves in 2011, 2014, and 2018, and included 18 349 observations in total. Outpatient costs, inpatient costs, and total health care costs were included in this study. Based on a 2-part random effects model, the effect of chronic disease on health service utilization was first explored by constructing a dummy variable for whether or not to utilize health care, followed by estimation of attributable costs in the population with health care utilization. Among the older adults in the sample, hypertension, heart disease, cataracts, arthritis, stroke or Cerebrovascular disease (CVD) and chronic lung disease are the 6 most prevalent chronic conditions. The costs attributable to the 6 chronic diseases mentioned above were 36.00% of outpatient costs, 55.92% of inpatient costs, and 45.05% of total health care costs for older adults. Of these, heart disease, stroke or CVD, and chronic lung disease accounted for 22.11%, 13.24%, and 10.56% of total health care costs, respectively. Moreover, the proportion of health care costs attributable to chronic diseases was higher for older adults who were male, lived in urban areas, and had a lower level of education. The proportion of health care costs attributable to chronic diseases is substantial among older adults in China. Health care costs associated with chronic diseases can be decreased with well-targeted interventions and comprehensive access to health services.
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Affiliation(s)
| | | | | | - Hua You
- Nanjing Medical University, Nanjing, China
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Wang Q, Liu S. The Effects and Pathogenesis of PM2.5 and Its Components on Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:493-506. [PMID: 37056681 PMCID: PMC10086390 DOI: 10.2147/copd.s402122] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/27/2023] [Indexed: 04/15/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD), a heterogeneous disease, is the leading cause of death worldwide. In recent years, air pollution, especially particulate matter (PM), has been widely studied as a contributing factor to COPD. As an essential component of PM, PM2.5 is associated with COPD prevalence, morbidity, and acute exacerbations. However, the specific pathogenic mechanisms were still unclear and deserve further research. The diversity and complexity of PM2.5 components make it challenging to get its accurate effects and mechanisms for COPD. It has been determined that the most toxic PM2.5 components are metals, polycyclic aromatic hydrocarbons (PAHs), carbonaceous particles (CPs), and other organic compounds. PM2.5-induced cytokine release and oxidative stress are the main mechanisms reported leading to COPD. Nonnegligibly, the microorganism in PM 2.5 may directly cause mononuclear inflammation or break the microorganism balance contributing to the development and exacerbation of COPD. This review focuses on the pathophysiology and consequences of PM2.5 and its components on COPD.
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Affiliation(s)
- Qi Wang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, People’s Republic of China
| | - Sha Liu
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, People’s Republic of China
- Correspondence: Sha Liu, Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, 35 Jiefang Avenue, Zhengxiang District, Hengyang, Hunan, 421001, People’s Republic of China, Email
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Xu J, Ji Z, Zhang P, Chen T, Xie Y, Li J. Disease burden of COPD in the Chinese population: a systematic review. Ther Adv Respir Dis 2023; 17:17534666231218899. [PMID: 38146618 PMCID: PMC10752056 DOI: 10.1177/17534666231218899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/17/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. OBJECTIVES This systematic review aimed to evaluate the disease burden of COPD in the Chinese population and to determine the factors influencing the economic burden of the disease. DESIGN This is a systematic review study. DATA SOURCES AND METHODS We searched PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, WANGFANG Data, and VIP databases for studies regarding the disease burden of COPD in mainland China published before 31 December 2022. The Agency for Healthcare Research and Quality's recommendation rating tool assessed the cross-sectional studies' risk of bias. RESULTS A total of 45 studies were included. The disability-adjusted life years (DALYs) for COPD have generally decreased in the Chinese population over the past 30 years. The total number of DALYs due to COPD in China decreased from 26.12 million person-years to 19.92 million person-years, with an annual decline rate of 0.9%. Subjects aged 40 years and older make up the majority of those with COPD in the Chinese population, and the condition is more prevalent among males than females, in rural areas than urban places, and in the West than the East. The median direct medical cost of COPD ranges from 150 to 2014 USD per capita per year. Among 23 influencing factors, age, hospitalization days, hospital type, gender, and career were the most significant variables that had an impact on the economic burden of COPD patients. CONCLUSION The overall burden of COPD in China has been decreasing over the past 30 years. But there is a lack of standardized indicators for the economic burden of COPD patients in China, and it is recommended to establish a unified standard. REGISTRATION The systematic review protocol was prospectively registered with PROSPERO (No. CRD42023393429).
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Affiliation(s)
- Jiaxin Xu
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Zile Ji
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Peng Zhang
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Tao Chen
- Center for Health Economics, University of York, York, UK
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-construction by Henan Province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China
| | - Yang Xie
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, 19 Renmin Road, Jinshui District, Zhengzhou, Henan 450046, China
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-construction by Henan province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China
| | - Jiansheng Li
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-construction by Henan Province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China
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Guo Y, Bai J, Zhang X, Jin Q, Liu Y, Yu C. Secular Trends of Mortality and Years of Life Lost Due to Chronic Obstructive Pulmonary Disease in Wuhan, China from 2010 to 2019: Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10685. [PMID: 36078400 PMCID: PMC9518558 DOI: 10.3390/ijerph191710685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) has been an important public health issue in China. This study aimed to analyze the temporal trends in mortality and years of life lost (YLL) from COPD, and explore the effects of age, period, and cohort in Wuhan, China from 2010 to 2019. METHODS Data were collected from the cause of death surveillance system in Wuhan. Age-standardized mortality rate (ASMR), age-standardized YLL rate (ASYR) and the estimated annual percent changes (EAPC) were calculated to evaluate the temporal trends. The age-period-cohort (APC) model was adopted to estimate the age, period, and cohort effects. RESULTS From 2010 to 2019, COPD accounted for 26,051.15 deaths and 394,659.58 person years YLL in Wuhan. Recently, the death burden of COPD in Wuhan has somewhat improved, especially after 2015, with declining trends in ASMR and ASYR. Additionally, the ASMR and ASYR of COPD was higher in males. And these of males showed the overall upward trends, with EAPCs of 1.06 (0.13, 2.00) and 1.21 (0.12, 2.31), respectively, while females showed downward trends since 2010. According to APC model, the age effect of COPD increased with age, and the cohort risk ratios (RRs) followed the overall downward trends. Period RRs for the Wuhan population generally tended to rise and then fall, with females showing a clear downward trend after 2015, while period RRs for males maintained an upward trend throughout the study period. CONCLUSIONS Recently, the death burden from COPD in Wuhan has improved, especially after 2015, with improvements in ASMR, ASYR and period RRs. Sex differences still exist. COPD posed a greater threat to the elderly, especially males. Public health managers should continue to execute more targeted programs to lessen the death burden of COPD in Wuhan.
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Affiliation(s)
- Yan Guo
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Jianjun Bai
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xiaoxia Zhang
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Qiman Jin
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Yijun Liu
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Chuanhua Yu
- School of Public Health, Wuhan University, Wuhan 430071, China
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