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Liu Y, Zhou X, Ding N, Song S, Gittelsohn J, Jiang N, Sundermeir SM, Ma Y, Wen D. Obesity contagion among classmates: Children's relation with each other regarding weight status, physical activity, and dietary intake. SSM Popul Health 2024; 26:101636. [PMID: 38516526 PMCID: PMC10955631 DOI: 10.1016/j.ssmph.2024.101636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
A series of influential articles suggests that obesity may spread between couples, siblings, and close friends via an obesity contagion phenomenon. Classmates, as important structural equivalents in one's social network, may experience obesity contagion. However, this has rarely been examined. Anthropometric measurements, questionnaire surveys, and geographic information were collected from 3670 children from 26 schools in Northeast China. We found that classmates were positively related in terms of body mass index (BMI), body fat, physical activity, and intake of vegetables, fruits, fast food, snacks, and sugar-sweetened beverages. One standard deviation (SD) increase in classmates' mean BMI and percentage body fat was associated with 0.19 SD higher individual BMI (95% confidence interval [CI]: 0.00, 0.39) and 0.31 SD higher percentage body fat (95% CI: 0.13, 0.48). Coefficients ranged from 0.48 to 0.76 in models for physical activity, and the dietary intake of vegetables, fruit, fast food, snacks, and sugar-sweetened beverages. Children's BMI and body fat were more strongly associated with the maximum and minimum body fat levels of their same-sex classmates than with those of their general classmates. Their dietary intake and physical activity were more strongly associated with the mean/median levels of their general classmates than with those of their same-sex classmates. This study suggests that children's BMI, body fat, physical activity, and dietary intake may be related to those of their classmates. Modeling healthy behaviors in the classroom may help children develop habits that support achieving and maintaining a healthy weight. Future interventions should consider the inclusion of classmates as a social network strategy for obesity prevention.
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Affiliation(s)
- Yang Liu
- China Medical University, Health Sciences Institute, Address: No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, PR China
| | - Xiaobei Zhou
- China Medical University, Health Sciences Institute, Address: No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, PR China
| | - Ning Ding
- China Medical University, Institute of International Medical Education, Address: No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, PR China
| | - Shenzhi Song
- China Medical University, Health Sciences Institute, Address: No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, PR China
| | - Joel Gittelsohn
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Human Nutrition Center, Address: 615 North Wolfe St, Baltimore, MD, 21205-2179, USA
| | - Nan Jiang
- China Medical University, Institute of International Medical Education, Address: No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, PR China
| | - Samantha M. Sundermeir
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Human Nutrition Center, Address: 615 North Wolfe St, Baltimore, MD, 21205-2179, USA
| | - Yanan Ma
- China Medical University, School of Public Health, Address: No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, PR China
| | - Deliang Wen
- China Medical University, Health Sciences Institute, Address: No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, PR China
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Yu Y, Yang J, Zheng L, Su H, Cao S, Jiang X, Liu X, Liu W, Wang Z, Meng F, Xu H, Wen D, Sun C, Song X, Vidal-Puig A, Cao L. Dysfunction of Akt/FoxO3a/Atg7 regulatory loop magnifies obesity-regulated muscular mass decline. Mol Metab 2024; 81:101892. [PMID: 38331318 PMCID: PMC10876605 DOI: 10.1016/j.molmet.2024.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Myoprotein degradation accelerates in obese individuals, resulting in a decline in muscular mass. Atg7 plays a crucial role in regulating protein stability and function through both autophagy-dependent and independent pathways. As obesity progresses, the expression of Atg7 gradually rises in muscle tissue. Nonetheless, the precise impact and mechanism of Atg7 in promoting muscle mass decline in obesity remain uncertain. The study aimed to elucidate the role and underly mechanism of Atg7 action in the context of obesity-induced muscle mass decline. METHODS In this study, we established a murine model of high-fat diet-induced obesity (DIO) and introduced adeno-associated virus delivery of short hairpin RNA to knock down Atg7 (shAtg7) into the gastrocnemius muscle. We then examined the expressions of Atg7 and myoprotein degradation markers in the gastrocnemius tissues of obese patients and mice using immunofluorescence and western blotting techniques. To further investigate the effects of Atg7, we assessed skeletal muscle cell diameter and the myoprotein degradation pathway in C2C12 and HSkMC cells in the presence or absence of Atg7. Immunofluorescence staining for MyHC and western blotting were utilized for this purpose. To understand the transcriptional regulation of Atg7 in response to myoprotein degradation, we conducted luciferase reporter assays and chromatin immunoprecipitation experiments to examine whether FoxO3a enhances the transcription of Atg7. Moreover, we explored the role of Akt in Atg7-mediated regulation and its relevance to obesity-induced muscle mass decline. This was accomplished by Akt knockdown, treatment with MK2206, and GST pulldown assays to assess the interaction between Atg7 and Akt. RESULTS After 20 weeks of being on a high-fat diet, obesity was induced, leading to a significant decrease in the gastrocnemius muscle area and a decline in muscle performance. This was accompanied by a notable increase in Atg7 protein expression (p < 0.01). Similarly, in gastrocnemius tissues of obese patients when compared to nonobese individuals, there was a significant increase in both Atg7 (p < 0.01) and TRIM63 (p < 0.01) levels. When palmitic acid was administered to C2C12 cells, it resulted in increased Atg7 (p < 0.01), LC3Ⅱ/Ⅰ (p < 0.01), and p62 levels (p < 0.01). Additionally, it promoted FoxO3a-mediated transcription of Atg7. The knockdown of Atg7 in the gastrocnemius partially reversed DIO-induced muscle mass decline. Furthermore, when Atg7 was knocked down in C2C12 and HSkMC cells, it mitigated palmitic acid-induced insulin resistance, increased the p-Akt/Akt ratio (p < 0.01), and reduced TRIM63 (p < 0.01). Muscular atrophy mediated by Atg7 was reversed by genetic knockdown of Akt and treatment with the p-Akt inhibitor MK2206. Palmitic acid administration increased the binding between Atg7 and Akt (p < 0.01) while weakening the binding of PDK1 (p < 0.01) and PDK2 (p < 0.01) to Akt. GST pulldown assays demonstrated that Atg7 directly interacted with the C-terminal domain of Akt. CONCLUSION The consumption of a high-fat diet, along with lipid-induced effects, led to the inhibition of Akt signaling, which, in turn, promoted FoxO3a-mediated transcription, increasing Atg7 levels in muscle cells. The excess Atg7 inhibited the phosphorylation of Akt, leading to a cyclic activation of FoxO3a and exacerbating the decline in muscle mass regulated by obesity. Consequently, Atg7 serves as a regulatory point in determining the decline in muscle mass induced by obesity.
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Affiliation(s)
- Yang Yu
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Jing Yang
- College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Lixia Zheng
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Han Su
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Sunrun Cao
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Xuehan Jiang
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Xiyan Liu
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Weiwei Liu
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China
| | - Zhuo Wang
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Fang Meng
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Hongde Xu
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China
| | - Chen Sun
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China.
| | - Xiaoyu Song
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China.
| | - Antonio Vidal-Puig
- MRC Metabolic Diseases Unit, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, CB2 1TN, Cambridge, UK; Centro de Investigacion Principe Felipe, Valencia, Spain; Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, China.
| | - Liu Cao
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China; College of Basic Medical Science, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang 110122, Liaoning, China.
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Sang L, Xu Y, Huang Y, Li Z, Wen D, Liu C, Wang Y, Xian L, Cheng L, Ye F, Wu H, Deng X, Li Y, Ye W, Zhong N, Li Y, Li S, Liu X. More attention should be paid to Omicron-associated sepsis: a multicenter retrospective study in south China. J Thorac Dis 2024; 16:1313-1323. [PMID: 38505014 PMCID: PMC10944721 DOI: 10.21037/jtd-23-808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/19/2024] [Indexed: 03/21/2024]
Abstract
Background The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly transmissible but causes less severe disease compared to other variants. However, its association with sepsis incidence and outcomes is unclear. This study aimed to investigate the incidence of Omicron-associated sepsis, as per the Sepsis 3.0 definition, in hospitalized patients, and to explore its relationship with clinical characteristics and prognosis. Methods This multicenter retrospective study included adults hospitalized with confirmed SARS-CoV-2 infection across six tertiary hospitals in Guangzhou, China from November 2022 to January 2023. The Sequential Organ Failure Assessment (SOFA) score and its components were calculated at hospital admission to identify sepsis. Outcomes assessed were need for intensive care unit (ICU) transfer and mortality. Receiver operating characteristic curves evaluated the predictive value of sepsis versus other biomarkers for outcomes. Results A total of 299 patients (mean age: 70.1±14.4 years, 42.14% female) with SOFA score were enrolled. Among them, 152 were categorized as non-serious cases while the others were assigned as the serious group. The proportion of male patients, unvaccinated patients, patients with comorbidity such as diabetes, chronic cardiovascular disease, and chronic lung disease was significantly higher in the serious than non-serious group. The median SOFA score of all enrolled patients was 1 (interquartile range, 0-18). In our study, 147 patients (64.19%) were identified as having sepsis upon hospital admission, with the majority of these septic patients (113, representing 76.87%) being in the serious group, the respiratory, coagulation, cardiovascular, central nervous, and renal organ SOFA scores were all significantly higher in the serious compared to the non-serious group. Among septic patients, 20 out of 49 (40.81%) had septic shock as indicated by lactate measurement within 24 hours of admission, and the majority of septic patients were in the serious group (17/20, 76.87%). Sepsis was present in 118 out of 269 (43.9%) patients in the general ward, and among those with sepsis, 34 out of 118 (28.8%) later required ICU care during hospitalization. By contrast, none of the patients without sepsis required ICU care. Moreover, the mortality rate was significantly higher in patients with than without sepsis. Conclusions A considerable proportion of patients infected with Omicron present with sepsis upon hospital admission, which is associated with a poorer prognosis. Therefore, early recognition of viral sepsis by evaluation of the SOFA score in hospitalized coronavirus disease 2019 patients is crucial.
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Affiliation(s)
- Ling Sang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou National Lab, Guangzhou, China
| | - Yonghao Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yongbo Huang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhengtu Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Deliang Wen
- Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou Medical, Guangzhou, China
| | - Changbo Liu
- Department of Critical Medicine, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yichun Wang
- Department of Critical Care Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lewu Xian
- Department of Intensive Care Unit, Affiliate Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
| | - Linling Cheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongkai Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xilong Deng
- Department of Critical Care Medicine, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yueping Li
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Weiyan Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou National Lab, Guangzhou, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yimin Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou National Lab, Guangzhou, China
| | - Shiyue Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoqing Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Song X, Ding N, Jiang N, Zhang X, Li H, Wen D. Moral distress from professionalism dilemmas and its association with self-rated professionalism behaviors among Chinese residents. Med Teach 2024:1-10. [PMID: 38329725 DOI: 10.1080/0142159x.2024.2307486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Residents inevitably witness or participate in a diverse range of professionalism dilemmas. However, few studies have focused on residents' moral distress from professionalism dilemmas and its relationship with residents' professionalism. This study aimed to understand the moral distress that Chinese residents may face after exposure to professionalism dilemmas and to examine the associations between moral distress and residents' perceived fulfillment of professionalism behaviors. METHODS We conducted a cross-sectional survey of residents from four standardized residency training bases in Liaoning Province, China, using stratified cluster sampling. A checklist of professionalism dilemmas, the Moral Distress Scale, and the Behavior-based Medical Professionalism Inventory were used to assess residents' moral distress from professionalism dilemmas and their perceived fulfillment of professionalism behaviors. Descriptive statistics, non-parametric tests, multiple linear regressions, and binary logistic regressions were used to analyze the data. RESULTS A total of 647 (81.1%) residents effectively completed the survey. The proportion of residents suffering from moral distress ranged from 58.4 to 90.6% for different professionalism dilemmas. As the number of professionalism dilemmas associated with moral distress increased, residents reported lower fulfillment of professionalism behaviors (β < 0, p < 0.05). Compared with residents with no distress, residents suffering from distress reported lower fulfillment of professionalism behaviors (OR < 1, p < 0.05). Among residents suffering from distress, as the distress intensity increased, residents reported higher fulfillment of professionalism behaviors (OR > 1, p < 0.05). CONCLUSIONS Residents suffered a wide range of moral distress from professionalism dilemmas, and residents with moral distress reported lower fulfillment of professional behaviors. A responsive reporting system for residents and reflection on role modeling may help residents cope with the negative effects of moral distress and professionalism dilemmas.
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Affiliation(s)
- Xinzhi Song
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, P. R. China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, P. R. China
| | - Nan Jiang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, P. R. China
| | - Xu Zhang
- Department of Public Service, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, P. R. China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, P. R. China
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Peng W, Zhang L, Wen F, Tang X, Zeng L, Chen J, Galea G, Wen D, Wang Y. Trends and disparities in non-communicable diseases in the Western Pacific region. Lancet Reg Health West Pac 2024; 43:100938. [PMID: 38456093 PMCID: PMC10920054 DOI: 10.1016/j.lanwpc.2023.100938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/03/2023] [Accepted: 09/29/2023] [Indexed: 03/09/2024]
Abstract
The WHO Western Pacific region bears disproportionate deaths from non-communicable diseases (NCDs), with increased overall NCD proportional mortality over the past two decades. The disease burden of mental health increased, resulting from rapid ageing, enhanced stress, and the COVID-19 pandemic, but it was largely neglected. The highly diverse cultures, religions, political systems, socioeconomic contexts, lifestyles, and environmental factors probably have led to massive disparities across countries in NCD mortality, risk factors, and NCD management. Geographically, East Asia had the lowest NCD mortality whilst Pacific islands had the highest. Economic booms, ageing, nutrition transition, social stress, prevalent tobacco use, and fast-increasing obesity and hyperglycaemia are important drivers of NCDs. Men tended to have more adverse behavioural and metabolic risk factors. Rural residents are catching up with their urban counterparts in metabolic risk factors and conditions. Sustainable strategies tailored to NCD patterns are needed to fight the NCD epidemic and related disparities.
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Affiliation(s)
- Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, People's Republic of China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, No. 16 Kunlun Road, Xining 810008, People's Republic of China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmenwai, Beijing 100069, People's Republic of China
| | - Fuyuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmenwai, Beijing 100069, People's Republic of China
| | - Xiao Tang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, People's Republic of China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, No. 16 Kunlun Road, Xining 810008, People's Republic of China
| | - Lingxia Zeng
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi'an Jiaotong University, Xi'an 710061, People's Republic of China
| | - Jiapeng Chen
- China Population and Development Research Center, No. 12 Dahuisi Road, Beijing, 100081, People's Republic of China
| | - Gauden Galea
- WHO China Representative Office, No. 23 Dongzhimenwai Street, Beijing 100600, People's Republic of China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, People's Republic of China
| | - Youfa Wang
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi'an Jiaotong University, Xi'an 710061, People's Republic of China
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Wei X, Hu J, Wen D. The risk prediction of intergenerational transmission of overweight and obesity between mothers and infants during pregnancy. BMC Pregnancy Childbirth 2024; 24:74. [PMID: 38254080 PMCID: PMC10804797 DOI: 10.1186/s12884-024-06268-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Overweight and obesity in mothers before pregnancy lead to overweight and obesity in their offspring, which is the main form of intergenerational transmission of overweight and obesity in early life. Many factors, especially non-genetic factors, may influence intergenerational transmission, but little prediction research has been conducted. Therefore, we analyzed the status of intergenerational transmission in maternal and infant overweight and obesity. Second, we explored the factors during the pregnancy that might affect the the intergenerational transmission; According to the two application scenarios of pregnancy screen and self-management, risk prediction models for pregnant women were carried out. METHODS Based on a prospective birth cohort, a total of 908 mothers and offspring were followed up during early life. Follow-up visits were performed at the first trimester, second trimester, third trimester, delivery, 42 days after delivery, and 6 months and 12 months of age. The investigation methods included questionnaire survey, physical examination, biological sample collection and clinical data collection. In terms of risk prediction, univariate analysis was used to screen candidate predictors. Second, multivariable Cox proportional hazard regression models were used to determine the final selected predictors. Third, the corresponding histogram models were drawn, and then the 10-fold cross-validation methods were used for internal verification. RESULTS Regarding intergenerational transmission of overweight and obesity between mothers and infants during pregnancy, the risk prediction model for pregnancy screen was constructed. The model established: h(t|X) = h0(t)exp.(- 0.95 × (Bachelor Degree or above) + 0.75 × (Fasting blood glucose in the second trimester) + 0.89 × (Blood pressure in the third trimester) + 0.80 × (Cholesterol in third trimester) + 0.55 × (Abdominal circumference in third trimester))., with good discrimination (AUC = 0.82) and calibration (Hosmer-Lemeshow2 = 4.17). The risk prediction model for self-management was constructed. The model established: h(t|X) = h0(t)exp. (0.98 × (Sedentary >18METs) + 0.88 × (Sleep index≥8) + 0.81 × (Unhealthy eating patterns Q3/Q4) + 0.90 × (Unhealthy eating patterns Q4/Q4) + 0.85 × (Depression)), with good discrimination (AUC = 0.75) and calibration (Hosmer-Lemeshow2 = 3.81). CONCLUSIONS The risk predictions of intergenerational transmission of overweight and obesity between mothers and infants were performed for two populations and two application scenarios (pregnancy screening and home self-management). Further research needs to focus on infants and long-term risk prediction models.
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Affiliation(s)
- Xiaotong Wei
- Institute of International Health Professions Education and Research, China Medical University, Shenyang, 110122, Liaoning Province, China
| | - Jiajin Hu
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning Province, China
| | - Deliang Wen
- Institute of International Health Professions Education and Research, China Medical University, Shenyang, 110122, Liaoning Province, China.
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Hu J, Liu B, Cui H, Liu Y, Wan N, Li L, Zheng L, Wang X, Yang Z, Ma Y, Liu C, Qiao C, Wen D. Dose-response associations of maternal prenatal noise exposure duration with antepartum depression status. BMC Pregnancy Childbirth 2024; 24:7. [PMID: 38166840 PMCID: PMC10759523 DOI: 10.1186/s12884-023-06200-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Antepartum depression has been reported to be associated with the intensity of maternal prenatal noise exposure; however, the association between noise exposure duration and the development of antepartum depression has not been established. This study aimed to determine the total and trimester-specific association of prenatal noise exposure duration with the development of antepartum depression. METHODS From May 2018 to June 2021, we recruited 2,166 pregnant women from Shengjing Hospital, northeast China. We used a standardized questionnaire to assess women's prenatal noise exposure and used the Edinburgh Postnatal Depression Scale to assess pregnant women's antepartum depression during the 1st -, 2nd -, and 3rd - trimesters. We calculated a cumulative noise exposure score ranging from 0 to 3, with a higher score reflecting higher frequency and longer duration of noise exposure during pregnancy. RESULTS Women who were exposed to noise for ≥ 15 min per day had an increased risk of antepartum depression compared with women who were not exposed to noise during pregnancy [odds ratio (OR) = 1.83, 95%CI:1.18, 2.83]. Noise exposure in a specific trimester was associated with higher risk of depression in the same trimester and subsequent trimesters. We observed increases in antepartum depression risk with increasing cumulative noise exposure scores (P for trend < 0.05 for all). Pregnant women with the highest scores had the highest risk of antepartum depression during the first (OR = 1.30, 95%CI:1.02, 1.65), second (OR = 1.75, 95%CI:1.23, 2.50) trimesters. Women with a cumulative noise exposure score of 2 had the highest risk of antepartum depression during the third trimester (OR = 1.79, 95%CI:1.14, 2.80), as well as during the whole pregnancy (OR = 1.94, 95%CI:1.14, 3.30). CONCLUSIONS Maternal prenatal noise exposure duration was positively associated with antepartum depression risk in a dose-response manner. It is necessary to develop strategies by which pregnant women can avoid excessive exposure to noise to prevent antepartum depression.
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Affiliation(s)
- Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA, 02215, USA
| | - Borui Liu
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Hong Cui
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China
| | - Yilin Liu
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China
| | - Ningyu Wan
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Lin Li
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China
| | - Lu Zheng
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Xiaochuan Wang
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Zhe Yang
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Caixia Liu
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China.
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China.
| | - Chong Qiao
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China.
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China.
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, 110122, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China.
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, 110122, China.
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Yang Q, Kong T, Bao Z, Yang S, Chen X, Zheng J, Xiong X, Wen D, Zhang Z. Association between the β-blocker use and patients with sepsis: a cohort study. Front Med (Lausanne) 2023; 10:1272871. [PMID: 37964887 PMCID: PMC10641384 DOI: 10.3389/fmed.2023.1272871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Objective This study aimed to assess whether β-blockers are associated with mortality in patients with sepsis. Method We conducted a retrospective cohort study of patients with sepsis using the Medical Information Market for Intensive Care (MIMIC)-IV and the emergency intensive care unit (eICU) databases. The primary outcome was the in-hospital mortality rate. The propensity score matching (PSM) method was adopted to reduce confounder bias. Subgroup and sensitivity analyses were performed to test the stability of the conclusions. Results We included a total of 61,751 patients with sepsis, with an overall in-hospital mortality rate of 15.3% in MIMIC-IV and 13.6% in eICU. The inverse probability-weighting model showed that in-hospital mortality was significantly lower in the β-blockers group than in the non-β-blockers group [HR = 0.71, 95% CI: 0.66-0.75, p < 0.001 in MIMIC-IV, and HR = 0.48, 95% CI: 0.45-0.52, p < 0.001 in eICU]. In subgroups grouped according to sex, age, heart rate, APSIII, septic shock, and admission years, the results did not change. Conclusion β-blocker use is associated with lower in-hospital mortality in patients with sepsis, further randomized trials are required to confirm this association.
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Affiliation(s)
| | | | | | | | | | | | | | - Deliang Wen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Chen S, Li H, Wen D. Social Support and Daytime Sleepiness Among Chinese Medical Students: Mediating Roles of Loneliness and Problematic Smartphone Use. Psychol Res Behav Manag 2023; 16:4083-4093. [PMID: 37817912 PMCID: PMC10561758 DOI: 10.2147/prbm.s432400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Background Sleep problems have become a serious threat to public health worldwide. Daytime sleepiness is an important indicator of many sleep problems, which have a significant impact on academic performance, physical and mental health, and wellbeing among medical students. We aimed to explore the factors associated with daytime sleepiness among medical students. Methods We conducted a cross-sectional survey of 466 medical students recruited via convenience sampling. Self-rated psychometric scales, including the Social Support Rate Scale, the Epworth Sleepiness Scale, the Chinese version of the UCLA loneliness scale, and the Mobile Phone Addiction Index (MPAI), were utilized to evaluate social support, daytime sleepiness, loneliness, and problematic smartphone use. A sequential mediation model was constructed with daytime sleepiness as the dependent variable, social support as the independent variable, and loneliness and problematic smartphone use as mediating variables. Age, gender, and grade were taken as covariates. Results Social support among medical students was negatively associated with loneliness, problematic smartphone use, and daytime sleepiness (p < 0.01). A sequential mediation analysis showed that loneliness (the first mediator) and problematic smartphone use (the second mediator) sequentially mediated the path from social support to daytime sleepiness among medical students (β = -0.008; 95% CI = -0.016, -0.002). Moreover, there were also significant mediating roles observed in the relationship between social support and daytime sleepiness via loneliness only (β = -0.037; 95% CI = -0.062, -0.015) and problematic smartphone use only (β = -0.022; 95% CI = -0.041, -0.008). Conclusion Social support, loneliness, and problematic smartphone use among medical students influenced their daytime sleepiness. Interventions targeting medical student loneliness and problematic smartphone use behaviors might attenuate the effects from low levels of social support and further improve daytime sleepiness.
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Affiliation(s)
- Sijian Chen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
- School of Nursing, China Medical University, Shenyang, People’s Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
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Hu J, Li M, Li C, Yin S, Tao L, Li L, Wan N, Liu Y, Liu B, Zheng L, Wang X, Yang Z, Ma Y, Qiao C, Wen D, Liu C. Trimester-specific associations of maternal dietary patterns with preterm birth: China Medical University birth cohort study. Food Funct 2023; 14:7682-7691. [PMID: 37540124 DOI: 10.1039/d3fo00691c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
The trimester-specific associations of maternal dietary patterns with preterm birth (PTB) are unclear. In a prospective prebirth cohort study, we aimed to examine the critical time window of maternal prenatal dietary patterns and the risk of PTB. We assessed prenatal dietary intake among 1500 pregnant women with validated food frequency questionnaires during the 1st, 2nd and 3rd trimester, respectively. We used logistic regression models and generalized estimating equation models to examine the trimester-specific associations and longitudinal associations between maternal dietary patterns in relation to risk of PTB and PTB subtypes. The incidence rate of PTB was 11.9% (179 out of 1500 pregnant women) in the present study. We observed that maternal adherence to a fish-seafood pattern in the 1st trimester was associated with higher risk of PTB [tertile 3 (T3) vs. tertile 1 (T1): OR = 2.29, 95% CI: 1.32-3.96] and iatrogenic preterm birth (IPTB) (T3 vs. T1: OR = 2.26, 95% CI: 1.21-4.20), while a fish-seafood pattern in the 2nd trimester was associated with lower risk of PTB (T3 vs. T1: OR = 0.49, 95% CI: 0.25-0.93). Maternal adherence to a dairy-egg pattern in the 2nd or 3rd trimester was associated with higher risks of PTB and IPTB. No dietary patterns were associated with spontaneous preterm birth. Our findings provide new evidence that specific dietary patterns during different trimesters may have different and even inverse health effects on pregnant women. This supports the necessity of guiding the maternal diet according to different periods of pregnancy to prevent PTB.
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Affiliation(s)
- Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
| | - Meihui Li
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
- Department of Obstetrics & Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
| | - Chuang Li
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
- Department of Obstetrics & Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
| | - Shaowei Yin
- Department of Obstetrics & Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
| | - Lin Tao
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
| | - Lin Li
- Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, China Medical University, Shenyang, China
| | - Ningyu Wan
- Health Sciences Institute, China Medical University, Shenyang, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
| | - Yilin Liu
- Department of Obstetrics & Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Borui Liu
- Health Sciences Institute, China Medical University, Shenyang, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
| | - Lu Zheng
- Health Sciences Institute, China Medical University, Shenyang, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
| | - Xiaochuan Wang
- Health Sciences Institute, China Medical University, Shenyang, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
| | - Zhe Yang
- Health Sciences Institute, China Medical University, Shenyang, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Chong Qiao
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
- Department of Obstetrics & Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, China
| | - Caixia Liu
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China.
- Department of Obstetrics & Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
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Chen S, Li H, Pang L, Wen D. The Relationship Between Social Media Use and Negative Emotions Among Chinese Medical College Students: The Mediating Role of Fear of Missing Out and the Moderating Role of Resilience. Psychol Res Behav Manag 2023; 16:2755-2766. [PMID: 37492860 PMCID: PMC10363671 DOI: 10.2147/prbm.s421404] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023] Open
Abstract
Objective This study aimed to examine the mediating role of fear of missing out (FoMO) and the moderating role of resilience in the association between social media use and negative emotions among medical college students in China during the COVID-19 pandemic. Participants and Methods A cross-sectional study design was conducted, medical college students from Qiqihar Medical University, China participated in the study. A total of 470 medical college students were recruited voluntarily to complete questionnaires on social media use, FoMO, resilience, and negative emotions. Results Social media use was positively associated with FoMO and negative emotions among medical students (p < 0.01). The total effect of social media use on negative emotions was significant (β = 1.101, SE = 0.079, p < 0.001). Social media use had no significant direct effect on negative emotions (β = 0.168, SE = 0.096, p > 0.05), but it had an indirect effect on negative emotions via mediation of FoMO (β = 0.933, SE = 0.106, 95% CI: 0.731 to 1.149). Moreover, resilience had a significant moderating effect on the relationship between FoMO and negative emotions (β = -0.021, SE = 0.005, 95% CI: -0.032 to -0.012). FoMO had a significant positive predictive effect on negative emotions at both levels of resilience (low resilience individuals: β = 1.079, SE = 0.076, p < 0.001; high resilience individuals: β = 0.212, SE = 0.094, p < 0.05). Conclusion Social media use and FoMO may be risk factors for increased negative emotions, and resilience should be considered in prevention and intervention strategies designed to mitigate negative emotions among medical college students.
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Affiliation(s)
- Sijian Chen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
- School of Nursing, China Medical University, Shenyang, People’s Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
| | - Lihong Pang
- School of Nursing, Qiqihar Medical University, Qiqihar, People’s Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
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Zhang M, Ma Y, Xie X, Sun M, Huang Z, Zhao Z, Zhang X, Li C, Gao X, Wu J, Wang L, Zhou M, Wen D. Trends in insufficient physical activity among adults in China 2010-18: a population-based study. Int J Behav Nutr Phys Act 2023; 20:87. [PMID: 37460936 DOI: 10.1186/s12966-023-01470-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/19/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The global prevalence of insufficient physical activity (PA) was reported to be 27.5% in 2016, and there were stable levels of insufficient PA worldwide between 2001 and 2016. The global target of a 10% reduction in insufficient PA by 2025 will not be met if the trends remain. The relevant data for trends in China were still scarce. This study aimed to determine nationwide temporal trends in insufficient PA among adults in China from 2010 to 2018. METHODS 645 903 adults aged 18 years or older were randomly selected from four nationally representative cross-sectional surveys of the China Chronic Disease and Risk Factor Surveillance conducted in 2010, 2013, 2015, and 2018. PA was measured using the Global Physical Activity Questionnaire. Temporal changes in insufficient PA prevalence and participation of domain-specific moderate- to vigorous-intensity PA (MVPA) were analyzed using logistic regression. RESULTS From 2010 to 2018, the age-adjusted prevalence of insufficient PA in China increased from 17.9% (95% confidence interval 16.3% to 19.5%) in 2010 to 22.3% (20.9% to 23.8%) in 2018 (P for trend < 0.001). By age group, with a significant increase in insufficient PA in adults aged 18-34 years (P for trend < 0.001), which rose more rapidly than in adults aged ≥ 35 years (P for interaction < 0.001). Insufficient PA has increased significantly among adults engaged in agriculture-related work, non-manual work, and other manual work (all P for trend < 0.05). And among the occupational groups, those engaged in agriculture-related work had the fastest increase (P for interaction = 0.01). The percentage of adults participating in work-related MVPA decreased from 79.6% (77.8% to 81.5%) to 66.8% (64.9% to 68.7%) along with a decrease in time spent on work-related MVPA, while percentages of adults participating in recreation-related MVPA increased from 14.2% (12.5% to 15.9%) to 17.2% (16.0% to 18.4%) (all P for trend < 0.05). CONCLUSIONS Among Chinese adults, an increasing trend was found in insufficient PA from 2010 to 2018, with more than one-fifth of adults failing to achieve the recommendation of adequate PA. More targeted PA promotion strategies should be developed to improve population health.
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Affiliation(s)
- Mei Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
- Health Sciences Institute, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, No. 77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Xili Xie
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Ming Sun
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Zhengjing Huang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhenping Zhao
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Xiao Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Chun Li
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Xingxing Gao
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Jing Wu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Limin Wang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China.
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China.
| | - Deliang Wen
- Health Sciences Institute, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China.
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, No. 77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China.
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Wang S, Li H, Chen X, Yan N, Wen D. The mediating role of psychological capital in the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic: a cross-sectional study. BMC Psychiatry 2023; 23:398. [PMID: 37277718 DOI: 10.1186/s12888-023-04894-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 05/22/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic. METHODS A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms. RESULTS Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms. LIMITATIONS This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias. CONCLUSIONS Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.
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Affiliation(s)
- Simeng Wang
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, PR China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, PR China
| | - Xin Chen
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9 West Section of Lvshun South Road, Lvshunkou District, Dalian, 116044, Liaoning, PR China
| | - Nan Yan
- School of Medical Applied Technology, Shenyang Medical College, No.146 Huanghe Street, Yuhong District, Shenyang, 110034, Liaoning, PR China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, PR China.
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Liu W, Ma R, Sun C, Xu Y, Liu Y, Hu J, Ma Y, Wang D, Wen D, Yu Y. Implications from proteomic studies investigating circadian rhythm disorder-regulated neurodegenerative disease pathology. Sleep Med Rev 2023; 70:101789. [PMID: 37253318 DOI: 10.1016/j.smrv.2023.101789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
Neurodegenerative diseases (NDs) affect 15% of the world's population and are becoming an increasingly common cause of morbidity and mortality worldwide. Circadian rhythm disorders (CRDs) have been reported to be involved in the pathogenic regulation of various neurologic diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease, multiple sclerosis and amyotrophic lateral sclerosis. Proteomic technology is helpful to explore treatment targets for CRDs in patients with NDs. Here, we review the key differentially expressed (DE) proteins identified in previous proteomic studies investigating NDs, CRDs and associated models and the related pathways identified by enrichment analysis. Furthermore, we summarize the advantages and disadvantages of the above studies and propose new proteomic technologies for the precise study of circadian disorder-mediated regulation of ND pathology. This review provides a theoretical and technical reference for the precise study of circadian disorder-mediated regulation of ND pathology.
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Affiliation(s)
- Weiwei Liu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Ruze Ma
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China; Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China
| | - Chen Sun
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China; Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Yingxi Xu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Yang Liu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Jiajin Hu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Yanan Ma
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China; Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110122, Liaoning, China
| | - Difei Wang
- Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China
| | - Deliang Wen
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China.
| | - Yang Yu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China.
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Zhang Y, Tu X, Zhang Y, Wen D, Zhao F, Yuan L, Li W. [Anti-inflammatory mechanism of Balanophora involucrata: a network pharmacology and molecular docking-based analysis and verification in lipopolysaccharide-induced RAW264.7 cells]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:383-392. [PMID: 37087582 PMCID: PMC10122734 DOI: 10.12122/j.issn.1673-4254.2023.03.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
Abstract
OBJECTIVE To investigate the main chemical constituents of Balanophora involucrata and the mechanism of its antiinflammatory effect based on network pharmacology and molecular docking technology. METHODS Literature reports, Materia Medica, GeneCards and other databases were searched for anti-inflammatory compounds and their targets. String database and Cytoscape 3.7.2 software were used to obtain the protein-protein interaction (PPI) network and the drug-active ingredienttargets network and for GO and KEGG enrichment analyses. Molecular docking was performed using Auto Dock Tools 1.5.6. In an inflammatory RAW264.7 cell model induced by lipopolysaccharide (LPS), the effect of 25, 50, 100, 200 μg/mL Balanophora involucrata extract was tested on the production of inflammatory cytokines and phosphorylation level of PI3K and Akt using ELISA and Western blotting. RESULTS A total of 318 common targets of drugs and diseases were identified, and the core targets were Src, HSP90AA1 and PIK3CA, involving cancer, PI3K/Akt, MAPK and other signaling pathways as shown by KEGG analysis. Molecular docking showed that both the main active constituents of Balanophora involucrata could spontaneously bind to the core targets. In the inflammatory cell model, treatment with Balanophora involucrata extract significantly inhibited the production of IL-1β at the concentrations of 100 and 200 μg/mL, reduced IL-6 and TNF-α expressions at the concentrations of 50, 100, and 200 μg/mL, and lowered phosphorylation levels of PI3K and Akt proteins at the concentrations of 25, 50, 100, and 200 μg/mL (all P < 0.05). CONCLUSIONS The anti-inflammatory mechanism of Balanophora involucrata involves multiple targets and multiple pathways, and its effect is mediated possibly by reducing IL-1β, IL-6 and TNF-α production and inhibiting phosphorylation levels of PI3K and Akt proteins to suppress the activation of the PI3K/Akt signaling pathway.
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Affiliation(s)
- Y Zhang
- Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases (Hubei Minzu University), Enshi 445000, China
- School of Medicine, Hubei Minzu University, Enshi 445000, China
| | - X Tu
- Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases (Hubei Minzu University), Enshi 445000, China
- Chinese Medicinal Materials Products Quality Supervision and Inspection Wenter in Wuling Mountainous Area, Enshi 445000, China
| | - Y Zhang
- School of Medicine, Hubei Minzu University, Enshi 445000, China
| | - D Wen
- Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases (Hubei Minzu University), Enshi 445000, China
- Chinese Medicinal Materials Products Quality Supervision and Inspection Wenter in Wuling Mountainous Area, Enshi 445000, China
| | - F Zhao
- School of Medicine, Hubei Minzu University, Enshi 445000, China
| | - L Yuan
- Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases (Hubei Minzu University), Enshi 445000, China
- School of Medicine, Hubei Minzu University, Enshi 445000, China
| | - W Li
- School of Medicine, Hubei Minzu University, Enshi 445000, China
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Liu Y, Trude ACB, Song S, Jiang N, Wang S, Gittelsohn J, Wen D. Childhood obesity inequality in northeast China: joint effect of social economic status and school neighborhood environment. BMC Public Health 2023; 23:318. [PMID: 36782186 PMCID: PMC9926811 DOI: 10.1186/s12889-023-15194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Obesogenic environment is important in driving obesity epidemic. Children spend large amount of their time in schools. School neighborhood environment, as well as its interaction with socioeconomic status (SES) needs to be explored to provide evidence for children obesity prevention policies. METHODS Objective anthropometric measurement, a household structured questionnaire, and school geospatial analyses were carried out on 3670 children (aged 9-12 years) of 26 schools in northeast China. Interaction between SES inter-categorical intersectionality group and school neighborhood environment was tested for the effect on children's body mass index z scores (z-BMI) and waist-hip ratio z scores (z-WHR), following formulation of SES inter-categorical intersectionality group based on household wealth, parental education, and parental occupation. RESULTS SES groups formed by household wealth, parental education and parental occupation was associated with z-BMI and z-WHR for girls. Those from moderate wealth & self-employed (M&S) families had the highest adjusted z-BMI and z-WHR among all SES groups. School neighborhood environment factors interacted with SES groups in association with WHR for girls. Number of school neighborhood supermarkets and residential sites were negatively associated with z-WHR for girls from M&S families (β= -0.45 (95%CI: -0.76, -0.15) for supermarkets; β= -0.01 (95%CI: -0.03, 0.00) for residential sites). Number of school neighborhood convenience stores and public transport stops were positively associated with z-WHR for girls from M&S families (β = 0.02 (95%CI: 0.00, 0.03) for convenience stores; β = 0.23 (95%CI: 0.15, 0.31) for public transport stops). While non-significant association was found for number of vegetable stores. CONCLUSION Girls from moderate wealth & self-employed families may be the group susceptible to school neighborhood environment. Local policies targeted at improving the school neighborhood environment may be one avenue for reducing socioeconomic disparities in obesity especially for girls.
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Affiliation(s)
- Yang Liu
- grid.412449.e0000 0000 9678 1884Institute of Health Science, China Medical University, Shenyang, China
| | - Angela Cristina Bizzotto Trude
- grid.411024.20000 0001 2175 4264Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, United States
| | - Shenzhi Song
- grid.412449.e0000 0000 9678 1884Institute of Health Science, China Medical University, Shenyang, China
| | - Nan Jiang
- grid.412449.e0000 0000 9678 1884Institute of International Medical Education, China Medical University, Shenyang, China
| | - Shihan Wang
- grid.412449.e0000 0000 9678 1884School of public health, China Medical University, Shenyang, China
| | - Joel Gittelsohn
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, Human Nutrition Center, Baltimore, United States
| | - Deliang Wen
- Institute of Health Science, China Medical University, Shenyang, China.
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Song X, Jiang N, Ding N, Li H, Xin C, Qu R, Wen D. "It really puts me in a bind", professionalism dilemmas reported by Chinese residents. Adv Health Sci Educ Theory Pract 2023:10.1007/s10459-022-10198-4. [PMID: 36595184 DOI: 10.1007/s10459-022-10198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Residents play a pivotal role in the healthcare system. However, few tools have systematically revealed the dilemmas and challenges faced by residents. This study aimed to develop a checklist for professionalism dilemmas based on a behavior-based professionalism framework and to examine the range and proportion of professionalism dilemmas heard of, witnessed, or experienced by Chinese residents. Mixed methods were used, comprising qualitative (document analysis and focus group interviews) and quantitative (a small-scale questionnaire survey) data. Document analysis summarized professionalism dilemma items from previous publications. For focus group interviews, we used narrative inquiry to explore and make sense of residents' experiences and perceptions of professionalism dilemmas. A small-scale questionnaire survey was conducted during each focus group to investigate the proportion of professionalism dilemma items that residents reported to have heard of, witnessed, or experienced. Through document analysis and focus group interviews, we developed a checklist of professionalism dilemmas based on a behavior-based professionalism framework. The checklist included 58 items over four domains, with 10 sub-domains (compassion, respect, communication, collaboration, integrity, duty, pursuit of excellence, fair stewardship of health care resources, patient confidentiality, and informed consent). We also sought a preliminarily subjective impression by exploring the proportion of residents who have heard of, witnessed, and experienced each of the professionalism dilemma items and residents' perspectives when faced with professionalism dilemmas. Residents inevitably encounter or experience a diverse range of professionalism dilemmas. This checklist of professionalism dilemmas that was developed could prove to be a significant reference for targeted professionalism education, both for the resident as well as for faculty. It can also act as a helpful tool for improving hospital management guidelines and patient education.
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Affiliation(s)
- Xinzhi Song
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Nan Jiang
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Chunyu Xin
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Ruoyi Qu
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China.
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Wang S, Li H, Chen X, Yan N, Wen D. Learning burnout and its association with perceived stress, social support, and the Big Five personality traits in Chinese medical students during the COVID-19 pandemic: a cross-sectional study. BMC Psychiatry 2022; 22:785. [PMID: 36514030 PMCID: PMC9745702 DOI: 10.1186/s12888-022-04453-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Owing to the coronavirus disease 2019, medical learning burnout has attracted increasing attention in educational research. It has a serious negative impact on medical students and their service quality. This could impair the professional development of medical students; weaken their personal and professional quality; and lead to problems such as increased medical errors and reduced patient care quality and satisfaction. This study aimed to examine the effects of perceived stress, social support, and the Big Five personality traits on learning burnout among medical students. METHODS In November 2021, a cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 616 third- year students. Learning burnout, perceived stress, social support, and the Big Five personality traits (neuroticism, extroversion, openness, agreeableness, and conscientiousness) were anonymously measured. A total of 583 students were included in the final sample. Hierarchical linear regression was performed to explore the effects of perceived stress, social support, and Big Five personality traits on medical students' learning burnout. RESULTS Perceived stress was positively associated with learning burnout (emotional exhaustion: ß = 0.577, p < 0.001; cynicism: ß = 0.543, p < 0.001; low professional efficacy: ß = 0.455, p < 0.001) whereas social support was negatively related with it (low professional efficacy: ß = -0.319, p < 0.001). Neuroticism had a positive effect on emotional burnout (ß = 0.152, p = 0.009). Extraversion (ß = -0.116, p = 0.006) and conscientiousness (ß = -0.363, p < 0.001) had a negative effect on low professional efficacy. Agreeableness negatively affected emotional exhaustion (ß = -0.181, p < 0.001) and cynicism (ß = -0.245, p < 0.001) and positively affected low professional efficacy (ß = 0.098, p = 0.008). The associated factors together accounted for an additional variance of learning burnout (emotional exhaustion: 39.0%; cynicism: 36.8%; low professional efficacy: 48.7%). CONCLUSIONS Social support is a positive resource for fighting medical students' burnout. Perceived stress was the strongest indicator of learning burnout. In addition to reducing perceived stress, developing extraversion, agreeableness, and conscientiousness should be included in burnout prevention and treatment strategies, particularly for medical students.
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Affiliation(s)
- Simeng Wang
- grid.412449.e0000 0000 9678 1884Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning 110122 People’s Republic of China
| | - Honghe Li
- grid.412449.e0000 0000 9678 1884Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning 110122 People’s Republic of China
| | - Xin Chen
- grid.411971.b0000 0000 9558 1426Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9 West Section of Lvshun South Road, Lvshunkou District, Dalian, Liaoning 116044 People’s Republic of China
| | - Nan Yan
- grid.415680.e0000 0000 9549 5392School of Medical Applied Technology, Shenyang Medical College, No.146 Huanghe Street, Yuhong District, Shenyang, Liaoning 110034 People’s Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China.
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Qu R, Ding N, Li H, Song X, Cong Z, Cai R, Zhu Y, Wen D. The mediating role of general academic emotions in burnout and procrastination among Chinese medical undergraduates during the COVID-19 pandemic: A cross-sectional study. Front Public Health 2022; 10:1011801. [PMID: 36544803 PMCID: PMC9760956 DOI: 10.3389/fpubh.2022.1011801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Background Academic procrastination has become more prevalent during the COVID-19 pandemic due to teaching/learning changes. This phenomenon induces academic burnout, which is already serious among medical students. However, the academic emotion, which is the factor most vulnerable to changes in the academic environment, is still unknown. Therefore, the current study aimed to investigate the mediating role of general academic emotions in procrastination and burnout among Chinese medical students during the COVID-19 pandemic. Methods This cross-sectional study enrolled 995 medical students from China Medical University. We applied the Chinese version of the Maslach Burnout Inventory Student Survey (MBI-SS), the Aitken Procrastination Inventory (API) and the General Academic Emotion Questionnaire for College Students (GAEQ) to evaluate the variables of interest. We examined the mediation effects of GAEs by hierarchical linear regression analysis. Results Correlation analyses showed a significant positive correlation between procrastination and burnout. Procrastination and burnout positively and negatively correlated with negative academic emotions, respectively. Hierarchical linear regression analyses showed that procrastination had positive associations with negative academic emotions, while it had negative associations with positive academic emotions. The contributions (as mediators) of GAEs to burnout and procrastination were 21.16% (NAEs), 29.75% (PAEs), 54.25% (NDEs) and 23.69% (PDEs). Conclusions The results indicate that academic emotions had mediating effects on procrastination and burnout. Medical students' worries about the uncertainty of the learning environment may have exacerbated academic burnout. Targeted improvements in the teaching environment to communicate encouragement and reduce anxiety and helplessness among medical undergraduates for implementing medical education while preventing and controlling the infection.
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Affiliation(s)
- Ruoyi Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Xinzhi Song
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Zhangzhao Cong
- Department of Teaching Affairs, China Medical University, Shenyang, China
| | - Ruoxin Cai
- The First Clinical Department, China Medical University, Shenyang, China
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China,*Correspondence: Deliang Wen
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20
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Hu J, Liu Y, Ma Y, Gao M, Wan N, Li L, Liu B, Wen D. Sweet foods dietary pattern enhances negative associations of perceived indoor air quality during pregnancy with postpartum depression. Indoor Air 2022; 32:e13124. [PMID: 36437672 DOI: 10.1111/ina.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/27/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Postpartum depression (PPD) is possibly caused by indoor air pollution and may be modified by maternal diet during pregnancy. Using the data from a prospective cohort study, we examined the interaction between indoor air quality and maternal dietary patterns on PPD development. A perceived indoor air quality (PIAQ) score was used to assess indoor air pollution. A higher PIAQ score indicated a worse indoor air quality. Women with higher PIAQ scores were at increased risk for PPD (tertile 3 vs. tertile 1, odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.37-3.29). Compared with a lower adherence to a "sweet foods pattern" (OR = 1.20, 95% CI = 0.66-2.18), a higher adherence to a "sweet foods pattern" enhanced the hazardous associations of the PIAQ on PPD (OR = 3.09, 95% CI = 1.81-5.27, adjusted p for interaction = 0.044). Higher adherence to a "whole grain-seafood pattern" and lower adherence to a "traditional pattern" also increased the risk for PPD, although the p values for the interaction were not significant. Our findings provide further evidence of the link between diet during pregnancy, air pollution, and PPD, and it can be used to develop PPD prevention strategies.
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Affiliation(s)
- Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Yilin Liu
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Ming Gao
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Ningyu Wan
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Lin Li
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Borui Liu
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Liaoning Key Laboratory of Obesity and Glucose, Lipid Associated Metabolic Diseases, Shenyang, China
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Hu J, Wan N, Ma Y, Liu Y, Liu B, Li L, Liu C, Qiao C, Wen D. Trimester-specific association of perceived indoor air quality with antenatal depression: China Medical University Birth Cohort Study. Indoor Air 2022; 32:e13167. [PMID: 36437675 DOI: 10.1111/ina.13167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Antenatal depression is associated with adverse birth and long-term outcomes for mothers and children. Pregnant women spend 90% of time indoors; however, the association between indoor air quality and risk of antenatal depression has not been established. In this study, we aim to determine the total and trimester-specific association of perceived indoor air quality (PIAQ) with antenatal depression. A total of 2166 pregnant women were enrolled during the first trimester and evaluated during the second and third trimesters in the China Medical University Birth Cohort Study, a prospective pre-birth cohort study in northeastern China. PIAQ scores were obtained during each of three trimesters, which a higher score indicated a worse indoor air quality. Antenatal depression was screened using an Edinburgh Postnatal Depression Scale (EPDS) and defined as an EPDS score ≥ 9. Prevalence of antenatal depression was 26.7%, 20.6%, and 20.9% during the first, second, and third trimesters, respectively. A higher PIAQ score was positively associated with a depression score throughout pregnancy (β = 0.27, 95% CI = 0.15-0.39). Trimester-specific adverse PIAQ exposure was associated with a higher depression score in the same trimester, but not with a higher score in a subsequent trimester. A dose-response pattern and incremental increases in risk of depression were observed with calculated adverse PIAQ exposures across all three trimesters, with the highest risk (OR = 3.24; 95% CI = 2.28-4.78) among women with adverse PIAQ across all three trimesters. The hazardous association between adverse PIAQ exposure and risk of depression were less pronounced among women with higher physical activity levels (P for interaction < 0.001). The results of present study provided important evidence that pregnant women's mental health was linked to indoor air quality during pregnancy. These findings could be helpful in the development of guidelines to prevent antenatal depression by improving indoor air quality.
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Affiliation(s)
- Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Ningyu Wan
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Yilin Liu
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, China
| | - Borui Liu
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Lin Li
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, China Medical University, Shenyang, China
| | - Caixia Liu
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, China
| | - Chong Qiao
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, China
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Wen D. 77P Hypermethylation of genes HIST1H4F, Septin9 and RASSF1 as the potential biomarker for nasopharyngeal carcinoma screening. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Yang Q, Chen W, Wen Y, Zheng J, Chen J, Yu S, Chen X, Chen W, Xiong X, Wen D, Zhang Z. Association Between Wait Time of Central Venous Pressure Measurement and Outcomes in Critical Patients With Acute Kidney Injury: A Retrospective Cohort Study. Front Public Health 2022; 10:893683. [PMID: 36016902 PMCID: PMC9395608 DOI: 10.3389/fpubh.2022.893683] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/08/2022] [Indexed: 01/22/2023] Open
Abstract
Background Hemodynamic management is of paramount importance in patients with acute kidney injury (AKI). Central venous pressure (CVP) has been used to assess volume status. We intended to identify the optimal time window in which to obtain CVP to avoid the incidence of adverse outcomes in patients with AKI. Methods The study was based on the Medical Information Mart for Intensive Care (MIMIC) IV database. The primary outcome was in-hospital mortality. Secondary outcomes included the number of ICU-free days and norepinephrine-free days at 28 days after ICU admission, and total fluid input and fluid balance during the first and second day. A time-dose-response relationship between wait time of CVP measurement and in-hospital mortality was implemented to find an inflection point for grouping, followed by propensity-score matching (PSM), which was used to compare the outcomes between the two groups. Results Twenty Nine Thousand and Three Hundred Thirty Six patients with AKI were enrolled, and the risk of in-hospital mortality increased when the CVP acquisition time was >9 h in the Cox proportional hazards regression model. Compared with 8,071 patients (27.5%) who underwent CVP measurement within 9 h and were assigned to the early group, 21,265 patients (72.5%) who delayed or did not monitor CVP had a significantly higher in-hospital mortality in univariate and multivariate Cox regression analyses. After adjusting for potential confounders by PSM and adjusting for propensity score, pairwise algorithmic, overlap weight, and doubly robust analysis, the results were still stable. The HRs were 0.58-0.72, all p < 0.001. E-value analysis suggested robustness to unmeasured confounding. Conclusions Among adults with AKI in ICU, increased CVP wait time was associated with a greater risk of in-hospital mortality. In addition, early CVP monitoring perhaps contributed to shortening the length of ICU stays and days of norepinephrine use, as well as better fluid management.
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Affiliation(s)
- Qilin Yang
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weixiao Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yichao Wen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiezhao Zheng
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jieru Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuilian Yu
- Department of Rheumatology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaohua Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weiyan Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xuming Xiong
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Deliang Wen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,*Correspondence: Deliang Wen
| | - Zhenhui Zhang
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Zhenhui Zhang
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Gao L, Luo D, Wu D, Sun Q, Liu Y, Wen D, Jia L. Effects of mammalian target of rapamycin and aryl hydrocarbon receptor-mediating autophagy signaling on the balance of Th17/Treg cells during perinatal bisphenol A exposure in female offspring mice. Environ Toxicol 2022; 37:1781-1789. [PMID: 35357751 DOI: 10.1002/tox.23525] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 03/07/2022] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
Bisphenol A (BPA)'s immunotoxic properties have received increasing interest, which can lead to immune dysfunction and related disease development. However, the mechanism is not completely clear. A growing body of evidence suggests that autophagy has important roles in innate immunity, inflammatory response, and adaptive immunity. This study aimed to investigate the possible mechanisms of mammalian target of rapamycin (mTOR), aryl hydrocarbon receptor (AhR), and autophagy in Treg/Th17 imbalance induced by perinatal BPA exposure. Our results showed that the number of Th17 cells in the spleen of offspring female mice significantly increased, while the number of Treg cells decreased significantly, which was consistent with the expression levels of up-regulation of RORγt protein and a down-regulation Foxp3 protein. The levels of mTOR, p-mTOR, P62, and AhR protein expression increased, and LC3 protein decreased in spleen. However, in the thymus, we found that RORγt and Foxp3 proteins changed most significantly in the low-dose BPA group, and the same as p-mTOR and P62 protein levels. We conjectured that the potential mechanism of the imbalance of Th17/Treg upon perinatal exposure to BPA was probably associated with autophagy dysfunction. Proper autophagy plays an important role in maintaining the homeostasis of the thymic and spleen immune system.
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Affiliation(s)
- Liang Gao
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, Liaoning, China
- School of Public Health, Jinzhou medical university, Jinzhou, Liaoning, China
| | - Dan Luo
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Dan Wu
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Qi Sun
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yang Liu
- Institute of Health Science, China Medical University, Shenyang, Liaoning, China
| | - Deliang Wen
- School of Public Health, Jinzhou medical university, Jinzhou, Liaoning, China
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, Liaoning, China
| | - Lihong Jia
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, Liaoning, China
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, Liaoning, China
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Yang Q, Gao J, Zeng X, Chen J, Wen D. Relationship Between Platelet Count and In-hospital Mortality in Adult Patients With COVID-19: A Retrospective Cohort Study. Front Med (Lausanne) 2022; 9:802412. [PMID: 35775003 PMCID: PMC9238274 DOI: 10.3389/fmed.2022.802412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/19/2022] [Indexed: 01/08/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) has become a global pandemic. Systemic inflammation in COVID-19 patients has been associated with poor clinical outcome. This study aims to determine the relationship between platelet count and in-hospital mortality. Methods The original data of this study were from article development and validation of a predictive model of in-hospital mortality in COVID-19 patients. In this secondary analysis, we adopted multi-variable logistic regression analyses and smooth curve fitting to assess the independent association between platelet count and in-hospital mortality. We further applied a two-piecewise linear regression model to examine the nonlinear association between platelet count and in-hospital mortality. Results Of the 2006 patients, the average age of the participants was 65.9 ± 16.5 years and 42.6% were women. We observed a U-shaped relationship between platelet count and in-hospital mortality. We found two different slopes, the correlations between platelet count and in-hospital mortality of COVID-19 patients were totally different below and above the inflection point which was around 370 × 109/L. On the left side of the inflection point, the OR was 0.996 (OR: 0.996, 95%CI: 0.994–0.998, p < 0.001). On the right side of the inflection point, the OR was 1.011 (OR: 1.011, 95%CI: 1.001–1.021, p = 0.029). Conclusions A U-shaped association between platelet count and in-hospital mortality was found in the patients with COVID-19. The optimal of platelet count associated with the lowest risk of in-hospital mortality was around 370 × 109/L.
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Affiliation(s)
- Qilin Yang
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jun Gao
- Department of Nephrology, Peking University International Hospital, Beijing, China
| | - Xiaomei Zeng
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Junyu Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Junyu Chen
| | - Deliang Wen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Deliang Wen
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Zheng L, Xie Y, Sun Z, Zhang R, Ma Y, Xu J, Zheng J, Xu Q, Li Z, Guo X, Sun G, Xing F, Sun Y, Wen D. Serum Spermidine in Relation to Risk of Stroke: A Multilevel Study. Front Nutr 2022; 9:843616. [PMID: 35464025 PMCID: PMC9021784 DOI: 10.3389/fnut.2022.843616] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/28/2022] [Indexed: 12/29/2022] Open
Abstract
The relationship between serum spermidine levels and future cardiovascular disease risk has not yet been well elucidated in the general population based on community studies. Using a nested case-control study, we estimated the association between serum spermidine level and future stroke. New stroke cases had higher baseline levels of spermidine than controls [182.8 (141.8–231.5) vs. 152.0 (124.3–193.0), P < 0.001]. After multivariable adjustment, individuals with spermidine ≥ 205.9 nmol/L (T3) higher risks of stroke (HR 5.02, 95% CI 1.58–16.02) with the lowest quartile (< 136.9 nmol/L) as reference. The association between serum spermidine levels and risk of stroke seemed to be consistent and was reproducible in our cross-sectional studies. In addition, comparisons of the areas under receiver operator characteristics curves confirmed that a model including spermidine had better discrimination than without (0.755 vs. 0.715, P = 0.04). Here we report a close relationship exists between serum spermidine levels and risk of stroke.
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Affiliation(s)
- Liqiang Zheng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Liqiang Zheng,
| | - Yanxia Xie
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Rui Zhang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Jiahui Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qianyi Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao Li
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Guozhe Sun
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fuguo Xing
- Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Yingxian Sun
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
- Yingxian Sun,
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, China
- Deliang Wen,
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Tang X, Liu Y, Hu J, Zhai L, Jia L, Ding N, Ma Y, Wen D. Association of waist circumference with blood pressure and familial dietary habits in preschool children: a cross-sectional study in northeastern China. Ital J Pediatr 2022; 48:53. [PMID: 35365196 PMCID: PMC8973802 DOI: 10.1186/s13052-022-01236-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background Childhood obesity increases the risk of elevated blood pressure (BP) in children. Body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) are traditional obesity indices, but the extent to which these indices are associated with elevated BP in childhood remains debatable. Moreover, the familial dietary environment plays an important role in obesity, so it is necessary to determine the most relevant dietary factors for childhood obesity to prevent elevated BP. Our study aimed to identify the obesity indices that are most closely associated with elevated BP and then to determine the independent familial dietary factors for those obesity indices. Method A total of 605 children aged 2 to 6 years, as well as their parents, were involved in this study. The weight, height, WC and BP of the children were measured. Information on familial environments was obtained by questionnaires completed by the parents. BMI, WC and WHtR were standardized into z scores, and categorical variables of these three obesity indices were defined as BMI Category, WC Category and WHtR Category. Logistic regression was used to analyse the associations between all obesity indices and elevated BP. Multivariate linear regression and logistic regression were used to determine the independent factors for obesity indices. Results The obesity indices that were most closely associated with elevated BP were WC and WC Category. Parental BMI, birth weight, eating wheat as a staple food, appetite, eating speed, snacking while watching TV, parental encouragement to eat a diverse assortment of foods and drinking milk were independently associated with WC in both males and females. The risk of abdominal obesity increased 1.375 times in males and 1.631 times in females if appetite increased one level. If eating speed increased one level, the risk of abdominal obesity increased 1.165 times in males and 0.905 times in females. Females who drank milk more than 6 times per week had a 0.546 times lower risk of abdominal obesity. Conclusion WC was an anthropometric parameter more closely associated with elevated BP. In addition to genetics, some familial dietary factors involving eating preference, eating habits and parental feeding practice were independently associated with WC and abdominal obesity in preschool children. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-022-01236-3.
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Affiliation(s)
- Xiao Tang
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,School of Public Health, Dalian Medical University, Dalian, Liaoning Province, 116044, P.R. China
| | - Yang Liu
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Lingling Zhai
- School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Lihong Jia
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Ning Ding
- Institute of International Medical Education, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China. .,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.
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Chen X, Chen J, Wang R, Zheng J, Yang Q, Chen J, Wen D, Xiong X. [Relationship of in-hospital mortality and using intra-aortic balloon pump with extracorporeal cardiopulmonary resuscitation in patients with cardiac arrest: a secondary analysis based on literature data]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2022; 34:269-273. [PMID: 35574744 DOI: 10.3760/cma.j.cn121430-20211014-01492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To assess the effect of intra-aortic balloon pump (IABP) on in-hospital mortality in patients with cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation (ECPR). METHODS A retrospective study was performed on 696 patients with intra-hospital cardiac arrest undergoing ECPR from Samsung Medical Center in Korea between January 2004 and December 2013. According to whether IABP was used, the patients were divided into ECPR group and ECPR+IABP group. Cox regression and propensity score matching (PSM) were used to examine the correlation between IABP usage and in-hospital mortality, and standardized mean difference (SMD) was used to check the degree of PSM. Survival analysis of in-hospital mortality was performed by the Kaplan-Meier method, and further analyzed by the Log-Rank test. Using the propensity score as weights, multiple regression model and inverse probability weighting (IPW) model were used for sensitivity analysis. In-hospital mortality, extracorporeal membrane oxygenation (ECMO) withdrawal success rate and neurological function prognosis were compared between the two groups. RESULTS A total of 199 patients with cardiac arrest undergoing ECPR were included, including 120 males and 79 females, and the average age was (60.0±16.8) years. Thirty-one patients (15.6%) were treated with ECPR and IABP, and 168 patients (84.4%) only received ECPR. The total hospitalized mortality was 68.8% (137/199). The 1 : 1 nearest neighbor matching algorithm was performed with the 0.2 caliper value. The following variables were selected to generate propensity scores, including age, gender, race, marital status, insurance, admission type, service unit, heart rate, mean arterial pressure, respiratory rate, pulse oxygen saturation, white blood cell count. After the propensity score matching, 24 pairs of patients were successfully matched, with the average age of (63.0±12.8) years, including 31 males and 17 females. The in-hospital mortality was 72.6% (122/168) and 48.4% (15/31) in the ECPR group and the ECPR+IABP group [hazard ratio (HR) = 0.48, 95% confidence interval (95%CI) was 0.28-0.82, P = 0.007]. Multiple regression model, adjusted propensity score, PSM and IPW model showed that the in-hospital mortality in the ECPR+IABP group was significantly lower compared with the ECPR group (HR = 0.44, 0.50, 0.16 and 0.49, respectively, 95%CI were 0.24-0.79, 0.28-0.91, 0.06-0.39 and 0.31-0.77, all P < 0.05). The combined application of IABP could improve the ECMO withdrawal success rate [odds ratio (OR) = 8.95, 95%CI was 2.72-29.38, P < 0.001] and neurological prognosis (OR = 4.06, 95%CI was 1.33-12.40, P = 0.014) in adult cardiac arrest patients. CONCLUSIONS In patients with cardiac arrest using ECPR, the combination of IABP was independently associated with lower in-hospital mortality, higher ECMO withdrawal success rate and better neurological prognosis.
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Affiliation(s)
- Xiaohua Chen
- Department of Intensive Care Unit, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong, China. Corresponding author: Xiong Xuming,
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Gao J, Chen S, Kong T, Wen D, Yang Q. The relationship between soluble CD73 and the incidence of septic shock in severe sepsis patients: a cross-sectional analysis of data from a prospective FINNAKI study. Ann Transl Med 2022; 10:302. [PMID: 35433945 PMCID: PMC9011292 DOI: 10.21037/atm-22-371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/01/2022] [Indexed: 11/06/2022]
Abstract
Background Methods Results Conclusions Keywords
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Affiliation(s)
- Jun Gao
- Department of Nephrology, Peking University International Hospital, Beijing, China
| | - Shanglin Chen
- Department of Laboratory Medicine, The Fifth People’s Hospital of Panyu District, Guangzhou, China
| | - Tianyu Kong
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Deliang Wen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qilin Yang
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Wang N, Ma Y, Liu Z, Liu L, Yang K, Wei Y, Liu Y, Chen X, Sun X, Wen D. Corrigendum to "Hydroxytyrosol prevents PM 2.5-induced adiposity and insulin resistance by restraining oxidative stress related NF-κB pathway and modulation of gut microbiota in a murine model" [Free Radic. Biol. Med. 141 (2019) 393-407]. Free Radic Biol Med 2022; 179:426. [PMID: 34509344 DOI: 10.1016/j.freeradbiomed.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Ningning Wang
- Department of Nutrition & Food Hygiene, School of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning, PR China
| | - Zhuoqun Liu
- School of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Lei Liu
- School of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Keming Yang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yang Liu
- The Institute of Health Science, China Medical University, Shenyang, Liaoning, PR China
| | - Xin Chen
- Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Xiance Sun
- Department of Occupational and Environmental Health, School of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Deliang Wen
- The Institute of Health Science, China Medical University, Shenyang, Liaoning, PR China.
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Wang Y, Liu Y, Song S, Gittelsohn J, Ouellette M, Ma Y, Wen D. Individual, parental and built environmental features as influencing factors of active travel to school in northeast China: findings from a cross-sectional study. BMJ Open 2022; 12:e047816. [PMID: 35074806 PMCID: PMC8788196 DOI: 10.1136/bmjopen-2020-047816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Active travel to school (ATS)-associated factors had been studied in some developed countries but rarely in China. We studied the associated factors of ATS at individual, parental and built environment domains in northeast China. DESIGN AND PARTICIPANTS A cross-sectional survey was conducted among 4-6 grade students in 2017. Sociodemographic features and information of parents were collected using questionnaires, and SuperMap (a geographical information system software) was used to catch built environment features. Logistic regression models were used to examine the relationship between multilevel factors and ATS. RESULTS Our study sample comprised 3670 primary school students aged from 8 to 15 (boys=51.0%, ATS=48.8%). Perceived to be fat (OR 1.25, 95% CI 1.00 to 1.55, p<0.05), feeling easy to walk for a short distance (OR 1.63, 95% CI 1.21 to 2.20, p<0.05), mother unemployed (OR 1.52, 95% CI 1.13 to 2.06, p<0.05), higher land use mix (OR 1.23, 95% CI 1.11 to 1.37, p<0.001) and higher density of public transport stations (OR 1.22, 95% CI 1.09 to 1.37, p<0.05) were positively associated with increased possibility of ATS, while higher household annual income (OR 0.60, 95% CI 0.44 to 0.83, p<0.05) and possession of private vehicles (OR 0.56, 95% CI 0.45 to 0.69, p<0.001) were negatively associated with possibility of ATS. CONCLUSIONS The significant factors associated with ATS were at every examined level, which implies multilevel interventions are needed to encourage ATS. Further interventions could focus on the children's willingness to lead students to opt for healthy behaviours, and children from wealthier families should be encouraged to choose ATS. Also, the government should improve built environment walkability so as to encourage ATS.
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Affiliation(s)
- Yinuo Wang
- Institute of Health Science, China Medical University, Shenyang, Liaoning, China
| | - Yang Liu
- Institute of Health Science, China Medical University, Shenyang, Liaoning, China
| | - Shenzhi Song
- Institute of Health Science, China Medical University, Shenyang, Liaoning, China
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Miranda Ouellette
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yanan Ma
- Biostatistics and Epidemiology, China Medical University Department of Social Sciences, Shenyang, Liaoning, China
| | - Deliang Wen
- Institute of Health Science, China Medical University, Shenyang, Liaoning, China
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Wei X, Hu J, Liu Y, Ma Y, Wen D. Association between Marginally Low Birth Weight and Obesity-Related Outcomes and Indirect Effects via Attention-Deficit Hyperactivity Disorder and Abnormal Eating. Obes Facts 2022; 15:197-208. [PMID: 34915511 PMCID: PMC9021619 DOI: 10.1159/000520902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/07/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Evidence of the association between children born with marginally low birth weight (MLBW) and obesity-related outcomes was controversial, and our study aimed to examine the role of attention-deficit hyperactivity disorder (ADHD) and/or abnormal eating in these associations. METHODS A retrospective cohort study consisting of 677 Chinese children was conducted. Obesity-related outcomes (body mass index [BMI], waist circumference [WC], skinfold thickness [SF], body fat, blood pressure, lipids, and blood glucose), behaviour problems (ADHD and eating behaviour) and birth weight were collected. Mediation analyses were used to explore whether ADHD and/or abnormal eating was an intermediary factor in the MLBW-OB relationship. RESULTS Children with MLBW tended to have higher SF, triglycerides, fasting blood glucose, waistline, body fat, and abdominal obesity risks. Birth weight was negatively related to obesity-related outcomes, and the associations were mediated, partially, by the increased risk of ADHD or abnormal eating behaviour after adjustment for the BMI Z score. Furthermore, lower birth weight predicted higher WC indirectly through emotional overeating caused by ADHD (β: -0.10; 95% confidence interval: -0.19, -0.01). CONCLUSION Our study suggests the hypothetical role of ADHD and abnormal eating as underlying mechanisms in the association between MLBW and obesity-related outcomes, providing novel scientific evidence for childhood development interventions.
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Affiliation(s)
- Xiaotong Wei
- Institute of Health Sciences, China Medical University, Shenyang, China,
| | - Jiajin Hu
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Yang Liu
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, China
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Song X, Li H, Jiang N, Song W, Ding N, Wen D. The mediating role of social support in the relationship between physician burnout and professionalism behaviors. Patient Educ Couns 2021; 104:3059-3065. [PMID: 33985846 DOI: 10.1016/j.pec.2021.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 04/08/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Burnout poses as an understudied challenge to professionalism, and social support may explain their relationship. We sought to investigate the role of social support (moderating or mediating) in the association between physician burnout and professionalism (with four behavioral domains: respect, integrity, excellence, responsibility). METHODS We invited 4100 physicians from nine tertiary hospitals in Liaoning province, China, during February 2017, to participate in a cross-sectional survey. Professionalism, burnout, and social support were respectively assessed using three standardized tools. Descriptive statistics, multivariable linear regression, and ordinal logistic regression were used to analyze the data. RESULTS 3506 physicians (85.5%) effectively completed the survey. After controlling for potential confounding factors, burnout was associated with lower professionalism (β = -0.65, SE = 0.07), particularly in respect (OR = 0.51, 95%CI: 0.41-0.64) and responsibility (OR=0.72, 95%CI: 0.57-0.90). However, there was no statistically significant association between burnout and integrity or excellence. Social support was associated with higher professionalism ((β = 0.24, SE = 0.02) and all of its behavioral domains and played a partial mediating effect on the association between burnout and professionalism. CONCLUSION Social support partially mediates the relationship between physician burnout and behavior-based professionalism. PRACTICE IMPLICATIONS Addressing burnout and promoting social support could be integral in fostering physician professionalism in the healthcare setting.
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Affiliation(s)
- Xinzhi Song
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, PR China.
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, PR China.
| | - Nan Jiang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, PR China.
| | - Wenwen Song
- Office of Development and Planning, China Medical University, Shenyang, PR China.
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, PR China.
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, PR China.
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Wu Q, Ma Y, Liu Y, Wang N, Zhao X, Wen D. Corrigendum to "CB2R agonist JWH-133 attenuates chronic inflammation by restraining M1 macrophage polarization via Nrf2/HO-1 pathway in diet-induced obese mice" [Life Sci. 260 (2020) 118424]. Life Sci 2021; 286:120102. [PMID: 34740464 DOI: 10.1016/j.lfs.2021.120102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Qiong Wu
- Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province 110122, PR China; Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province 110004, PR China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning Province 110122, PR China
| | - Yang Liu
- Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province 110122, PR China
| | - Ningning Wang
- School of Public Health, Dalian Medical University, Dalian, Liaoning Province 116044, PR China
| | - Xin Zhao
- Medical Research Center/Liaoning Key Laboratory of Research and Application of Animal Models for Environmental and Metabolic Diseases, Benxi, Liaoning Province 117004, PR China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province 110122, PR China.
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Wen D, Xu Z, An R, Ren J, Jia Y, Li J, Zheng M. Predicting haemodynamic significance of coronary stenosis with radiomics-based pericoronary adipose tissue characteristics. Clin Radiol 2021; 77:e154-e161. [PMID: 34852918 DOI: 10.1016/j.crad.2021.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/29/2021] [Indexed: 01/06/2023]
Abstract
AIM To investigate the diagnostic performance of the radiomics features of pericoronary adipose tissue (PCAT) in determining haemodynamically significant coronary artery stenosis as evaluated by fractional flow reserve (FFR). MATERIALS AND METHODS A total of 92 patients with clinically suspected coronary artery disease who underwent coronary computed tomography (CT) angiography (CCTA), invasive coronary angiography (ICA), and FFR examination within 1 month were included retrospectively, and 121 lesions were randomly assigned to the training and testing set. Based on manual segmentation of PCAT, 1,116 radiomics features were computed. After radiomics robustness assessment and feature selection, radiomics models were established using the different machine-learning algorithms. The area under the receiver operating characteristic (ROC) curve (AUC) and net reclassification index (NRI) were analysed to compare the discrimination and reclassification abilities of radiomics models. RESULTS Two radiomics features were selected after exclusions, and both were significantly higher in coronary arteries with FFR ≤0.8 than those with FFR >0.8. ROC analysis showed that the combination of CCTA and decision tree radiomics model achieved significantly higher diagnostic performance (AUC: 0.812) than CCTA alone (AUC: 0.599, p=0.015). Furthermore, the NRI of the combined model was 0.820 and 0.775 in the training and testing sets, respectively, suggesting the radiomics features of PCAT had were effective in classifying the haemodynamic significance of coronary stenosis. CONCLUSIONS Adding PCAT radiomics features to CCTA enabled identification of haemodynamically significant coronary artery stenosis.
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Affiliation(s)
- D Wen
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, Shaanxi province, China
| | - Z Xu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, Shaanxi province, China
| | - R An
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, Shaanxi province, China
| | - J Ren
- GE Healthcare China, Daxing District, 1 Tongji South Road, Beijing, 100176, China
| | - Y Jia
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, Shaanxi province, China
| | - J Li
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, Shaanxi province, China
| | - M Zheng
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, Shaanxi province, China.
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Wen D, Balacco DL, Bardhan A, Harper N, Walsh D, Ryan G, Liu L, Guy A, McGrath JA, Ogboli M, Heagerty AHM. Localized autosomal recessive epidermolysis bullosa simplex arising from a novel homozygous frameshift mutation in DST (BPAG1). Clin Exp Dermatol 2021; 47:497-502. [PMID: 34806203 DOI: 10.1111/ced.14917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/26/2022]
Affiliation(s)
- D Wen
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Adult Epidermolysis Bullosa Unit, Department of Dermatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - D L Balacco
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - A Bardhan
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Adult Epidermolysis Bullosa Unit, Department of Dermatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - N Harper
- Adult Epidermolysis Bullosa Unit, Department of Dermatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - D Walsh
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - G Ryan
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - L Liu
- National Diagnostic EB Laboratory, Viapath, St Thomas' Hospital, London, UK
| | - A Guy
- National Diagnostic EB Laboratory, Viapath, St Thomas' Hospital, London, UK
| | - J A McGrath
- National Diagnostic EB Laboratory, Viapath, St Thomas' Hospital, London, UK
| | - M Ogboli
- Paediatric Epidermolysis Bullosa Unit, Department of Paediatric Dermatology, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - A H M Heagerty
- Adult Epidermolysis Bullosa Unit, Department of Dermatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Yang YS, Wen D, Zhao XF. Correction to: Transmembrane Protease TMPRSS4 Promotes the Formation and Development of Mismatch Repair Deficient Colon Cancer Liver Metastasis. Bull Exp Biol Med 2021; 172:112. [PMID: 34796428 DOI: 10.1007/s10517-021-05343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - X F Zhao
- Department of General Surgery, Dalian University Affiliated Xinhua Hospital, Dalian, China.
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Wen D, Yang YS, Gao DZ, Wang Z, Jiang QW, Zhao XF. Oridonin Enhances the Anti-Metastasis Effect of Oxaliplatinliplatin on Colorectal Cancer Liver Metastasis. Bull Exp Biol Med 2021; 172:26-32. [PMID: 34792718 DOI: 10.1007/s10517-021-05324-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Indexed: 11/26/2022]
Abstract
The anti-metastasis effect of oridonin in combination with oxaliplatin on colorectal cancer liver metastasis was studied using a BALB/c nude mouse model. The liver condition, bloody ascites, cholestasis, and liver metastasis scores in the three groups receiving oxaliplatin combined with oridonin were significantly milder than in the control group and importantly the anti-migratory effect of oxaliplatin combined with oridonin was obviously the strongest (p<0.05). Oridonin possessed no hepatotoxicity; instead, it effectively alleviated liver injury caused by oxaliplatin. Oridonin alone or in combination with oxaliplatin significantly decreased serum levels of α-fetoprotein and carcinoembryonic antigen. Therefore, oridonin combined with oxaliplatin displays great potential to markedly increase the anti-metastasis effect of oxaliplatin in the treatment of liver metastases of colorectal cancer.
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Affiliation(s)
- D Wen
- Department of General Surgery, Dalian University Affiliated Xinhua Hospital, Dalian, China
| | - Y S Yang
- Department of General Surgery, Dalian University Affiliated Xinhua Hospital, Dalian, China
| | - D Z Gao
- Department of General Surgery, Dalian University Affiliated Xinhua Hospital, Dalian, China
| | - Z Wang
- Department of General Surgery, Dalian University Affiliated Xinhua Hospital, Dalian, China
| | - Q W Jiang
- Department of General Surgery, Dalian University Affiliated Xinhua Hospital, Dalian, China
| | - X F Zhao
- Department of General Surgery, Dalian University Affiliated Xinhua Hospital, Dalian, China.
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Liu L, Wang X, Liu Y, Zhao X, Xu Z, Ma Y, Xu G, Wen D. Association of plasma branched-chain amino acids with overweight: A Mendelian randomization analysis. Obesity (Silver Spring) 2021; 29:1708-1718. [PMID: 34490739 DOI: 10.1002/oby.23240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/16/2021] [Accepted: 05/25/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A Mendelian randomization (MR) framework was applied to disentangle the causal effect of branched-chain amino acids (BCAAs) and overweight/obesity in Chinese adolescents. METHODS Circulating BCAA levels were measured by liquid chromatography coupled with mass spectrometry. A total of 7 BCAAs and 12 BMI-associated common variants identified from released genome-wide association study results were genotyped. Furthermore, a bidirectional MR approach was undertaken to disentangle the causal effect of BCAAs and overweight/obesity, using two-stage regression. RESULTS Using the inverse variance-weighted strategy and the weighted genetic scoring instruments, the estimated odds ratio per 1-arbitrary-unit increase in the total BCAA level on overweight and obesity odds after adjusting for age and sex was 2.40 (95% CI: 1.38 to 3.42, p < 0.001) and 2.55 (95% CI: 1.35 to 4.82, p = 0.004), respectively. Furthermore, additional MR tests were undertaken using a reversed model, testing the causal effect of increasing BMI variants on total BCAA level. By contrast, no evidence that increased BMI was causally associated with the total BCAA level (estimated β associated with 1-kg/m2 increase in BMI = 0.05, 95% CI: -0.17 to 0.28, p = 0.642) was observed. CONCLUSIONS In summary, BCAAs may be causally associated with overweight/obesity or, rather, a congenital dysmetabolism of BCAAs could be a cause of overweight/obesity in adolescents.
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Affiliation(s)
- Lei Liu
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Xiaolin Wang
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, The Chinese Academy of Sciences, Dalian, Liaoning Province, China
| | - Yang Liu
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Xinjie Zhao
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, The Chinese Academy of Sciences, Dalian, Liaoning Province, China
| | - Zhiyong Xu
- Educational Research Centre of Huanggu District, Shenyang, Liaoning Province, China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning Province, China
| | - Guowang Xu
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, The Chinese Academy of Sciences, Dalian, Liaoning Province, China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning Province, China
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Li C, Li X, Wu D, Chen Q, Xiao Z, Wen D, Zhai L, Jia L. Influence of Dietary Behaviors on Dyslipidemia in Pregnant Women and Its Effects on Physical Development of Fetuses and Infants: A Bidirectional Cohort Study. Nutrients 2021; 13:nu13103398. [PMID: 34684402 PMCID: PMC8538455 DOI: 10.3390/nu13103398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/16/2021] [Accepted: 09/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Gestational diabetes can alter the trajectory of fetal development, but there are few studies on the effects of abnormal lipid metabolism on physical development of infants. We aimed to explore the prevalence of maternal dyslipidemia, its influencing factors and effects on the physical development of fetuses and infants, as well as the role of leptin in this process. METHODS Questionnaire surveys and main outcome measures were administered among 338 pairs of pregnant women and newborns. RESULTS The detection rate of maternal dyslipidemia was 31.5%. The median levels of TG (triglyceride) and TG/HDL (high-density lipoprotein) ratio were higher in large-for-gestational-age (LGA) newborns. Birth weight was positively related to infants' height and weight at six months and one year old (p < 0.05). Leptin was positively related to TG levels of pregnant women and newborns' birth weight (p < 0.05). Logistic regression analysis showed that having greater than or equal to four meals a day (OR = 6.552, 95%CI = 1.014-42.338) and liking to eat lightly flavored food during pregnancy (OR = 1.887, 95%CI = 1.048-3.395) were independent risk factors of maternal dyslipidemia. CONCLUSIONS The prevalence of dyslipidemia was relatively high in pregnant women and was affected by dietary behaviors. Abnormal lipid levels during pregnancy could affect weight and length at birth, which might be associated with increasing leptin levels in cord blood, and then the weight of infants would be influenced by birth weight.
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Affiliation(s)
- Chenyang Li
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; (C.L.); (X.L.); (D.W.); (Q.C.); (Z.X.)
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang 110122, China;
| | - Xuening Li
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; (C.L.); (X.L.); (D.W.); (Q.C.); (Z.X.)
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
| | - Dan Wu
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; (C.L.); (X.L.); (D.W.); (Q.C.); (Z.X.)
| | - Qi Chen
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; (C.L.); (X.L.); (D.W.); (Q.C.); (Z.X.)
| | - Zhe Xiao
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; (C.L.); (X.L.); (D.W.); (Q.C.); (Z.X.)
| | - Deliang Wen
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang 110122, China;
- Institute of Health Science, China Medical University, Shenyang 110122, China
| | - Lingling Zhai
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; (C.L.); (X.L.); (D.W.); (Q.C.); (Z.X.)
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang 110122, China;
- Correspondence: (L.Z.); (L.J.); Tel.: +86-133-8688-7486 (L.J.)
| | - Lihong Jia
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; (C.L.); (X.L.); (D.W.); (Q.C.); (Z.X.)
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang 110122, China;
- Correspondence: (L.Z.); (L.J.); Tel.: +86-133-8688-7486 (L.J.)
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Xu Y, Yu T, Ma G, Zheng L, Jiang X, Yang F, Wang Z, Li N, He Z, Song X, Wen D, Kong J, Yu Y, Cao L. Berberine modulates deacetylation of PPARγ to promote adipose tissue remodeling and thermogenesis via AMPK/SIRT1 pathway. Int J Biol Sci 2021; 17:3173-3187. [PMID: 34421358 PMCID: PMC8375237 DOI: 10.7150/ijbs.62556] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022] Open
Abstract
Pharmacological stimulation of adipose tissue remodeling and thermogenesis to increase energy expenditure is expected to be a viable therapeutic strategy for obesity. Berberine has been reported to have pharmacological activity in adipose tissue to anti-obesity, while the mechanism remains unclear. Here, we observed that berberine significantly reduced the body weight and insulin resistance of high-fat diet mice by promoting the distribution of brown adipose tissue and thermogenesis. We have further demonstrated that berberine activated energy metabolic sensing pathway AMPK/SIRT1 axis to increase the level of PPARγ deacetylation, which leads to promoting adipose tissue remodeling and increasing the expression of the thermogenic protein UCP-1. These findings suggest that berberine that enhances the AMPK/SIRT1 pathway can act as a selective PPARγ activator to promote adipose tissue remodeling and thermogenesis. This study proposes a new mechanism for the regulation of berberine in adipose tissue and offers a great prospect for berberine in obesity treatment
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Affiliation(s)
- Yingxi Xu
- Department of Clinical Nutrition, Shengjing Hospital of China Medical University, Shenyang, 110004, China.,College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Tianhao Yu
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110002, China
| | - Guojing Ma
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Lixia Zheng
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Xuehan Jiang
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Fan Yang
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Zhuo Wang
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Na Li
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Zheng He
- Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
| | - Xiaoyu Song
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China
| | - Juan Kong
- Department of Clinical Nutrition, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Yang Yu
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122.,Institute of Health Sciences, China Medical University, Shenyang 110122, Liaoning, China
| | - Liu Cao
- College of Basic Medical Science, Institute of Translational Medicine, Key Laboratory of Medical Cell Biology, Ministry of Education, Key Laboratory of Liaoning Province, China Medical University, Shenyang, Liaoning Province, P.R. China, 110122
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Song X, Jiang N, Li H, Ding N, Wen D. Medical professionalism research characteristics and hotspots: a 10-year bibliometric analysis of publications from 2010 to 2019. Scientometrics 2021; 126:8009-8027. [PMID: 34248230 PMCID: PMC8256397 DOI: 10.1007/s11192-021-03993-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/03/2021] [Indexed: 11/28/2022]
Abstract
An abundance of publications on medical professionalism have been published in recent years. Our study aimed to analyze the external characteristics of publications on professionalism using bibliometrics, to describe its current developments and trends, and to explore professionalism research hotspots using co-word analysis. We retrieved literature on professionalism published from 2010 to 2019 from the Web of Science database. Histcite and CiteSpace were used to analyze external characteristics of publications, including publication trends and distributions of publications by country/region, institution, author, and journal. Co-word analysis was conducted to analyze research hotspots, using the Bibliographic Item Co-Occurrence Matrix Builder and Graphical Clustering Toolkit. We constructed a strategic diagram to show the state of each research hotspot and the relationship between the various hotspots in this field. Results showed publications on professionalism increased in number year by year as a whole. The USA, including its institutions and authors, maintained the top position worldwide in terms of numbers of publications and citations. Among scholarly journals, Academic Medicine has published more articles and has had higher citations per paper than any other journal. Six research hotspots on professionalism were identified, visualized, and expounded. Of these, the theme of "measurement and evaluation of clinical competence" received the most attention in the field of professionalism. The reporting of quantifiable knowledge on the characteristics and research hotspots of publications could help inform gaps in the field of medical professionalism and provide evidence and guidance for future work for researchers, physicians, and educators.
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Affiliation(s)
- Xinzhi Song
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122 People's Republic of China
| | - Nan Jiang
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122 People's Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122 People's Republic of China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122 People's Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122 People's Republic of China
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Zhuang X, Liu Y, Gittelsohn J, Lewis E, Song S, Ma Y, Wen D. Sugar-Sweetened Beverages Consumption and Associated Factors among Northeastern Chinese Children. Nutrients 2021; 13:2233. [PMID: 34209665 PMCID: PMC8308402 DOI: 10.3390/nu13072233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 01/04/2023] Open
Abstract
(1) Background: The present study aimed to investigate the association between home-related factors, community environmental factors, and sugar-sweetened beverages (SSBs) intake among Northeastern Chinese children. (2) Methods: Cross-sectional. Children with complete data were included in the analysis (n = 901). A questionnaire modified according to BEVQ-15 measured the intake of SSBs. Logistic regression was applied to determine the factors associated with the consumption of SSBs. IBM SPSS Statistics 23.0 was applied to perform all statistical analyses. (3) Results: The mean total amount of SSBs consumed on a weekly basis was 2214.04 ± 2188.62 mL. Children's weekly pocket money, frequency of SSBs purchase, SSBs availability at home, the number of accessible supermarkets, and frequency of weekly visits to convenience stores were all found to be associated with a high intake of SSBs among all children. Among children of normal weight, the findings indicated that weekly pocket money, SSBs availability at home, and number of accessible supermarkets were associated with a high SSBs intake. At the same time, frequency of SSBs purchase, mother's SSBs intake, and frequency of weekly visits to convenience stores were associated with a high SSBs intake among children with obesity. (4) Conclusions: Given the potential negative health effects of high SSBs intake, it is crucial to pay attention to home-related factors and community environment.
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Affiliation(s)
- Xuxiu Zhuang
- Institute of Health Science, China Medical University, Shenyang 110000, China; (X.Z.); (Y.L.); (S.S.); (Y.M.)
| | - Yang Liu
- Institute of Health Science, China Medical University, Shenyang 110000, China; (X.Z.); (Y.L.); (S.S.); (Y.M.)
| | - Joel Gittelsohn
- Human Nutrition Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.G.); (E.L.)
| | - Emma Lewis
- Human Nutrition Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.G.); (E.L.)
| | - Shenzhi Song
- Institute of Health Science, China Medical University, Shenyang 110000, China; (X.Z.); (Y.L.); (S.S.); (Y.M.)
| | - Yanan Ma
- Institute of Health Science, China Medical University, Shenyang 110000, China; (X.Z.); (Y.L.); (S.S.); (Y.M.)
| | - Deliang Wen
- Institute of Health Science, China Medical University, Shenyang 110000, China; (X.Z.); (Y.L.); (S.S.); (Y.M.)
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Liu WQ, Bai R, Ma CL, Yu F, Xie B, Dong M, Ha J, Wen D. Metabolomics Changes of Serum and Tissues in Mice Died of Acute Tetracaine Poisoning. Fa Yi Xue Za Zhi 2021; 37:166-174. [PMID: 34142476 DOI: 10.12116/j.issn.1004-5619.2020.401006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Indexed: 11/30/2022]
Abstract
Abstract Objective To study the changes of metabolites in serum and tissues (kidney, liver and heart) of mice died of acute tetracaine poisoning by metabolomics, to search for potential biomarkers and related metabolic pathways, and to provide new ideas for the identification of cause of death and research on toxicological mechanism of acute tetracaine poisoning. Methods Forty ICR mice were randomly divided into control group and acute tetracaine poisoning death group. The model of death from acute poisoning was established by intraperitoneal injection of tetracaine, and the metabolic profile of serum and tissues of mice was obtained by ultra-high performance liquid chromatography-electrostatic field orbitrap high resolution mass spectrometry (UPLC-Orbitrap HRMS). Multivariate statistical principal component analysis (PCA) and orthogonal partial least square-discriminant analysis (OPLS-DA) were used, combined with t-test and fold change to identify the differential metabolites associated with death from acute tetracaine poisoning. Results Compared with the control group, the metabolic profiles of serum and tissues in the mice from acute tetracaine poisoning death group were significantly different. Eleven differential metabolites were identified in serum, including xanthine, spermine, 3-hydroxybutylamine, etc.; twenty-five differential metabolites were identified in liver, including adenylate, adenosine, citric acid, etc.; twelve differential metabolites were identified in heart, including hypoxanthine, guanine, guanosine, etc; four differential metabolites were identified in kidney, including taurochenodeoxycholic acid, 11, 12-epoxyeicosatrienoic acid, dimethylethanolamine and indole. Acute tetracaine poisoning mainly affected purine metabolism, tricarboxylic acid cycle, as well as metabolism of alanine, aspartic acid and glutamic acid. Conclusion The differential metabolites in serum and tissues of mice died of acute tetracaine poisoning are expected to be candidate biomarkers for this cause of death. The results can provide research basis for the mechanism and identification of acute tetracaine poisoning.
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Affiliation(s)
- W Q Liu
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China.,School of Chemical and Pharmaceutical Engineering, Hebei University of Science and Technology, Shijiazhuang 050018, China
| | - R Bai
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - C L Ma
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - F Yu
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - B Xie
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - M Dong
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
| | - J Ha
- School of Chemical and Pharmaceutical Engineering, Hebei University of Science and Technology, Shijiazhuang 050018, China
| | - D Wen
- Forensic Identification Center of Hebei Medical University, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Key Laboratory of Forensic Medicine, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China
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Hu J, Aris IM, Lin PID, Wan N, Liu Y, Wang Y, Wen D. Association of Maternal Dietary Patterns during Pregnancy and Offspring Weight Status across Infancy: Results from a Prospective Birth Cohort in China. Nutrients 2021; 13:nu13062040. [PMID: 34203618 PMCID: PMC8232115 DOI: 10.3390/nu13062040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 12/22/2022] Open
Abstract
Literature on maternal dietary patterns during pregnancy and offspring weight status have been largely equivocal. We aimed to investigate the association of maternal dietary patterns with infant weight status among 937 mother–infant dyads in a Chinese birth cohort. We assessed maternal diet during pregnancy using food frequency questionnaires (FFQ) and three-day food diaries (TFD) and examined infants’ body weight and length at birth, 1, 3, 6, 8 and 12 months. Maternal adherence to the “protein-rich pattern (FFQ)” was associated with lower infant body mass index z-scores (BMIZ) at birth, 3 and 6 months and lower odds of overweight and obesity (OwOb) across infancy (quartile 3 (Q3) vs. quartile 1 (Q1): odds ratio (OR): 0.50, (95% confidence interval: 0.27, 0.93)). Maternal adherence to the “vegetable–fruit–rice pattern (FFQ)” was associated with higher BMIZ at birth, 3 and 6 months and higher odds of OwOb across infancy (Q3 vs. Q1: OR: 1.79, (1.03, 3.12)). Maternal adherence to the “fried food–bean–dairy pattern (TFD)” was associated with lower BMIZ at 3, 6, 8 and 12 months and lower odds of OwOb (Q3 vs. Q1: OR: 0.54, (0.31, 0.95)). The study results may help to develop interventions and to better define target populations for childhood obesity prevention.
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Affiliation(s)
- Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang 110122, China; (J.H.); (N.W.); (Y.L.); (Y.W.)
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang 110122, China
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA; (I.M.A.); (P.-I.D.L.)
| | - Izzuddin M. Aris
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA; (I.M.A.); (P.-I.D.L.)
| | - Pi-I D. Lin
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA; (I.M.A.); (P.-I.D.L.)
| | - Ningyu Wan
- Health Sciences Institute, China Medical University, Shenyang 110122, China; (J.H.); (N.W.); (Y.L.); (Y.W.)
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang 110122, China
| | - Yilin Liu
- Health Sciences Institute, China Medical University, Shenyang 110122, China; (J.H.); (N.W.); (Y.L.); (Y.W.)
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang 110122, China
| | - Yinuo Wang
- Health Sciences Institute, China Medical University, Shenyang 110122, China; (J.H.); (N.W.); (Y.L.); (Y.W.)
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang 110122, China; (J.H.); (N.W.); (Y.L.); (Y.W.)
- Correspondence:
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Wu D, Liu H, Liu Y, Wei W, Sun Q, Wen D, Jia L. Protective effect of alpha-lipoic acid on bisphenol A-induced learning and memory impairment in developing mice: nNOS and keap1/Nrf2 pathway. Food Chem Toxicol 2021; 154:112307. [PMID: 34058234 DOI: 10.1016/j.fct.2021.112307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/24/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
The adverse effects of bisphenol A (BPA) on learning and memory may be related with oxidative stress, but the mechanisms are unclear. This study aimed to investigate the mechanism of damaged learning and memory caused by BPA through inducing oxidative stress, as well as to explore whether alpha-lipoic acid (ALA) show a protective action. Female mice were exposed to 0.1 μg/mL BPA, 0.2 μg/mL BPA, 0.6 mg/mL ALA, and 0.2 BPA + ALA through drinking water for 8 weeks. The results showed that ALA protected against the impairment of spatial, recognition, and avoidance memory caused by BPA. ALA replenished the reduce of hippocampus coefficient, serum estradiol (E2) level, and hippocampal neurotransmitters levels induced by BPA. ALA alleviated BPA-induced oxidative stress and hippocampal histological changes. BPA exposure reduced the levels of synaptic structural proteins and PKC/ERK/CREB pathway proteins, and ALA improved these reductions. ALA altered the protein levels of nNOS and keap1/Nrf2 pathway affected by BPA. Our results suggested that impairments of learning and memory caused by BPA was related to the damage of hippocampal synapses mediated by oxidative stress, and ALA protected learning and memory by reducing the oxidative stress induced by BPA through regulating the nNOS and keap1/Nrf2 pathway.
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Affiliation(s)
- Dan Wu
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, 110122, China.
| | - Hezuo Liu
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Yang Liu
- Institute of Health Science, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, 110122, China.
| | - Wei Wei
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Qi Sun
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Deliang Wen
- Institute of Health Science, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, 110122, China.
| | - Lihong Jia
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, 110122, China.
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Abstract
BACKGROUND The study aims to use the cross-lagged model and utilize data from the Born in Shenyang Cohort Study to characterize the bidirectional associations of the term-born infants' neurodevelopment in five domains and physical growth in early life. METHOD This study consists of 688 mother-child dyads from the Born in Shenyang Cohort Study. Infants' anthropometric (weight and length) and development in neurological outcomes (Gesell Development Scale) were measured at the age of 6 and 12 months. Cross-lagged analyses and multiple linear regression analyses were used to explore the longitudinal relationships in both directions. RESULTS In terms of longitudinal studies, the inverse associations between infants' two skills (gross motor and social behavior) at the age of 6 months with BMI Z -scores at the age of 12 months (gross motor: aβ = - 0.20, 95% CI: - 0.31 to- 0.09; social behavior: aβ = - 0.23, 95% CI: - 0.33 to- 0.13) were found. Conversely, a higher infant Z -scored BMI at the age of 6 months predicted a lower gross motor at the age of 12 months (aβ = - 0.08, 95% CI: - 0.12 to- 0.04). In cross-lagged analyses, an adverse association in both directions between gross motor and Z -scored BMI was observed. CONCLUSION We found bidirectional relationships between infants' neurodevelopment of gross motor with physical growth and suggested the term-born infants, who are on the edge of the developmental danger, should not be overlooked.
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Affiliation(s)
- Xiaotong Wei
- Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 Liaoning P.R. China
| | - Jiajin Hu
- Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 Liaoning P.R. China
| | - Liu Yang
- Department of Obstetrics and Gynecology, Shenyang Women and Children Health Care Centre, Shenyang, Liaoning China
| | - Ming Gao
- Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 Liaoning P.R. China
| | - Lin Li
- Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning China
| | - Ning Ding
- Curriculum and Teaching Research Office, Research Center of Medical Education, China Medical University, Shenyang, Liaoning China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110122 Liaoning China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 Liaoning P.R. China
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Zhen S, Ma Y, Han Y, Zhao Z, Yang X, Wen D. Serum galectin-3BP as a novel marker of obesity and metabolic syndrome in Chinese adolescents. BMJ Open Diabetes Res Care 2021; 9:9/1/e001894. [PMID: 33910911 PMCID: PMC8094345 DOI: 10.1136/bmjdrc-2020-001894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/01/2021] [Accepted: 02/07/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Childhood obesity (OB) and metabolic syndrome (MetS) have become a worldwide health problem. Comparative proteomic approaches are widely used in human OB to analyze protein changes in blood plasma. The present study determined the galectin-3 binding protein (galectin-3BP) expression level in different weight categories and assessed the associations between galectin-3BP and OB and MetS. RESEARCH DESIGN AND METHODS The current study included 932 Chinese adolescents 13-18 years of age. The biochemical and anthropometric variables of all the subjects were evaluated using standardized procedures. The differentially expressed proteins (DEPs) were investigated among 60 adolescents (20 normal weight, 20 overweight and 20 obese) using tandem mass tag (TMT) quantitative proteomics. The serum galectin-3BP level was measured using ELISA. The associations between galectin-3BP and OB and MetS were analyzed in 932 adolescents using multiple logistic regression analyses. RESULTS A significant DEP, galectin-3BP, can effectively separate the obese from the normal weight group using TMT. Adolescents in tertile 3 of galectin-3BP, when compared with adolescents in the tertile 1, were positively associated with OB (OR=3.32, 95% CI 1.79 to 6.16) and MetS (OR=3.28, 95% CI 1.30 to 8.26). The receiver operating characteristic curve for galectin-3BP in subjects with MetS indicated that the area under the curve was 0.85 (95% CI 0.79 to 0.91). CONCLUSIONS This study confirmed an association between galectin-3BP and OB in Chinese adolescents, and galectin-3BP was also positively associated with MetS, and thus might be useful for identifying adolescents with MetS.
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Affiliation(s)
- Shihan Zhen
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, China
| | - Yanshuo Han
- School of Public Health, China Medical University, Shenyang, China
| | - Zhongyi Zhao
- School of Public Health, China Medical University, Shenyang, China
| | - Xuelian Yang
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, China
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Yang Q, Zheng J, Chen W, Chen X, Wen D, Chen W, Xiong X, Zhang Z. Association Between Preadmission Metformin Use and Outcomes in Intensive Care Unit Patients With Sepsis and Type 2 Diabetes: A Cohort Study. Front Med (Lausanne) 2021; 8:640785. [PMID: 33855034 PMCID: PMC8039324 DOI: 10.3389/fmed.2021.640785] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/05/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Sepsis is a deadly disease worldwide. Effective treatment strategy of sepsis remains limited. There still was a controversial about association between preadmission metformin use and mortality in sepsis patients with diabetes. We aimed to assess sepsis-related mortality in patients with type 2 diabetes (T2DM) who were preadmission metformin and non-metformin users. Methods: The patients with sepsis and T2DM were included from Medical Information Mart for Intensive Care -III database. Outcome was 30-day mortality. We used multivariable Cox regression analyses to calculate adjusted hazard ratio (HR) with 95% CI. Results: We included 2,383 sepsis patients with T2DM (476 and 1,907 patients were preadmission metformin and non-metformin uses) between 2001 and 2012. The overall 30-day mortality was 20.1% (480/2,383); it was 21.9% (418/1,907), and 13.0% (62/476) for non-metformin and metformin users, respectively. After adjusted for potential confounders, we found that preadmission metformin use was associated with 39% lower of 30-day mortality (HR = 0.61, 95% CI: 0.46–0.81, p = 0.007). In sensitivity analyses, subgroups analyses, and propensity score matching, the results remain stable. Conclusions: Preadmission metformin use may be associated with reduced risk-adjusted mortality in patients with sepsis and T2DM. It is worthy to further investigate this association.
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Affiliation(s)
- Qilin Yang
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiezhao Zheng
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weiyan Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaohua Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Deliang Wen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weixiao Chen
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xuming Xiong
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhenhui Zhang
- Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Wang Y, Liu L, Ding N, Li H, Wen D. The Mediating Role of Stress Perception in Pathways Linking Achievement Goal Orientation and Depression in Chinese Medical Students. Front Psychol 2021; 12:614787. [PMID: 33679530 PMCID: PMC7934623 DOI: 10.3389/fpsyg.2021.614787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/06/2021] [Indexed: 11/25/2022] Open
Abstract
Mental health problems are frequent obstacles in medical students’ careers as doctors. Given that previous studies overlook the mediation of stress perception, the current study expanded previous goal orientation researches by addressing an unexplored mechanism. This study aims to examine the mediational roles of stress perception (perceived stressors and stress-related cognition) on the relationship between achievement goal orientation and depression in medical students. A total of 1,015 Chinese 2-year medical students completed a multi-section questionnaire. Hypotheses were examined by structural equation modeling. The findings suggest that performance-avoidance goal orientation and perceived stressors both demonstrated direct facilitative effects on depression, whereas stress-related cognition demonstrated direct obstructive effects on depression. Both perceived stressors and stress-related cognition mediated the relationship between achievement goal orientation and depression. The findings spark a new perspective on motivational intervention that assist students in adopting mastery-approaching strategy as well as ways of coping with stressful academic situations. Identifying students with achievement goal orientation and providing them with the appropriate supportive services may help them to manage stress and mitigate or prevent depression.
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Affiliation(s)
- Yan Wang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Luping Liu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
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