Publications by authors named "Qingshan Geng"

33 Publications

Associations between depression, nutrition, and outcomes among individuals with coronary artery disease.

Nutrition 2021 Jan 14;86:111157. Epub 2021 Jan 14.

School of Medicine, South China University of Technology, Guangzhou, China; Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. Electronic address:

Objectives: Depression and malnutrition are prevalent among people with coronary artery disease (CAD) and can affect their prognosis, but the relationship between depression and malnutrition and its co-effect on prognosis is not clear. We sought to explore that relationship and its effects.

Methods: In this study, the nutritional and emotional statuses of 547 people with CAD were assessed using the Controlling Nutritional Status (CONUT) score and the Patient Health Questionnaire-9. The average follow-up period was 2.1 y, after which we explored the relationship between depression and nutrition and prognosis.

Results: A total of 41% of the participants were found to have mild malnutrition, 10% moderate to severe malnutrition, 26% had mild depression, and 11% had moderate to severe depression. A total of 20.6% of the participants were found to have comorbidities of depression and malnutrition; and both moderate to severe depression (adjusted hazard ratio [HR], 1.674; 95% confidence interval [CI], 1.098-2.551) and moderate to severe malnutrition (adjusted HR, 1.686; 95% CI, 1.073-2.648) were observed to be risk factors for the composite end point. Participants with comorbidities of depression and malnutrition were found to have increased risk of cardiovascular death (HR, 5.390; 95% CI, 1.483-19.589) and composite end point (adjusted HR, 1.791; 95% CI, 1.133-2.833) compared to those without both depression and malnutrition.

Conclusions: Depression and malnutrition were found to be risk factors for adverse outcomes in people with CAD. People with CAD should pay attention to their emotional and nutritional statuses, and interventions must be timely and efficient.
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http://dx.doi.org/10.1016/j.nut.2021.111157DOI Listing
January 2021

Multimorbidity in cardiovascular disease and association with life satisfaction: a Chinese national cross-sectional study.

BMJ Open 2020 12 24;10(12):e042950. Epub 2020 Dec 24.

Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China

Background: The coexistence of multiple chronic conditions is very common in cardiovascular disease (CVD). However, the prevalence of CVD multimorbidity in China and its influence on life satisfaction have not been reported. This study aimed to investigate the proportions of 12 chronic comorbid diseases in CVD and the associations of multimorbidity with life satisfaction in patients with CVD.

Methods: We conducted a cross-sectional study in a nationally representative sample of 3478 participants with CVD aged 45 years or more who participated in the China Health and Retirement Longitudinal Study 2015. Correlations of multimorbidity with 12 chronic diseases in CVD and life satisfaction were investigated using logistic regression models, after adjusting for 12 covariates.

Results: The proportion of multimorbidity among participants with CVD was 93.3% (89.4% for middle-aged adults and 95.4% for older adults; 92.9% for men and 93.5% for women). The proportion of participants with CVD multimorbidity who were dissatisfied with life was 11.2%, significantly higher than those without any chronic diseases (χ=5.147, p=0.023). Life satisfaction in patients with CVD decreased with increased number of comorbidities (χ=45.735, p<0.001). Kidney disease (OR=1.933, 95% CI: 1.483 to 2.521), memory-related diseases (MRDs) (OR=1.695, 95% CI: 1.149 to 2.501) and dyslipidaemia (OR=1.346, 95% CI: 1.048 to 1.729) were significantly associated with reduced life satisfaction when adjusting for 12 covariates.

Conclusions: In this nationally representative cross-sectional study, life satisfaction was reduced by multimorbidity of CVD. Kidney disease had the greatest influence on life satisfaction in patients with CVD, followed by dyslipidaemia and MRDs. Our study emphasises the importance of preventing of chronic diseases in adults with CVD.
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http://dx.doi.org/10.1136/bmjopen-2020-042950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768954PMC
December 2020

Assessing mental stress on myocardial perfusion and myocardial blood flow in women without obstructive coronary disease: protocol for a mechanistic clinical trial.

BMJ Open 2020 12 8;10(12):e038362. Epub 2020 Dec 8.

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.

Introduction: Two-thirds of women with symptoms of angina have 'angina with no obstructive coronary artery disease' (ANOCA). Growing evidence supports the use of coronary artery function testing for the diagnosis of ANOCA. Research into the prevalence of mental stress-induced myocardial ischaemia (MSIMI) among women with ANOCA is lacking. MSIMI is common in clinically stable patients with coronary artery disease. It is not associated coronary stenosis but is a prognostic risk factor. Here, we describe the rationale and protocol for a mechanistic clinical trial to test the following hypotheses: (1) that MSIMI is more common in women with ANOCA women than in age-matched and sex-matched controls, and (2) MSIMI is associated with mental stress-induced myocardial blood flow (MBF) change but not with adenosine vasodilator stress-induced MBF change.

Methods And Analysis: This is a mechanistic clinical trial. 84 women with confirmed ANOCA and 42 aged-matched healthy women (neither angina symptoms nor coronary stenosis) are to be recruited for mental and adenosine vasodilator stress tests. Positron emission tomography CT with ammonia N-13 will be used to evaluate the myocardial perfusion and MBF changes between stress and rest. MSIMI is defined as a summed difference score (SDS) of ≥3 and adenosine stress-induced myocardial ischaemia is defined as an SDS of ≥4. Other assessments include Reactive Hyperemia Index for microvascular endothelial function, peripheral arterial tonometry or digital vasomotor response, and a series of blood and psychometric tests.

Ethics And Dissemination: This mechanistic clinical trial was approved by the Ethics Committee of Guangdong Provincial People's Hospital. Findings will be disseminated through peer-reviewed publications and conference presentations.

Trial Registration Number: NCT03982901; Pre-results.
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http://dx.doi.org/10.1136/bmjopen-2020-038362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725072PMC
December 2020

Cardiometabolic Risk Factors and Preclinical Target Organ Damage Among Adults in Ghana: Findings From a National Study.

J Am Heart Assoc 2020 12 7;9(24):e017492. Epub 2020 Dec 7.

Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention Department of Cardiology Guangdong Cardiovascular Institute Guangdong Provincial People's HospitalGuangdong Academy of Medical Sciences Guangzhou China.

Background Although sub-Saharan Africa has a high prevalence of cardiovascular diseases (CVDs), there remains a lack of systematic and comprehensive assessment of risk factors and early CVD outcomes in adults in sub-Saharan Africa. Methods and Results Using a stratified multistage random sampling method, we recruited 1106 men and women, aged >18 years, from the general population in Ghana to participate in a national health survey from 2016 to 2017. In Ghanaian adults, the age-standardized prevalence of known CVD risk factors was 15.1% (95% CI, 12.9%-17.3%) for obesity, 6.8% (95% CI, 5.1%-8.5%) for diabetes mellitus, 26.1% (95% CI, 22.9%-29.4%) for hypertension, and 9.3% (95% CI, 7.1%-11.5%) for hyperuricemia. In addition, 10.1% (95% CI, 7.0%-13.2%) of adults had peripheral artery disease, 8.3% (95% CI, 6.7%-10.0%) had carotid thickening, 4.1% (95% CI, 2.9%-5.2%) had left ventricular hypertrophy, and 2.5% (95% CI, 1.5%-3.4%) had chronic kidney disease. Three CVD risk factors appeared to play prominent roles in the development of target organ damage, including obesity for peripheral artery disease (odds ratio [OR], 2.22; 95% CI, 1.35-3.63), hypertension for carotid thickening (OR, 1.92; 95% CI, 1.22-3.08), and left ventricular hypertrophy (OR, 5.28; 95% CI, 2.55-12.11) and hyperuricemia for chronic kidney disease (OR, 5.49; 95% CI, 2.84-10.65). Conclusions This comprehensive health survey characterized the baseline conditions of a national cohort of adults while confirming the prevalence of CVD risk factors, and early CVD outcomes have reached epidemic proportions in Ghana. The distinct patterns of risk factors in the development of target organ damage present important challenges and opportunities for interventions to improve cardiometabolic health among adults in Ghana.
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http://dx.doi.org/10.1161/JAHA.120.017492DOI Listing
December 2020

Consistency of Positron Emission Tomography and Myocardial Contrast Echocardiography in Diagnosing Mental Stress-Induced Myocardial Ischemia: Study Protocol of a Prospective Study-Background, Design and Method.

Ultrasound Med Biol 2020 Dec 6;46(12):3200-3209. Epub 2020 Sep 6.

Department of Internal Medicine, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.

Mental stress-induced myocardial ischemia (MSIMI) has attracted increasing attention in the last 30 y. Positron emission tomography/computed tomography (PET/CT) is among the most accurate methods for evaluating myocardial perfusion. Even so, echocardiography seems to be a more harmless option when the radiation exposure and high expense of PET/CT are considered. To date, no previous studies have compared the consistency between echocardiography and PET/CT in the diagnosis of MSIMI. The primary aim of this research was to compare the consistency of myocardial contrast echocardiography and PET/CT in diagnosing MSIMI in women with angina symptom/ischemia but no obstructive coronary artery disease (INOCA). Fifty adult female patients with INOCA were recruited for a 12-min-long mental stress test. Each patient underwent both echocardiography and PET/CT at baseline and during mental stress testing; the interval between the two examinations was 1-3 d and the sequence was assigned naturally. MSIMI is defined by a summed difference score (SDS) ≥3 on PET-CT during mental stress testing. It is also defined by new abnormal wall motion, ejection fraction reduction ≥5%, and/or development of ischemic ST change on the electrocardiogram during mental stress testing. This study examined the consistency of PET/CT and myocardial contrast echocardiography in diagnosing MSIMI.
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http://dx.doi.org/10.1016/j.ultrasmedbio.2020.07.029DOI Listing
December 2020

The psychological impact of COVID-19 pandemic on medical staff in Guangdong, China: a cross-sectional study.

Psychol Med 2020 Jul 6:1-9. Epub 2020 Jul 6.

Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.

Background: During previous pandemic outbreaks, medical staff have reported high levels of psychological distress. The aim of the current study was to report a snapshot of the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic and its correlated factors on medical staff in Guangdong, China.

Methods: On the 2nd and 3rd February 2020, soon after the start of the COVID-19 pandemic, we surveyed medical staff at four hospitals in Guangdong, China, to collect demographic characteristics, Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-14), and Insomnia Severity Index (ISI) scores.

Results: Complete responses were received from 1045 medical staff. Respondents were divided into high- and low-risk groups according to their working environment of contacting with potential or confirmed COVID-19 cases. The proportion of staff with anxiety (55.4% v. 43.0%, p < 0.001) or depression (43.6% v. 36.8%, p = 0.028) was significantly higher in the high-risk group than the low-risk group. The percentage of staff with severe anxiety was similar in the two groups. Doctors were more susceptible to moderate-to-severe depressive symptoms. The high-risk group had higher levels of clinical insomnia (13.5% v. 8.5%, p = 0.011) and were more likely to be in the upper quartile for stress symptoms (24.7% v. 19.3%, p = 0.037) than the low-risk group. Additionally, work experience negatively correlated with insomnia symptoms.

Conclusions: It is important for hospitals and authorities to protect both the physical and psychological health of medical staff during times of pandemic, even those with a low exposure risk.
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http://dx.doi.org/10.1017/S0033291720002561DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371926PMC
July 2020

Macrophages: First guards in the prevention of cardiovascular diseases.

Life Sci 2020 Jun 18;250:117559. Epub 2020 Mar 18.

Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 ZhongshanEr Road, Guangzhou, Guangdong 510100, China. Electronic address:

Cardiovascular diseases (CVD) remain one of the leading causes of mortality worldwide, especially in developing countries. It is widely known that severe inflammation can lead to atherosclerosis, which can cause various downstream pathologies, including myocardial injury and viral myocarditis. To date, several strategies have been proposed to prevent and cure CVD. The use of targeting macrophages has emerged as one of the most effective therapeutic approaches. Macrophages play a crucial role in eliminating senescent and dead cells while maintaining myocardial electrical activity and repairing myocardial injury. They also contribute to tissue repair and remodeling and plaque stabilization. Targeting macrophage pathways can, therefore, be advantageous in CVD care since it can lead to decreased aggregation of mononuclear cells at the injured site in the heart. Furthermore, it inhibits the development of pro-inflammatory factors, facilitates cholesterol outflow, and reduces the lipid concentration. More in-depth studies are still needed to formulate a comprehensive classification of phenotypes for different macrophages and determine their roles in the pathogenesis of CVD. In this review, we summarize the recent advances in the understanding of the role of macrophages in the prevention and cure of CVD.
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http://dx.doi.org/10.1016/j.lfs.2020.117559DOI Listing
June 2020

Associations of cardiovascular disease and depression with memory related disease: A Chinese national prospective cohort study.

J Affect Disord 2020 04 15;266:187-193. Epub 2020 Jan 15.

Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China. Electronic address:

Background: Association of cardiovascular disease (CVD) or depression and memory has been studied. But hardly any studies on the association of coexistence of CVD and depression and memory.

Methods: This is a prospective cohort study of a nationally representative sample of 12,272 adults aged 45 years and more who participated in the China health and retirement longitudinal study 2011 to 2015. All variables were acquired by self-reporting questions. The associations between coexistence of CVD and depression with memory related disease (MRD) were investigated by using Cox proportional hazards regression models.

Results: Among the 12,272 participants (mean age 65.69 years; 46.8% male) in this study, 56.9% no CVD or depression and 6.7% coexistence of CVD and depression. After adjustment for age, sex, marriage, living place, registered permanent residence, education level, smoking status, alcoholic intake, sleep status, nap status, social communication, health before 15 years, life satisfaction, cognitive function, and 11 chronic diseases risk factors, depression alone was significantly high risk for MRD (HR:1.64; 95% CI: 1.09-2.49); coexistence of CVD and depression increased the risk for MRD significantly higher (HR: 4.72; 95%CI: 2.91-7.64).

Limitations: Diseases were all self-reported and we couldn't adjust for all the potential confounders, which might be prone to information error and residual confounding.

Conclusions: In a nationally representative cohort with median 4 years of follow-up, depression alone and co-existence of depression and CVD could significantly increase the risk of MRD. Our study supports the idea of prevention of memory disease from a psycho-cardiology aspect.
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http://dx.doi.org/10.1016/j.jad.2020.01.054DOI Listing
April 2020

The salivary-α-amylase level after stroop test in anxious patients can predict the severity of anxiety.

Neurosci Lett 2020 01 11;715:134613. Epub 2019 Nov 11.

Guangdong General Hospital, School of Medicine, South China University of Technology, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou 510080, China. Electronic address:

Individuals with anxiety disorder often exhibit as imbalance in response to stressors. We sought to explore the relationship between physiological as well as psychological responses under acute mental stress and the severity of the disease. 20 Generalized Anxiety Disorder (GAD) patients (14 males, mean age 46 ± 10 years) were confronted with the stroop test, during which salivary-α-amylase (sAA), salivary cortisol, and heart rate variability (HRV) were assessed. The results showed that stroop test as a stressor induced autonomic nervous response in GAD patients, which was mainly manifested as the increase in HRV representing sympathetic nervous system and the decrease in HRV representing vagal nerve activity. Moreover, the basic function of sympathetic-adrenal medulla system was hyperfunctional in GAD patients while theirs reactivity was limited, which showed the more serious the lesion was, the higher the baseline value of sAA was, and the less sAA secretion increase would be, or even decrease after mental stress. The change of sAA after stroop test in GAD patients can predict the severity of anxiety, but subjective psychological perception can not.
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http://dx.doi.org/10.1016/j.neulet.2019.134613DOI Listing
January 2020

Associations of cardiovascular disease and depression with memory related disease: A Chinese national prospective cohort study.

J Affect Disord 2020 01 28;260:11-17. Epub 2019 Aug 28.

Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China. Electronic address:

Background: Association of cardiovascular disease (CVD) or depression and memory has been studied. But hardly any studies on the association of coexistence of CVD and depression and memory.

Methods: This is a prospective cohort study of a nationally representative sample of 12,272 adults aged 45 years and more who participated in the China health and retirement longitudinal study 2011 to 2015. All Variables were acquired by self-reporting questions. The associations between coexistence of CVD and depression with memory related disease (MRD) were investigated by using Cox proportional hazards regression models.

Results: Among the 12,272 participants (mean age 65.69 years; 46.8% male) in this study, 56.9% no CVD or depression and 6.7% coexistence of CVD and depression. After adjustment for age, sex, marriage, living place, registered permanent residence, education level, smoking status, alcoholic intake, sleep status, nap status, social communication, health before 15 years, life satisfaction, cognitive function, and 11 chronic diseases risk factors, depression alone was significantly high risk for MRD (HR:1.64; 95% CI: 1.09-2.49); coexistence of CVD and depression increased the risk for MRD significantly higher (HR: 4.72; 95%CI: 2.91-7.64).

Limitations: Diseases were all self-reported and we couldn't adjust for all the potential confounders, which might be prone to information error and residual confounding.

Conclusions: In a nationally representative cohort with median 4 years of follow-up, depression alone and coexistence of depression and CVD could significantly increase the risk of MRD. Our study supports the idea of prevention of memory disease from a psycho-cardiology aspect.
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http://dx.doi.org/10.1016/j.jad.2019.08.081DOI Listing
January 2020

Healthcare-seeking behavior among pregnant women in the Chinese hierarchical medical system: a cross-sectional study.

Int J Equity Health 2019 08 19;18(1):129. Epub 2019 Aug 19.

College of Humanities and Social Sciences, China Medical University, 77 Puhe Road, Shenbei New District, Shenyang, Liaoning, China.

Background: Hierarchical medical systems are common in developed countries, but it's not optimistic in China. This study aimed to identify the factors affecting healthcare-seeking behavior among pregnant women in Guangdong, China.

Methods: We conducted a cross-sectional, observational survey, developed using the Andersen's behavioral model. Pregnant women were randomly selected using a two-stage, stratified, random sampling method from hospitals in Guangdong, China. A multinomial logistic regression was used to identify statistically significant variables from aspect of environmental, demographic and pregnancy characteristics associated with pregnant women seeking healthcare at primary, secondary or tertiary hospitals.

Results: A total of 1393 pregnant women returned the survey after attending 1 of 12 hospitals within 4 cities of the Guangdong province: 537 (38.5%) of the respondents attended a primary hospital, 437 (31.4%) a secondary hospital, and 419 (30.1%) a tertiary hospital. Women attending primary hospitals were more likely to live closer to the hospital, live rurally, and be educated to a lower level. Several factors were significantly associated with attendance at a secondary vs a primary hospital: the woman's perceived necessity to seek maternal healthcare (OR 1.73, 95% CI [1.1,2.74]), the woman's choice of delivery hospital (OR 1.45, 95% CI [1.01,2.07]), or urban living (OR 1.39, 95% CI [1.03,1.88]). Characteristics associated with attendance at a tertiary vs a primary hospital were: a history of pregnancy complications (OR 2.35, 95% CI [1.43,3.86]), travel to the hospital by public transport/taxi (OR 2.09/2.67, 95% CI [1.35,3.22]/ [1.45,4.92]), urban living (OR 1.58, 95% CI [1.14,2.18]), or a planned current pregnancy (OR 1.53, 95% CI [1.07,2.19]).

Conclusion: Medical needs and convenience both play a role in the choice of hospital for antenatal care, and impact on equity utilization of health services. Pregnant women without risk factors and with higher levels of education should be a target population for guiding to choose a more proper level of hospital.
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http://dx.doi.org/10.1186/s12939-019-1037-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700827PMC
August 2019

Antidepressant-like effects of ginseng fruit saponin in myocardial infarction mice.

Biomed Pharmacother 2019 Jul 1;115:108900. Epub 2019 May 1.

Department of Physiology, Nanjing Medical University, Jiangsu, 211166, China. Electronic address:

Background: Recently, the development of cardiovascular disease (CVD) has been proved to be closely associated with depression in which 5-HT plays a crucial role. Ginseng Fruit Saponin (GFS) and Metoprolol are two drugs which have beneficial effects on the cardiovascular system in Myocardial Infarction (MI) mice. However, their effects on depression-like behaviors after MI and its underlying mechanisms remain unknown. We aimed to investigate their antidepressive-like effects as well as their impacts on the 5-HT system.

Methods: The MI model was established by ligating left anterior descending coronary artery. Mice were administered with GFS, Metoprolol or saline for 4 weeks. Cardiac function was evaluated and depressive-like behaviors were quantified at the end of the experiments. Masson's staining was used to assess myocardial fibrosis while immunohistochemistry, western blot, ELISA and qPCR were performed to analyze the levels of 5-HT and its related genes.

Results: Compared with MI groups, Both GFS and Metoprolol treatments significantly improved cardiac function and reduced myocardial fibrosis. Moreover, GFS but not Metoprolol increased the levels of 5-HT in the cortex and rescued depression-like behaviors in MI mice.

Conclusions: GFS has potential antidepressive effects and the mechanisms involve the regulation of 5-HT concentrations in the cortex.
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http://dx.doi.org/10.1016/j.biopha.2019.108900DOI Listing
July 2019

An Improved Method of Handling Missing Values in the Analysis of Sample Entropy for Continuous Monitoring of Physiological Signals.

Entropy (Basel) 2019 Mar 12;21(3). Epub 2019 Mar 12.

Faculty of Health Sciences, University of Macau, Taipa, Macau 999078, China.

Medical devices generate huge amounts of continuous time series data. However, missing values commonly found in these data can prevent us from directly using analytic methods such as sample entropy to reveal the information contained in these data. To minimize the influence of missing points on the calculation of sample entropy, we propose a new method to handle missing values in continuous time series data. We use both experimental and simulated datasets to compare the performance (in percentage error) of our proposed method with three currently used methods: skipping the missing values, linear interpolation, and bootstrapping. Unlike the methods that involve modifying the input data, our method modifies the calculation process. This keeps the data unchanged which is less intrusive to the structure of the data. The results demonstrate that our method has a consistent lower average percentage error than other three commonly used methods in multiple common physiological signals. For missing values in common physiological signal type, different data size and generating mechanism, our method can more accurately extract the information contained in continuously monitored data than traditional methods. So it may serve as an effective tool for handling missing values and may have broad utility in analyzing sample entropy for common physiological signals. This could help develop new tools for disease diagnosis and evaluation of treatment effects.
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http://dx.doi.org/10.3390/e21030274DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7514754PMC
March 2019

Associations of mood symptoms with NYHA functional classes in angina pectoris patients: a cross-sectional study.

BMC Psychiatry 2019 03 5;19(1):85. Epub 2019 Mar 5.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Guangzhou, 510080, People's Republic of China.

Background: Depression and anxiety are prevalent and associated with a worse prognosis in coronary heart disease (CHD) patients. However, the influence of disease severity on mood symptoms is unknown. The specific associations of mood symptoms with NYHA classes remain unexplored.

Methods: In this cross-sectional study, 443 consecutive inpatients with angina pectoris (AP) confirmed by angiography were included into analysis. Somatic and cognitive symptom scores derived from Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess mood symptoms. Predictors for depression and anxiety with strict and lax standards were compared. We hypothesized NYHA classification to be an indicator of disease severity through analyses with clinical features using ordinal logistic model. Applying both binary and ordinal logistic models, we evaluated the associations of mood symptoms with NYHA classes.

Results: Discrepancy of disease severity existed between the depressed and nondepressed. NYHA classification was proved to be an integrated index under influence of age, coronary stenosis, heart failure and diabetes. NYHA class I and II individuals with AP were at equivalent risk for depression (NYHA II vs I: binary model OR 1.32 (0.59,2.96), p = 0.50; ordinal model OR 1.17 (0.73,1.88), p = 0.52), however NYHA class III/IV patients shared a sharply higher risk (NYHA III/IV vs I: binary model OR 3.32 (1.28,8.61), p = .013; ordinal model OR 3.94 (2.11,7.36), p < .001). Analyses on somatic and cognitive depressive symptoms confirmed this finding and hinted a greater impact of education background on mood when patient's condition is unstable. Anxiety seemed in the whole picture irrelevant with NYHA classes. Comparing with NYHA class I/II, AP patients in NYHA class III/IV tended to be less anxious. However, when CHD became unstable, the calmness may immediately be broken up. A great distinction of the ratio of anxiety and depression symptom scores between NYHA class III/IV stable and unstable AP patients (p = .018) was observed.

Conclusions: Mood symptoms in CHD patients are to a great extend derived from disease itself. Only for patients with relatively serious physical condition, unexpected discomforts caused by disease notably impact the emotions. Education background tends to influence the mood especially when disease is still unstable.
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http://dx.doi.org/10.1186/s12888-019-2061-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402172PMC
March 2019

Left atrial volume index is superior to left atrial diameter index in relation to coronary heart disease in hypertension patients with preserved left ventricular ejection fraction.

Clin Exp Hypertens 2020 30;42(1):1-7. Epub 2019 Jan 30.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, The First Affiliated Hospital of South China University of Technology, Guangzhou, China.

: Research hypothesis is that left atrial (LA) volume index is superior to LA diameter index for coronary heart disease and LA volume index is important to refine risk stratification.: We retrospectively enrolled 222 asymptomatic non-ischemic patients with hypertension who had stored digital images in 2012. Patients were followed up for coronary heart disease over a median of 3.2 years. The Area under receiver operating characteristic curve for LA parameters with coronary heart disease was evaluated. Cox regression was used to assess the association between left atrial parameters and coronary heart disease.: The mean age of patients was 62 years, 45% were men, and mean left atrial diameter, mean left atrial volume, mean LA diameter index, mean LA volume index was 32 mm, 43 ml, 21 mm/m2, 27 ml/m2, respectively. After 3.2 years follow up, 10 patients experienced coronary heart disease. Compared with patients without coronary heart disease, LA diameter index and LA volume index increased in coronary heart disease group (P < 0.05). Multivariate cox regression analysis showed, adjusted for age, sex, smoking, cholesterol, fasting plasma glucose, diabetes, systolic blood pressure, left ventricular mass index, and E/e' ratio, a unit rise in LA volume index was associated with a 15% increase in the risk of coronary heart disease. (HR:1.155; 95% CI 1.002-1.332). Compared with LA diameter index, the area under receiver operating characteristic curve values for predicting coronary heart disease were higher for LA volume index (0.797).: Our study showed that LA volume index was superior to LA diameter index. LA volume index had independent prognostic implications in terms of coronary heart disease prediction in hypertension patients with preserved left ventricular ejection fraction.
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http://dx.doi.org/10.1080/10641963.2018.1557680DOI Listing
March 2020

A Novel Noninvasive Method to Assess Optimal Diuresis in Patients With Heart Failure.

JACC Heart Fail 2019 01;7(1):82-83

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http://dx.doi.org/10.1016/j.jchf.2018.10.021DOI Listing
January 2019

Modulation of apoptosis-related microRNAs following myocardial infarction in fat-1 transgenic mice vs wild-type mice.

J Cell Mol Med 2018 11 14;22(11):5698-5707. Epub 2018 Sep 14.

Department of Cardiovascular Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

Background: microRNAs (miRNAs) post-transcriptionally regulate cardiac repair following myocardial infarction (MI). Omega-3 polyunsaturated fatty acid (ω-3 PUFAs) may support cardiac healing after MI, but the mechanism is unclear.

Methods: The fat-1 transgenic mouse expresses a ω-3 fatty acid desaturase which converts ω-6 PUFAs to ω-3 PUFAs in vivo. MI was induced in fat-1 transgenic (n = 30) and wild-type (WT) mice (n = 30) using permanent ligation. Other transgenic and WT mice underwent sham procedure (n = 30 and n = 30, respectively). One week after occlusion, cardiac function was measured by echocardiography and the infarct size was assessed using histology and miRNA microarray profiling. Expression of selected miRNA was confirmed using quantitative real-time PCR.

Results: One week following MI, the fat-1 transgenic myocardium had better cardiac function, a smaller fibrotic area, and fewer apoptotic cardiomyocytes than WT myocardium. Post-MI profiling showed 33 miRNAs that were significantly up-regulated, and 35 were down-regulated, in fat-1 group compared to the WT group (n = 3 and n = 2 mice, respectively). Among selected apoptosis-associated miRNAs, 9 miRNAs were up-regulated (miR-101a-3p, miR-128-3p,miR-133a-5p,miR-149-5p,miR-192-5p,miR-1a-3p,miR-208a-3p,miR-29c-5p,miR-30c-2-3p), and 3 were down-regulated (miR-210-3p,miR-21a-3p,miR-214-3p) in fat-1 transgenic mice compared with WT mice. Kyoto encyclopaedia of genes and genomes (KEGG) pathway analysis indicated likely roles for these miRNAs in MI. Furthermore, Bcl-2 expression was increased, and caspase-3 decreased, in infarcted fat-1 transgenic mouse hearts compared to WT hearts.

Conclusions: ω-3 PUFAs may have a protective effect on cardiomyocytes following MI through their modulation of apoptosis-related miRNAs and target genes.
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http://dx.doi.org/10.1111/jcmm.13846DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201345PMC
November 2018

Mediating Effects of Patients' Stigma and Self-Efficacy on Relationships Between Doctors' Empathy Abilities and Patients' Cellular Immunity in Male Breast Cancer Patients.

Med Sci Monit 2018 Jun 12;24:3978-3986. Epub 2018 Jun 12.

Guangdong General Hospital, Guangzhou, Guangdong, China (mainland).

BACKGROUND Doctors' empathy is closely related to patients' health. This study aimed to examine whether patients' stigma and self-efficacy play a mediating role in the relationship between doctors' empathy abilities and patients' cellular immunity in male patients with breast cancer. MATERIAL AND METHODS Doctors' empathy scores and patients' demographic data, disease condition, stigma, and self-efficacy were measured. Patient T cell subset was tested at admission and 3 months after the operation and was compared by paired t test. The multivariate linear regression model was applied to analyze the factors influencing the immune index. Pearson correlation analysis and structural equation modeling were applied to explore the relationships among patients' stigma, self-efficacy, and cellular immunity and doctors' empathy abilities. RESULTS At the 2 time points, only the change in NK subset was statistically significant, while the changes in percentage of CD3+, CD4+, CD8+, and B cells were not statistically significant. The doctors' empathy abilities were negatively correlated with patients' stigma and were positively related to patients' self-efficacy. Patients' stigma was negatively related to NK subset, while self-efficacy was positively associated with NK subset. Patients' stigma and self-efficacy played a mediating role in the relationship between doctors' empathy abilities and patients' NK subset, and stigma had a stronger effect than self-efficacy. CONCLUSIONS Doctors' empathy abilities affected breast cancer patients' NK subset through their stigma and self-efficacy. The mental health of male breast cancer patients need more attention and empathy education needs to be improved.
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http://dx.doi.org/10.12659/MSM.910794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029513PMC
June 2018

High Plasma Exposure of Statins Associated With Increased Risk of Contrast-Induced Acute Kidney Injury in Chinese Patients With Coronary Artery Disease.

Front Pharmacol 2018 30;9:427. Epub 2018 Apr 30.

Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

The role of statins in reducing the incidence of contrast-induced acute kidney injury (CI-AKI) remains controversial. We sought to evaluate the association between CI-AKI and high plasma exposure of statins in coronary artery disease (CAD) patients undergoing coronary angiography (CAG). This association was first evaluated in 1,219 patients with CAD receiving atorvastatin (AT) therapy and validated in 635 patients receiving rosuvastatin (RST) therapy. The plasma concentrations of statins were quantified using validated UPLC-MS/MS methods and CI-AKI incidence was assessed during the first 48 h postoperatively. Among all participants ( = 1,854), AKI occurred in 57 of 1219 (4.7%) in the AT cohort and 30 of 635 (4.7%) in the RST cohort. High plasma AT-all exposure was associated with increased risk of CI-AKI (odds ratio [OR]: 2.265; 95% confidence interval [CI]: 1.609-3.187; < 0.0001). Plasma AT-all concentration in the CI-AKI group (22.40 ± 24.63 ng/mL) was 2.6-fold higher than that in the control group (8.60 ± 9.65 ng/mL). High plasma RST exposure also significantly increased the risk of CI-AKI (OR: 2.281; 95% CI: 1.441-3.612; = 0.0004). We further divided patients into two subgroups for each statin according to baseline renal function, and association between high plasma statin exposure and CI-AKI still remained highly significant in both subgroups. This study suggests for the first time that high plasma exposure of statins may significantly increase the risk of CI-AKI. Statins should be used with greater caution in CAD patients undergoing CAG to reduce the occurrence of CI-AKI.
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http://dx.doi.org/10.3389/fphar.2018.00427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5936793PMC
April 2018

The renoprotective effects of simvastatin and atorvastatin in patients with acute coronary syndrome undergoing percutaneous coronary intervention: An observational study.

Medicine (Baltimore) 2017 Aug;96(32):e7351

Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital Guangdong Academy of Medical Sciences, Guangdong, China.

Some statins, such as atorvastatin, have proven renoprotective effects. The comparative renoprotective potential of simvastatin is less clear. This study aimed to compare the renoprotective effects of simvastatin with atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This observational study examined the medical records of 271 patients who were treated at the Guangdong Cardiovascular Institute from April 2004 to February 2008. Patients had received either 40 mg simvastatin (n = 128) or 20 mg atorvastatin (n = 143), daily, for a period of at least 6 months following PCI. Declined renal function (DRF) was defined at the occurrence of chronic kidney disease (CKD) or elevated CKD stages at 6-months post-PCI. Results showed that the incidence of DRF was similar among patients taking simvastatin or atorvastatin (25.00% vs 26.57%, respectively). Kaplan-Meier survival analysis showed that patients who developed DRF had a higher incidence of mortality and major adverse cardiovascular events (MACEs) than those without DRF (17.41% vs 28.57%, P = .0308). Multivariate logistic regression analysis identified diabetes and baseline estimated glomerular filtration rate as independent risk factors for DRF. Collectively, our results indicate that simvastatin has comparable renoprotective effects to atorvastatin in ACS patients undergoing PCI. Further studies are warranted to confirm the comparative renoprotective effects of statins.
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http://dx.doi.org/10.1097/MD.0000000000007351DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556196PMC
August 2017

Predictive value of F-FDG PET/CT in patients with acute type B aortic intramural hematoma.

J Nucl Cardiol 2019 04 2;26(2):633-641. Epub 2017 Aug 2.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, No. 96, Dongchuan Road, Guangzhou, 510100, Guangdong, China.

Background: The clinical course and predictors of adverse aortic events (AAE) in patients with acute Stanford type B intramural hematoma (IMH) remain controversial. This study aimed to investigate whether F-FDG PET/CT can predict risk in patients with acute type B IMH.

Methods And Results: This study included 34 patients with acute type B IMH who underwent PET/CT within 14 days from the onset of symptoms. The maximal standardized uptake values (SUVmax) of F-FDG uptake was significantly different between patients with or without AAE (4.3 ± 0.6 vs 3.7 ± 1.0, P = 0.020), but not the target to blood ratio (TBR, SUVmax divided by SUV in the superior vena cava) (1.6 ± 0.2 vs 1.5 ± 0.5, P = 0.064). In patients with initial ulcer-like projection (ULP), a blood-filled pouch protruding into the IMH, which was seen in 25 patients(74%), both the SUVmax and TBR were significantly higher in patients who developed AAE, (4.3 ± 0.6 vs 3.3 ± 0.5, P = 0.001; 1.6 ± 0.2 vs 1.4 ± 0.2, P = 0.01); the TBR >1.5, which is determined from receiver-operating-characteristic curve, had a sensitivity of 73% and a specificity of 80% in predicting AAE.

Conclusion: Patients with ULP and high F-FDG uptake were more likely to develop AAE and may require closer surveillance with serial imaging.
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http://dx.doi.org/10.1007/s12350-017-1014-9DOI Listing
April 2019

Strong correlation between lung ultrasound and chest computerized tomography imaging for the detection of acute lung injury/acute respiratory distress syndrome in rats.

J Thorac Dis 2016 Jul;8(7):1443-8

Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China ;

Background: Lung ultrasound (LUS) is a clinical imaging technique for diagnosing acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In humans and several large animals, LUS demonstrates similar specificity and sensitivity to computerized tomography (CT) scanning. Current study evaluated the degree of agreement between LUS and CT imaging in characterizing ALI/ARDS in rats.

Methods: Thirty male Sprague-Dawley rats were imaged by LUS before randomization into three groups to receive intratracheal saline, 3 or 6 mg/kg LPS respectively (n=10). LUS and CT imaging was conducted 2 hours after instillation. Cross table analyses and kappa statistics were used to determine agreement levels between LUS and CT assessments of lung condition.

Results: Before instillation, rats presented with a largely A-pattern in LUS images, however, a significantly increase B-lines were observed in all groups after instillation and showed dose response to LPS or to saline. One rat treated with 6 mg/kg lipopolysaccharide (LPS) presented with lung consolidation. The agreement between the LUS and the CT in detecting the main characteristics of ALI/ARDS in rat was strong (r=0.758, P<0.01, k=0.737).

Conclusions: In conclusion, LUS detects ALI/ARDS with high agreement with micro PET/CT scanning in a rat model, suggesting that LUS represents a positive refinement in rat ALI/ARDS disease models.
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http://dx.doi.org/10.21037/jtd.2016.05.15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958808PMC
July 2016

The Role of the Myocardial Microvasculature in Mental Stress-Induced Myocardial Ischemia.

Clin Cardiol 2016 Apr 19;39(4):234-9. Epub 2016 Feb 19.

Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China.

There is increasing evidence that mental stress can manifest as physical diseases. One such condition is mental stress-induced myocardial ischemia (MSIMI); a silent, transient, myocardial ischemic response to stressful conditions. We propose that the cardiac microvasculature may be an important site for the interplay between mental stress and MSIMI. This study is a review of the literature discussing the prevalence and emerging mechanisms underlying MSIMI. We identified several aspects underlying MSIMI, including psychological, genetic, and physiological causes. Several sources suggested that dysfunctional cardiac microvasculature might be a contributing factor in the development of stress-induced myocardial ischemia. The literature also suggested that although MSIMI has distinct features and pathophysiology, its occurrence might indicate an increased future risk of cardiovascular events. We found that dysfunctional cardiac microvasculature may be the key point of interaction between mental stress and transient myocardial ischemia and that the development of MSIMI might be a "silent" indicator for future cardiac events.
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http://dx.doi.org/10.1002/clc.22522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490863PMC
April 2016

Self-rated chronic conditions and 2-week prevalence in adults in Zhongshan, China: an epidemiological survey.

BMJ Open 2015 Nov 11;5(11):e008441. Epub 2015 Nov 11.

Department of Internal Medicine, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.

Objective: To examine the association between behavioural factors and the risk of chronic conditions and 2-week prevalence.

Design: This was a cross-sectional survey.

Setting: The study was conducted in Zhongshan, China.

Participants: A multistage clustering sampling method was used to select a representative sample of residents from the household registration system between July and September 2011. The overall sample replacement rate was 9.4%, and the final sample included 43 028 individuals.

Outcome Measures: Chronic conditions and 2-week prevalence.

Results: 4979 (11.6%) of the participants reported having at least one chronic condition, 1067 (2.5%) had two or more concurrent chronic conditions, and 6830 (15.9%) reported having at least one disease in a 2-week recall period. The most common chronic condition was primary hypertension, which was reported by 6.8% of participants. Logistic regression models demonstrated that the main factors for having a chronic condition and 2-week prevalence were older age (≥65 years of age; OR 44.91, 95% CI 33.05 to 61.03; and OR 12.71, 95% CI 10.44 to 15.46, respectively), obesity (OR 3.00, 95% CI 2.63 to 3.42; and OR 2.50, 95% CI 2.22 to 2.82, respectively) and being a former smoker (OR 3.02, 95% CI 2.54 to 3.58; and OR 3.24, 95% CI 2.74 to 3.82, respectively).

Conclusions: This study suggests that older age, obesity and unhealthy behaviours are high-risk factors for poorer health status among the residents of Zhongshan, China. The present findings highlight the importance of recognising and managing harmful behaviours in order to improve health.
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http://dx.doi.org/10.1136/bmjopen-2015-008441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654384PMC
November 2015

Screening for pectus excavatum among primary students and establishment of a pectus excavatum screening program in Dongguan, China.

J Thorac Dis 2015 May;7(5):868-74

1 Public Health College, Sun Yat-sen University Medical School, Guangzhou 510120, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 3 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China ; 4 National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 5 Department of Pediatric, Dongguan 5th People's Hospital, Dongguan 523905, China ; 6 Dongguan Human Resources and Social Security Bureau, Dongguan 523000, China.

Objective: To carry out pectus excavatum (PEx) screening among primary school students in Dongguan, with an attempt to establish a PEx screening program and provide epidemiological evidences for developing guidelines on the diagnosis and treatment of PEx for young children.

Methods: A total of 479,402 primary school students who were already in school in 2012 or newly enrolled in 2013 from 422 primary schools in 32 towns in Dongguan, Guangdong Province were screened for PEx. Meanwhile, about 420 medical staff from the infirmaries of 422 primary schools were provided with a serial of training, with an attempt to establish a PEx screening program and network.

Results: Valid screening results were obtained from 477,627 pupils (99.62%) from 406 primary schools in 31 towns. These students aged 4-15 years (mean: 8.78 years), among whom there were 244,545 males (N1; mean age: 8.22 years) and 233,082 females (N2; mean age: 8.89 years). Totally 257 PEx patients were identified, yielding a prevalence of 0.583%, among whom there were 176 males (N3; mean age: 8.79 years) and 81 females (N4; mean age: 8.77 years). With the PEx patients as the PEx group and the healthy children as the control group, chi square test with gender as the dependent variable showed that the incidence of PEx was significantly different between male and female students (P=0.00) (N3:N4 =2.172:1). In addition, 410 medical staff from the school infirmaries were trained, and a PEx screening program and network was established.

Conclusions: The screening for PEx was successfully performed among pupils who were already in school in 2012 or newly enrolled in 2013 from 422 primary schools in Dongguan, Guangdong Province. Statistical analysis showed that the incidence of PEx differed between male and female pupils. A stable effective PEx screening program was established, which will provide personal and technical supports for the early diagnosis and treatment of this condition.
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http://dx.doi.org/10.3978/j.issn.2072-1439.2015.04.48DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454853PMC
May 2015

Risk factors for HIV and syphilis infection among male sex workers who have sex with men: a cross-sectional study in Hangzhou, China, 2011.

BMJ Open 2015 Apr 28;5(4):e006791. Epub 2015 Apr 28.

Department of AIDS Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.

Objective: To investigate the prevalence and risk factors of HIV and syphilis infection among men who have sex with men (MSM) in male sex workers (MSW).

Design: Cross-sectional survey.

Setting: Hangzhou, China.

Participants: 259 MSW in MSM were recruited by respondent-driven sampling from May 2011 to December 2011.The inclusion criteria were: (1) age ≥18 years; (2) engaging in sex with men in the previous year and (3) willing to cooperate in the implementation of the study.

Outcome Measures: HIV-related knowledge, high-risk behaviour and condom use.

Results: Among these MSW in MSM, 23.2% were infected with HIV and/or syphilis, 8.9% were infected only with HIV, 12.7% only with syphilis and 1.5% with HIV/syphilis co-infection; 96.6% sold sex to males, 8.9% bought sex from males and 15.4% sold sex to females; 49.0% had non-commercial sex behaviours with males and 24.3% with females. The rate of condom use while having commercial sex with clients was 86.9% and 53.3% (selling anal and oral sex to males, respectively), 95.5% (buying sex from males) and 77.5% (selling sex to females), respectively. Regarding their non-commercial sex behaviour, the rate of condom use was 77.2% (with males) and 49.2% (with females), respectively. Multivariate analysis showed that age >30 years (OR 1.055; 95% CIs 1.015 to 1.095) and having ≥10 non-commercial male sex partners (OR, 1.573; 95% CI 1.018 to 2.452) were significantly associated with HIV/syphilis infection, while heterosexuality (OR, 0.238; 95% CI 0.066 to 0.855) was significantly associated with a low HIV/syphilis infection rate.

Conclusions: The MSW in MSM population in Hangzhou has a high prevalence of HIV/syphilis infection, poor perceived risks of HIV and more engagement in unsafe sex with its clients and partners, in addition to a low rate of condom use. These risk factors may account for their relatively high infection rate of HIV/syphilis.
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http://dx.doi.org/10.1136/bmjopen-2014-006791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420951PMC
April 2015

Association of oxidative stress biomarkers with gestational diabetes mellitus in pregnant women: a case-control study.

PLoS One 2015 27;10(4):e0126490. Epub 2015 Apr 27.

Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China.

Objective: The relationship between gestational diabetes mellitus (GDM) and oxidative stress has not been fully elucidated. This study examined the association between biomarkers of oxidative stress and GDM.

Methods: We conducted a case-control study which included 36 women presenting with GDM and 36 asymptomatic matched control subjects who visited Guangzhou Women and Children's Medical Centre, China, from June 2012 to December 2012. Pregnant women were prospectively recruited to the study, and blood samples were collected at the time of a routine oral glucose tolerance test. These samples were then analyzed for levels of endocrine and surrogate markers of oxidative stress.

Results: Compared to control subjects, women with GDM exhibited elevated values for plasma glucose, insulin, and insulin resistance (IR), and showed reduced HOMA pancreatic β-cell function (HOMA-B), insulin sensitivity index (ISI), insulinogenic index, and corrected insulin response at 24-28 weeks gestation. A bivariate logistic regression analysis showed that levels of high-sensitivity C reactive protein (hs-CRP) and high fluorescence reticulocytes at fasting, and hs-CRP in a 1-h OGTT, were significantly associated with GDM. A linear regression analysis showed that levels of hs-CRP (P = 0.003) and reticulocytes (P = 0.029) at fasting were associated with IR, and levels of hs-CRP (P = 0.002) and monocytes (P = 0.006) in a 1-h OGTT were associated with ISI.

Conclusions: Pregnant women with GDM developed a pathological IR and exhibited β-cell dysfunction. Their decreased ability to compensate for oxidative stress was associated with increased IR and a reduced ISI, which might be important factors in GDM.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0126490PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411158PMC
April 2016

Relationships of mental health problems with stress among civil servants in Guangzhou, China.

Community Ment Health J 2014 Nov 3;50(8):991-6. Epub 2014 Apr 3.

Department of Prevention Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, People's Republic of China.

Psychosocial problems and stress-related diseases account for a high proportion of health problems. This study aimed to assess stress status and mental health, and their relationships with each other among civil servants in China. In a cross-sectional study of 600 randomly selected civil servants in 2007, we assessed mental health via the Symptom Checklist 90 (SCL-90), and stress status via a Self-Rated Stress Scale. Canonical correlation analysis was performed to assess the interrelationships among mental health symptoms and the various stressors. The participants scored higher in the total score and the seven domains of the SCL-90 (except for interpersonal sensitivity and hostility), compared with the norms documented in China. Canonical correlation analysis demonstrated positive and direct relationship in the first canonical function indicating that the nine mental health problems and various stressors were related (Canonical correlation = 0.715). Among the civil servants, mental health problems are highly associated with various stressors.
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http://dx.doi.org/10.1007/s10597-014-9726-7DOI Listing
November 2014

Impact of an educational programme on reproductive health among young migrant female workers in Shenzhen, China: an intervention study.

Int J Behav Med 2014 Aug;21(4):710-8

Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, People's Republic of China.

Background: Reproductive health and sexually transmitted diseases (STD) account for a high proportion of health problems in the rural-to-urban young female migrant workers in China. Improving these conditions remains highly challenging.

Purpose: To developed an educational programme to advance the reproductive health of the female workers.

Method: An intervention study was conducted between July 2010 and April 2011 in Shenzhen. Two commune factories were selected to participate and provided a control cluster receiving routine local government health services and a second cluster receiving an educational intervention in addition to the routine services. The intervention included distribution and free access to educational study materials. The factory workers' knowledge, attitudes and behaviour in the area of reproductive health and STD were the main study outcomes.

Results: Compared with the control cluster, at the 6-month follow-up assessment, the intervention cluster had a significantly higher proportion of correct answers to queries about human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (standardised coefficients of multiple linear regression (B) 0.047; P = 0.020) and awareness of places providing free contraceptives (odds ratio [OR] 2.011, 95% confidence interval [CI] 1.635-2.472; P < 0.001), and a significantly lower proportion accepting premarital sex (OR 0.492, 95% CI 0.416-0.582; P < 0.001), practising premarital sex (OR 0.539, 95% CI 0.478-0.608; P < 0.001) or suffering from gynaecological disorders (OR 0.801, 95% CI 0.697-0.921; P = 0.002).

Conclusion: A community-based educational intervention targeting unmarried female migrant workers appears to be effective in substantially improving their knowledge of reproductive health and their attitudes and behaviour towards health, and in reducing prevalence of STD.
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http://dx.doi.org/10.1007/s12529-014-9401-yDOI Listing
August 2014

Quality of life in China rural-to-urban female migrant factory workers: a before-and-after study.

Health Qual Life Outcomes 2013 Jul 23;11:123. Epub 2013 Jul 23.

Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou 51018, PR, China.

Background: Rural-to-urban female migrant workers have a lower quality of life compared to the general population. Improving these conditions remains highly challenging. This paper reports the health-related quality of life (HRQoL) of the female migrant workers in an educational project.

Methods: In this before-and-after study, a community-based health education intervention was developed to improve female migrant workers' HRQoL and job satisfaction. A factory was selected as the location to implement the trial, using a before-and-after design. The education intervention included distribution and free access to study materials, monthly lectures, and counseling. The primary endpoint was HRQoL, and gynecological disease and job satisfaction were secondary endpoints. We assessed HRQoL at baseline and at 6-month follow-up using the Health Survey Short Form (SF-36).

Results: Compared to the baseline assessment, the participants at the 6-month survey reported higher General Health scores (standardized-β coefficients (Betas) of β = 0.056; P <0.001), Vitality scores (β = 0.066; P <0.001), Mental Health scores (β = 0.062; P <0.001), mental component summary scores (β = 0.040; P <0.001), and job satisfaction (Odds Ratio [OR] 2.104, 95% confidence interval [CI] 1.837-2.408; P <0.01).

Conclusions: A community-based educational intervention, targeted at female migrant workers, appears effective in improving HRQoL and job satisfaction.
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http://dx.doi.org/10.1186/1477-7525-11-123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725152PMC
July 2013