Data regarding the prevalence of hepatic fibrotic burden across the spectrum of hypothyroidism are scarce. Hence, we aimed to evaluate the prevalence of liver fibrotic burden across the spectrum of hypothyroidism. 30,091 individuals who attended a Health Management Centre between 2019 and 2021 were cross-sectionally analyzed. Participants were categorized as having strict-normal thyroid function, low-normal thyroid function, subclinical hypothyroidism, and overt hypothyroidism. Hepatic fibrosis was assessed by vibration-controlled transient elastography (VCTE). Significant and advanced fibrosis were defined as liver stiffness measurement in VCTE of 8.1–9.6 and 9.7–13.5 kPa, respectively. Among both men and women, low-normal thyroid function group, subclinical hypothyroidism group, and overt hypothyroidism group all have more liver fibrosis present, including mild fibrosis, significant fibrosis, advanced fibrosis, and cirrhosis, than the strict-normal thyroid function group. The low-normal thyroid function group have the similar liver fibrotic burden to the subclinical hypothyroidism group. The highest liver fibrotic burden was noted in the overt hypothyroidism group. Both significant and advanced liver fibrosis were significantly associated with low-normal thyroid function, subclinical hypothyroidism, and overt hypothyroidism in both men and women. Liver fibrotic burden are highly prevalent in subjects with overt hypothyroidism. Moreover, fibrotic burden increased across the spectrum of hypothyroidism even within the low normal thyroid function. These results suggested that screening for liver fibrosis in patients with hypothyroidism is necessary.

Objective:To explore the influence on the willingness to seek medical treatment by revising the recommendations for prevention and treatment in the medical examination report.Methods:Revising the prevention and treatment recommendations for four diseases, including proteinuria, hyperuricemia, hydronephrosis and renal insufficiency to clearly inform the etiology and prognosis of them. Using a cross-sectional study method, pre-revision prevention and treatment recommendations (version A) and post-revision prevention and treatment recommendations (version B) questionnaires were randomly distributed to medical examiners and at the health management center of our hospital in Wuhan. An ordinal logistic regression model and a binary logistic regression model were used to analyze the correlation of the understanding of diseases and the willingness to seek medical treatment with different connotation of the prevention and treatment recommendations, respectively.Results:A total of 530 valid questionnaires were collected, of which 267 were from version A and 263 from version B. There was no significant difference in the socio-demographic profile of respondents between version A and version B. For the four high risk factors of kidney diseases mentioned above, version B was better than version A in terms of understanding and willingness to seek medical treatment ( P<0.001). The level of understanding OR(95% CI) were 3.691(2.570, 5.301), 2.238(1.511, 3.320), 4.293(6.353, 2.903) and 5.275(7.877, 3.529) respectively. The willingness to seek medical treatment OR(95% CI) were 3.554(2.441, 5.175), 2.850(1.975, 4.114), 5.144(3.457, 7.654) and 4.225(2.868, 6.224) respectively. All the P values were lower than 0.001. Conclusions:Improving the connotation of prevention and treatment recommendations in the medical examination report can help increase the willingness for early medical consultation.

To explore the relationship between Dietary Approaches to Stop Hypertension (DASH) diet and serum uric acid (SUA) levels among the Chinese adult population, and verify the mediating effect of BMI between DASH diet and SUA levels. A total of 1125 adults were investigated using a self-administered food frequency questionnaire. SUA levels were determined by uricase colorimetry. The total DASH score ranged from 9 to 72. The relationship between the DASH diet and SUA levels was examined by multiple adjusted regression analysis. Method of Bootstrap was used to test the mediation effect of BMI in the correlation of the DASH diet and SUA levels. After multivariable adjustment, there was a significant linear relationship between the DASH diet and SUA (P < 0.001). Compared with the lowest group, SUA of participants in group of highest DASH diet score decreased by 34.907 (95% CI − 52.227, − 17.588; P trend < 0.001) μmol/L. The association between the DASH diet scores and SUA levels was partly mediated by BMI (− 0.26, Bootstrap 95% CI − 0.49, − 0.07), with 10.53% of the total effect being mediated. Adopting the DASH diet might be helpful in reducing SUA level, and the effect might be partly mediated by BMI.

高尿酸血症已成为常见慢性病，亟需探索行之有效的健康管理方案。正确认识高尿酸血症、重视其危害有助于高尿酸血症健康管理的效率提升和效果改善，本文从高尿酸血症的流行病学、主要危害、管理现状及策略等方面进行总结，旨在提升人民群众对高尿酸血症的认识，增强健康管理主观能动性，为高尿酸血症的健康管理实践提供理论参考。

Objective:To investigate the correlation between Helicobacter pylori ( H.pylori) infection and albuminuria inphysical examination population. Methods:It was a cross-sectional study. All the adults who received physical examination and underwent 13C-urea breath test at the Physical Examination Center in Tongji Hospital in 2021 were selected as the study subjects. General data (such as demographic information and past medical history) were documented. The physical measurement and blood biochemical indicators were checked too. Multivariate analysis was used to analyze the relationship between H. pylori infection and albuminuria. Results:A total of 30 311 subjects were included in this analysis. There were 17 123 males and 13 188 females with an age of (44.51±12.17) years. The positive rate of H. pylori infection was 27.3%. The incidence of albuminuria in subjects with H. pylori infection was 6.7%, and it was 6.1% in the subjects without H. pylori infection ( P=0.031). After adjusting for the confounding factors such as gender, age, diabetes and hypertension, H. pylori infection was independently associated with the risk of albuminuria (odds ratio ( OR)=1.133, 95% CI: 1.018-1.261, P=0.022). Conclusion:H. pylori infection is positively correlated with the occurrence of albuminuria in the physical examination population.

The relation between exposure to single metal/metalloid and the risk of chronic kidney disease (CKD) remains unclear. We aimed to determine the single and mixed associations of 21 heavy metals/metalloids exposure and the risk of CKD. We performed a cross-sectional study that recruited 4055 participants. Multivariate logistic regression, linear regression and weighted quantile sum (WQS) regression were conducted to explore the possible effects of single and mixed metals/metalloids exposure on the risk of CKD, the risk of albuminuria and changes in the estimated glomerular filtration rate (eGFR). In single-metal models, Cu, Fe, and Zn were positively associated with increased risks of CKD ( P-trend < 0.05). Compared to the lowest level, the highest quartiles of Cu (OR = 2.94; 95% CI: 1.70, 5.11; P -trend < 0.05), Fe (OR = 2.39; 95% CI: 1.42, 4.02; P -trend < 0.05), and Zn (OR = 2.35; 95% CI: 1.31, 4.24; P -trend < 0.05) were associated with an increased risk of CKD. After multi-metal adjustment, the association with the risk of CKD remained robust for Cu ( P < 0.05). Weighted quantile sum regression revealed a positive association between mixed metals/metalloids and the risk of CKD, and the association was largely driven by Cu (43.7%). Specifically, the mixture of urinary metals/metalloids was positively associated with the risk of albuminuria and negatively associated with eGFR.

China has the largest number of vaccinated population around the world. However, there has been few research on the prevalence and associated factors of vaccine hesitation among parents of preschool children. Therefore, we conducted this study to evaluate the status of vaccine hesitation and its associated factors among children’s parents. A cluster random sampling method was adopted to select six community health service centers in Shenzhen, and parents of preschool children who were immunized in the vaccination outpatient department of the selected community health centers were surveyed using a structured self-administered questionnaire. Vaccine hesitation was assessed by the Parent Attitudes about Childhood Vaccines (PACV) scale. A multiple linear regression analysis was used to assess the associated factors for vaccine hesitance among children's parents. A total of 1025 parents (response rate, 93.18%) filled out the questionnaires. The average score of vaccine hesitancy was 43.37 (SD = 10.34) points. 23.61% of parents wanted children to get all the recommended shots, 53.76% of them did not believe that many of the illnesses shots prevent were severe, and 75.41% of them could not guarantee the information they receive about shots. The results of multiple linear regression showed that the number of children in the family ( β = −0.93, 95% CI: −1.31 to 0.54), health status of the child ( β = 0.47, 95% CI: 0.07 to 0.87), education level of the parents (Father: β = −0.84, 95%CI: −1.37 to 0.31; Mother: = −1.59, 95%CI:−2.13 to −1.05), and annual family income ( β = 1.64, 95%CI: 1.13–2.16) were significantly associated with vaccine hesitation. The average score of parents' vaccine hesitation in Shenzhen was 43.37. The results showed that the number of children in the family, health status of the children, education level of the parents and annual family income were important factors associated with the parents' vaccine hesitation.

Objective:To analyse the relationship between serum electrolyte concentrations and risk of cardiovascular events in physical examination population.Methods:A cross-sectional study design was applied to survey 8 445 adults whose serum high-sensitivity cardiac tropon Ⅰ (hs-cTnⅠ) and serum electrolytes (chloride, phosphorus, calcium, sodium, potassium and magnesium) concentrations were measured at the health examination center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to February 28, 2022. The risk of cardiovascular events was classified into three levels according to the serum hypersensitive cardiac troponin Ⅰ(hs-cTnⅠ) concentration: low, middle or high risk group. One-way analysis of variance was applied to compare the differences in serum electrolyte concentrations of participants with different risk levels of cardiovascular events. Ordered multi-category logistic regression was performed to analyze the correlation between serum electrolyte levels and the risk of cardiovascular events.Results:The concentration of potassium and magnesium ion in the subjects with low risk of cardiovascular events were both higher than those in the middle and high risk group [potassium ion (4.28±0.29) vs (4.24±0.34), (4.23±0.36) mmol/L, magnesium ion (0.88±0.06) vs (0.87±0.07), (0.87±0.07) mmol/L](both P<0.05), while the concentration of sodium ion was lower [(140.54±1.75) vs (140.88±1.73), (140.81±2.20) mmol/L]( P<0.001); the concentration of phosphorus ion in the high-risk group was lower than those in the middle and low risk groups [(1.04±0.17) vs (1.08±0.16), (1.05±0.15) mmol/L]( P=0.001); no significant difference was found in the concentrations of chloride and calcium ion among the three groups (both P>0.05). Compared to subjects with normal concentrations of electrolyte, the risk level of cardiovascular events in subjects with hypokalemia ( OR=6.96, 95% CI: 3.67-13.10) and hypomagnesemia ( OR=5.00, 95% CI: 1.01-24.50) was higher(both P<0.05). Within the normal range, sodium concentration was positively correlated with the risk of cardiovascular events ( OR=1.08, 95% CI: 1.03-1.14; P<0.001). Conclusions:The serum sodium, potassium and magnesium concentrations in health examination subjects are correlated with the risk of cardiovascular events. Maintaining the balanced concentration of serum potassium and magnesium, as well as low sodium levels within normal limits may help prevent cardiovascular events.

目的 了解深圳市某街道居民膳食模式现状及其与血尿酸的关联性.方法 以方便抽样抽取深圳市某街道三家社区卫生服务中心为研究现场,采集社区居民静脉血测定血尿酸,同时开展问卷调查.通过因子分析构建膳食模式,采用多元线性回归分析膳食模式与血尿酸之间的关联.结果 共纳入1125名研究对象,采取五种膳食模式,分别为"加工食品"模式、"高蛋白"模式、"传统"模式、"奶类"模式及"东方"模式;多元线性回归分析结果显示,"奶类"模式和"东方"模式与血尿酸呈显著负相关关系,与因子得分最低组相比,得分最高组血尿酸分别降低46.89(95％CI:-65.37,-28.43;Ptrend<0.001)μmol/L和31.22(95％CI:-50.16,-12.29;Ptrend=0.033)μmol/L;其他模式与血尿酸之间的关联不显著.结论 "奶类"模式及"东方"模式与血尿酸存在一定关联,居民多喝牛奶、多摄入新鲜蔬菜和精粮可能有助于控制血尿酸水平.

目的 探究我国社区首诊研究的现状、热点和未来发展方向.方法 以中国学术期刊网络出版总库(CNKI)期刊全文数据库为数据来源,借助Citespace软件绘制知识图谱,运用文献计量学方法,从发文量、作者及机构合作、关键词等角度对社区首诊相关研究文献进行分析.结果 我国社区首诊研究起步较晚,发文数量不稳定,近两年有所减少;研究机构间合作网络较为松散,核心研究团队尚未形成;社区首诊制度、社区首诊影响因素和分级诊疗是该领域的研究热点.结论 当前我国社区首诊研究仍处于探索阶段,医保、基层人才培养、基本药物制度以及社区首诊实施效果评价等主题将成为该领域的未来研究方向.

Background: China has the largest number of vaccinated population around the world. However, there has been little research on the prevalence and associated factors of vaccine hesitation among Chinese parents of preschool child, and further research is urgently needed. Therefore, we carried out a survey to evaluate the status of vaccine hesitation and its associated factors among children’s parents and provided an reference for relevant research and policy-making. Methods: A cluster random sampling method was adopted to select 6 community health service centers of Shenzhen, and parents of preschool children who were immunized in the vaccination outpatient department in the selected community health centers were recruited and surveyed using a structured questionnaire. Vaccine hesitation was assessed by the Parent Attitudes about Childhood Vaccines (PACV) scale. A multi-variable analysis assessed the relationship between demographics characteristics and scores of hesitance scale. Results: A total of 1,025 parents filled out the questionnaires with effective recovery rate of 93.18%. The average score of vaccine hesitancy was 43.37 (43.37±10.34) points, with 58.50% of parents have delayed having their child get a shot, and 74.73% of parents concerned that their child might have a serious side effect from a shot. The results of multiple linear regression showed the number of children in the family (β=-0.93, 95%CI: -1.31 – -0.54), the health status of the child (β=0.47, 95%CI: 0.07 – 0.87), the education level of the parents (Father:β=-0.84, 95%CI: -1.37 – -0.31; Mother: = -1.59, 95%CI: -2.13 – -1.05), and the annual family income (β=1.64, 95%CI: 1.13 – 2.16) were significant associated with vaccine hesitation. Conclusions: The average score of parents' vaccine hesitation in Shenzhen was 43.37. The results showed that the number of children in the family, the health status of the children, the educational level of the parents and the annual family income were important factors influencing the parents' vaccine hesitation.Funding Information: This study was supported by the National Social Science Foundation of China (18ZDA085) and Science and Technology Innovation Commission of Shenzhen.Declaration of Interests: We declare that we have no conflict of interests.Ethics Approval Statement: This study was approved by the Research Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China and performed in accordance with the principles of the Declaration of Helsinki. Respondents were informed that their participation was voluntary, and consent was implied on the completion of the questionnaire.

Background: Epidemiology evidence on the effect of serum uric acid levels (SUAs), hyperuricemia, and gout on the risk of type 2 diabetes (T2DM) is inconsistent. We conducted a meta-analysis of cohort studies to comprehensively summarize the issue.Methods: We searched the PubMed and Embase databases to November 2019 for studies conformed to the inclusion criteria. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated with random-effect meta-analysis. We conducted dose-response meta-analysis to investigate the relation between SUA and T2DM risk. Meta-regression analyses, subgroup analyses and sensitivity analyses were performed to identify potential sources of heterogeneity.Findings: A total of 23 prospective studies involving 737468 participants were identified. A significantly positive association between higher uric acid level, hyperuricemia, gout and T2DM risk was observed, respectively(RR=1.20, 95% CI 1.14, 1.27; RR=1.52, 95% CI 1.21, 1.91; RR=1.35, 95% CI 1.16, 1.57). Piecewise dose-response analysis found a linear trend for SUA higher than 4.5mg/dl, with one mg/dl increase of SUA level associated with 8% increase of T2DM risk (RR=1.08, 95%CI= 1.03, 1.13, P=0.001). Unadjusted for hypertension found a positive association between gout and T2DM risk (RR=1.40, 95% CI 1.22, 1.66), while adjusted for hypertension found the relation to be non-significant (RR=1.31, 95% CI 0.78, 2.21).Interpretation: The present findings suggest that higher SUA levels, hyperuricemia and gout are risk factors for T2DM. It is necessary for hyperuricemia and gout patients to test blood glucose regularly and prevent T2DM. For general population, lowering serum uric acid might protect from incident T2DM.Funding Statement: The authors stated that they received no funding for this work.Declaration of Interests: The authors declare that they have no conflicts of interest.Ethics Approval Statement: The authors planned and conducted this review under the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses: the PRISMA statement.

Epidemiological evidence on the association between sedentary behaviors and the risk of depression is inconsistent. We conducted a meta-analysis of prospective studies to identify the impact of sedentary behaviors on the risk of depression. We systematically searched in the PubMed and Embase databases to June 2019 for prospective cohort studies investigating sedentary behaviors in relation to the risk of depression. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated with random-effect meta-analysis. In addition, meta-regression analyses, subgroup analyses, and sensitivity analyses were performed to explore the potential sources of heterogeneity. Twelve prospective studies involving 128,553 participants were identified. A significantly positive association between sedentary behavior and the risk of depression was observed (RR = 1.10, 95% CI 1.03–1.19, I 2 = 60.6%, P < 0.01). Subgroup analyses revealed that watching television was positively associated with the risk of depression (RR = 1.18, 95% CI 1.07–1.30), whereas using a computer was not (RR = 0.99, 95% CI 0.79–1.23). Mentally passive sedentary behaviors could increase the risk of depression (RR = 1.17, 95% CI 1.08–1.27), whereas the effect of mentally active sedentary behaviors were non-significant (RR = 0.98, 95% CI 0.83–1.15). Sedentary behaviors were positively related to depression defined by clinical diagnosis (RR = 1.08, 95% CI 1.03, 1.14), whereas the associations were statistically non-significant when depression was evaluated by the CES-D and the Prime-MD screening. The present study suggests that mentally passive sedentary behaviors, such as watching television, could increase the risk of depression. Interventions that reduce mentally passive sedentary behaviors may prevent depression.

面对现行高等院校大型设备管理中的弊端和新形势下物联网技术应用的挑战,该文基于多年高校大型设备的实践管理经验,研究总结了构建高校“自助共享”式智慧实验室管理体系的经验,旨在为合理有效利用高校大型设备仪器提供一定的参考.

Stringent COVID-19 control measures were imposed in Wuhan between January 23 and April 8, 2020. Estimates of the prevalence of infection following the release of restrictions could inform post-lockdown pandemic management. Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270–0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423–0.574%). The prevalence of SARS-CoV-2 infection in Wuhan was therefore very low five to eight weeks after the end of lockdown.

Background: After the outbreak of Coronavirus disease in 2019 (COVID-19), stringent lockdown measures were imposed in Wuhan between January 23, 2020 and April 8, 2020. To provide evidence on the post-lockdown risk of COVID-19 epidemic in Wuhan, the city government conducted a citywide nucleic acid screening of SARS-CoV-2 infection between May 14 and June 1, 2020. Methods: All city residents aged ≥6 years were potentially eligible to participate the screening programme. The rate of detection of asymptomatic infected cases was calculated, and their demographic and geographic distributions were investigated. ArcGIS 10.0 was used to draw a geographic distribution of asymptomatic infected persons. Results: The screening programme recruited a total of 9,899,828 persons (response rate, 92.9%). The screening found no newly confirmed patients with COVID-19, and identified 300 asymptomatic infected cases (detection rate 0.303/10,000). In addition, 107 of 34,424 previously recovered patients with a history of COVID-19 diagnosis were tested positive (relapse rate, 0.31%). Virus culture of SARS-CoV-2 was negative for all 300 asymptomatic cases and all 107 recovered COVID-19 patients. A total of 1,174 close contacts of asymptomatic cases were traced and all of them had a negative nucleic acid testing result. Conclusions: Prevalence of COVID-19 nucleic acid test positivity was very low in the Wuhan general population, in recovered cases and in contacts of asymptomatic cases, five to eight weeks after the end of lockdown. These findings help resolve concerns about the post-lockdown risk of COVID-19 epidemic, and promote the recovery of economy and normal social life in Wuhan.

疾病预防控制、临床诊治、基础医学和计算机管理的 有机结合已成为当今医学发展的重要趋势.2019 年 8 月 30 日国家标准化管理委员会发布了《生物样本库质量和能力通用要求》(GB/T 37864-2019),对推动我国生物样本库的标准化构建和学科建设与发展具有重要的意义,也标志着国内生物样本库建设进入了全面实施标准化发展的新时代.

目的:本研究运用扎根理论分析武汉市基层医疗卫生机构服务人员对分级诊疗制度的认知情况及其影响因素,为该地区巩固和完善分级诊疗制度提供参考和借鉴.方法:本研究在目的抽样的基础上,对湖北省武汉市2个辖区内18家社区卫生服务中心和6家社区卫生服务站共65名医疗卫生服务人员进行半结构化访谈,通过开放性、关联性和选择性编码对分级诊疗制度的认知情况进行整合分析.结果:本研究经三级编码梳理出与分级诊疗制度认知相关的60个初始概念,28个范畴,9个主范畴和2个核心范畴,明确了分级诊疗制度认知的3项内容(制度内容、制度执行和制度效果)及5个影响因素(条件、能力、发展、政策和患者因素).结论:基层医务人员对分级诊疗制度本身持肯定态度,但对制度的落实和效果持负向态度.条件、能力等五个核心因素可直接或间接地影响基层医疗卫生服务人员对分级诊疗制度的认知情况.

Background: Stroke is one of the world's leading causes of death. Many studies have checked the relationship between short-term exposure to particulate matter (PM) and stroke, but few have focused on the effect of long-term exposure to PM2.5 (particulate matters with an aerodynamic diameter of <= 2.5 mu m). This study aimed to quantitatively examine the relationship of long-term exposure to PM2.5 with stroke incidence and mortality. Methods: We identified relevant studies by searching the PubMed, EMBASE and MEDLINE. After the systematical review of pertinent studies, random-effect meta-analysis was conducted to investigate the association between long-term exposure to PM2.5 and stroke. Results: Our meta-analysis included 16 cohort studies with more than 2.2 million people and above 49 149 endpoint events (incident stroke and death from stroke). The pooled hazard ratio (HR) for each 5 mu g/m(3) increment in PM2.5 was 1.11 (95% CI: 1.05, 1.17) (CI for confidence interval) for incidence of stroke and 1.11 (95% CI:1.05, 1.17) for mortality of stroke. In the region-specific analysis, significant association between PM2.5 and incidence of stroke was found in North America (HR =1.09, 95% CI:1.05, 1.14) and Europe (HR =1.07, 95% CI:1.05, 1.10), while the pooled result of Asia showed no significance (HR= 2.31, 95% CI:0.49, 10.95). Conclusions: Long-term exposure to PM2.5 is an important risk factor for stroke. Since air quality is intimately related to everyone, policies aimed at reducing particulate matters will benefit public health a lot.