OBJECTIVES:This study aimed to culturally adapt and validate the Chinese Mandarin version of the 10-Item Eating Assessment Tool (EAT-10-CM) for Chinese community-dwelling older adults. METHOD:A total of 346 Chinese community-dwelling older adults participated in this study, with 47 individuals included in the second testing phase. Reliability was assessed through internal consistency and test-retest reliability. Validity analysis covered several aspects: instrument validity, convergent validity, concurrent validity, content validity, and discriminant validity. Instrument validity was assessed by comparing EAT-10-CM scores between participants with and without oropharyngeal dysphagia (OD). Convergent validity was evaluated by comparing the EAT-10-CM with the Dysphagia Handicap Index (DHI). Concurrent validity was assessed by comparing the EAT-10-CM with the Penetration-Aspiration Scale. Content validity was examined using the content validity index, based on the input of 10 expert reviewers. Discriminant validity was analyzed using receiver operating characteristic (ROC) analysis to determine the optimal cutoff value. RESULTS:The Cronbach's alpha for the total scale and individual items was > 0.9, indicating excellent internal consistency. Test-retest reliability was assessed using Pearson's correlation analysis, which showed a strong correlation (r > .7), demonstrating good stability over time. Significant differences in EAT-10-CM scores were observed between participants with OD and healthy individuals, supporting the instrument's ability to differentiate between these groups. The EAT-10-CM showed significant correlations with the DHI and the Penetration-Aspiration Scale (p < .001). The content validity index was 0.95 for the scale and ≥ 0.8 for each item. ROC analysis determined an optimal cutoff value of 3.00, with corresponding sensitivity and specificity values of 0.865 and 0.940, respectively. CONCLUSIONS:The EAT-10-CM is a culturally adapted and validated instrument specifically for Chinese older adults with good reliability and validity. The optimal cutoff value of 3.00 provides a useful threshold for clinical assessment.

Background:Given the rising incidence of hepatocellular carcinoma (HCC) globally, especially in China, information about independent risk factors for survival and disease prognosis of the illness is scarce. In the field of HCC research, there is an urgent need for a scientific basis to enhance the accuracy of clinical diagnosis, optimize the course of therapy, and accurately predict the prognosis. Against this backdrop, the objective of this work was to develop a scientific, efficient, and methodical nomogram to forecast the survival prognosis of HCC. Methods:A real-world study collected clinical data from January 1, 2011, to December 31, 2019, for individuals with HCC. Overall survival (OS) was determined using Kaplan-Meier analysis. Independent risk variables were identified using Cox proportional hazards regression. A nomogram predicting 1-, 3-, and 5-year OS was created. The reliability of the predictions of the model was assessed using receiver operating characteristic (ROC), calibration, and decision curve analysis (DCA). Results:Data from 1,128 HCC cases showed 1-, 3-, and 5-year OS rates were 86.3%, 65.3%, and 43.1%, respectively. Univariate Cox regression identified 13 variables influencing HCC survival including age, HCC screening status, hepatitis C virus (HCV) status, nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) status, liver cirrhosis, elevated alpha-fetoprotein (AFP), Child-Pugh grade, tumor size, tumor number, treatment method, tumor thrombus, and extrahepatic metastasis (P<0.05). Multivariate analysis confirmed HCC screening status, tumor size, ALD, Child-Pugh classification, and therapy method as independent prognostic factors (P<0.05). The nomogram achieved an area under the ROC curve (AUC) of 0.868. Calibration curves of the 1-, 3-, and 5-year survival times and the DCA curve confirmed its predictive accuracy. Conclusions:Patients without HCC screening, tumor size >5 cm, ALD, Child-Pugh grade C, and conservative treatment had a poor survival prognosis. A nomogram based on these risk variables provides a reliable tool for predicting the survival chances of patients with HCC.

Objectives: This study reported the clinical effect of intermittent oro-esophageal tube feeding (IOE) versus nasogastric tube feeding (NGT) on cerebral small vessel disease (CSVD) patients with dysphagia. Methods: This randomized controlled study included 60 CSVD patients with dysphagia who received routine treatment. Participants were randomly divided into the intervention group (with IOE, n = 30) and the control group (with NGT, n = 30). The study lasted 15 days for each patient and assessments were conducted at baseline and after treatment. The primary outcome was dysphagia including Penetration-Aspiration Scale and Functional Oral Intake Scale. The secondary outcomes were 1) nutritional status, including (i) body mass index, (ii) serum albumin, (iii) hemoglobin, 2) aspiration pneumonia, 3) activities of daily living (ADL), 4) quality of life (QOL). Results: At admission, there were no significant differences (P > 0.05) in baseline assessment. After treatment, both groups showed significant improvement in dysphagia, nutritional status, ADL, and QOL. There were significant differences (P < 0.05) between the two groups in dysphagia, nutritional status [body mass index: (19.53 f 1.40) kg/m2 vs. (18.35 f 1.54) kg/m2; albumin: (42.06 f 2.64) g/L vs. (39.49 f 2.77) g/L; hemoglobin: (128.85 f 6.34) mg/L vs. (123.14 f 7.92) mg/L], aspiration pneumonia (6.67% vs. 33.33%), ADL [(69.07 f 6.33) vs. (63.56 f 6.75)], and QOL [(78.07 f 8.64) vs. (72.48 f 7.76)]. There were no severe adverse events during the treatment. Conclusions: Compared to NGT, IOE demonstrated advantages in improving dysphagia, nutritional status, ADL, QOL, and aspiration pneumonia in CSVD patients with dysphagia who received routine treatment. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cardiometabolic multimorbidity (CM), defined as the coexistence of two or three cardiometabolic disorders, is one of the most common and deleterious multimorbidities. This study aimed to investigate the association of Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with the prevalence of CM. The data were obtained from the 2021 health checkup database for residents of the Electronic Health Management Center in Xinzheng, Henan Province, China. 81,532 participants aged ≥ 60 years were included in this study. Logistic regression models were used to estimate the odd ratios (ORs) and 95% confidence intervals (CIs) for CUN-BAE, BMI, WC, and WHtR in CM. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory ability of different anthropometric indicators for CM. The multivariable-adjusted ORs (95% CIs) (per 1 SD increase) of CM were 1.799 (1.710–1.893) for CUN-BAE, 1.329 (1.295–1.364) for BMI, 1.343 (1.308–1.378) for WC, and 1.314 (1.280–1.349) for WHtR, respectively. Compared with BMI, WC and WHtR, CUN-BAE had the highest AUC in both males and females (AUC: 0.642; 95% CI 0.630–0.653 for males, AUC: 0.614; 95% CI 0.630–0.653 for females). CUN-BAE may be a better measure of the adverse effect of adiposity on the prevalence of CM than BMI, WC, and WHtR.

ObjectiveTo understand the network relationship of influencing factors for hyperlipidemia in the elderly population of Henan province and predict their disease risk, providing a reference basis for formulating prevention and intervention measures for hyperlipidemia. MethodsFrom July to December 2022, a multi-stage random sampling method was used to select 123 741 elderly individuals aged ≥ 60 years old in Henan province for questionnaire surveys, physical examinations, and laboratory tests. Based on multivariate unconditional logistic regression analysis, a hyperlipidemia Bayesian network model was constructed using the Max-Min Hill-Climbing (MMHC) algorithm to analyze the network relationship of influencing factors for hyperlipidemia in the local elderly population and predict their disease risk. ResultsAmong the 116 091 elderly individuals in Henan province finally included in the analysis, 33 023 had hyperlipidemia, with a prevalence rate of 28.45%; 9 873, 13 738, 14 765, and 4 338 individuals had high total cholesterol (TC), high triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C), and high low-density lipoprotein cholesterol (LDL-C), respectively, with prevalence rates of 8.50%, 11.83%, 12.72%, and 3.74%, respectively. Multivariate unconditional logistic regression analysis showed that female gender, waist-to-height ratio (WHtR) ≥ 0.5, body mass index (BMI) ≥ 18.5, central obesity, hypertension, and diabetes were risk factors for hyperlipidemia in the elderly population of Henan province, while age ≥ 80 years old and junior high school education or above were protective factors. Bayesian network model analysis showed that gender, BMI, hypertension, and diabetes were directly associated with hyperlipidemia, while age, education level, WHtR, and central obesity were indirectly associated. Risk inference results showed that the highest risk of hyperlipidemia was 41.6% for elderly male hypertensive individuals with BMI ≥ 28.0, 38.8% for obese elderly individuals, and 37.0% for the elderly individuals with hypertension and diabetes.ConclusionThe prevalence of hyperlipidemia in the elderly population of Henan province was relatively low. Gender, age, education level, BMI, WHtR, central obesity, hypertension, and diabetes were the main influencing factors for hyperlipidemia in the local elderly population. In the prevention and control of hyperlipidemia, attention should be particularly paid to the elderly male hypertensive individuals with BMI ≥ 28.0.

The association between fasting plasma glucose (FPG), an important indicator of overall glycemic status, and the risk of cardiovascular mortality has been well investigated. The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. This study aimed to identify long-term FPG trajectories and investigate the association between trajectory groups and cardiovascular and all-cause mortality. A latent class growth mixture modeling (LCGMM) was used to identify FPG trajectories. Cox proportional hazard models were used to estimate associations between FPG trajectories and the risk of all-cause and cardiovascular mortality. A U-shaped relationship between FPG and all-cause and cardiovascular mortality was observed in the restricted cubic spline regression models. Two FPG longitudinal trajectories of low-level (mean FPG = 5.12mmol/L) and high-level (mean FPG = 6.74mmol/L) were identified by LCGMM. After being adjusted for potential confounders, compared with the low-level category, the hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.23(1.16–1.30) and 1.25(1.16–1.35), respectively, for the high-level group. Long-term FPG trajectories are significantly associated with and potentially impact the risk of all-cause and cardiovascular mortality.

RationaleWith the accelerating process of population aging, the comorbidity of chronic disease (CCD) has become a major public health problem that threatens the health of older adults.ObjectiveThis study aimed to assess whether CCD is associated with basic activities of daily living (BADL) and explore the factors influencing BADL in older adults.MethodA cross-sectional community health survey with stratified random sampling among older residents (≥60 years old) was conducted in 2022. A questionnaire was used to collect information on BADL, chronic diseases, and other relevant aspects. Propensity score matching (PSM) was used to match the older adults with and without CCD. Univariate and multivariate logistic regression analyses were used to explore the factors influencing BADL. PSM was used to match participants with single-chronic disease (SCD) and CCD.ResultsAmong the 47,720 participants, those with CCD showed a higher prevalence of BADL disability (13.07%) than those with no CCD (6.33%) and SCD (7.39%). After adjusting for potential confounders with PSM, 6,513 pairs of cases with and without CCD were matched. The univariate analysis found that the older adults with CCD had a significantly higher prevalence of BADL disability (13.07%, 851 of 6,513) than those without CCD (9.83%, 640 of 6,513, P < 0.05). The multivariate logistic regression analysis revealed that CCD was a risk factor for BADL in older adults [OR = 1.496, 95% CI: 1.393–1.750, P < 0.001]. In addition, age, educational level, alcohol intake, social interaction, annual physical examination, retirement benefits, depression, weekly amount of exercise, and years of exercise were related to BADL disability (P < 0.05). PSM matching was performed on participants with CCD and SCD and showed that the older adults with CCD had a significantly higher prevalence of BADL disability (13.07%, 851 of 6,513) than those with SCD (11.39%, 742 of 6,513, P < 0.05).ConclusionThe older adults with CCD are at a higher risk of BADL disability than their counterparts with no CCD or SCD. Therefore, we advocate paying attention to and taking measures to improve the health and quality of life of these individuals.

This study aimed to develop the Dysphagia Handicap Index-Chinese Mandarin (DHI-CM) and to assess its reliability and validity. This prospective study was conducted in China with individuals who speak Mandarin. The DHI-CM was developed according to a five-stage process. 264 patients with oropharyngeal dysphagia (OD) and 187 healthy individuals completed the study. Reliability was assessed using Cronbach’s α and test–retest reliability. Differences between healthy participants and patients with OD were analyzed for instrument validity. Convergent and concurrent validity were assessed using the Swallowing Quality of Life Questionnaire (SWAL-QoL) and Functional Oral Intake Scale (FOIS), respectively. The Content Validity Index (CVI) was used to assess content validity. Exploratory and Confirmatory Factor Analyses (EFA and CFA, respectively) were used to assess structural validity. The Cronbach’s alpha was > 0.9 for the total score and every individual subscale. The Pearson and intraclass correlation coefficients were both > 0.8. The patients with OD showed significantly higher scores in the DHI-CM and its subscales than the healthy individuals. Significant correlations were found between most subscales of the DHI-CM and both the SWAL-QoL and FOIS. The CVI of the DHI-CM was 0.892 and ranged between 0.878 and 1.000 for the subscales. The EFA identified three components that explained 24.33

Objective To understand the impaired self-care ability after stroke and its influencing factors among urban and rural elderly people in Henan province,and provide a reference for taking corresponding intervention measures.Methods From July to December 2022,a multi-stage random sampling method was used to select 3 193 elderly people aged≥65 years old who had lived in the local area for≥2.5 years after stroke in 15 districts(counties)of five major regions of eastern Henan,western Henan,southern Henan,northern Henan,and central Henan for a questionnaire survey,and the impaired self-care ability after stroke and its influencing factors of urban and rural elderly people in the region were analyzed.Results Among the 3 067 elderly people after stroke in Henan province finally included in the analysis,554 had impaired self-care ability,with an impairment rate of 18.06％after stroke;the impairment rates of self-care ability after stroke among urban and rural elderly people in Henan province were 10.96％and 20.00％,respectively,and the impairment rate of self-care ability after stroke among urban elderly people was lower than that among rural elderly people(x2=28.513,P＜0.001);the results of multivariate unconditional logistic regression analysis showed that smoking,kidney disease,heart disease,eye disease,and liver disease were risk factors for impaired self-care ability after stroke among urban elderly people in Henan province,while exercise habits were a protective factor for impaired self-care ability after stroke among urban elderly people in Henan province.Smoking,hearing impairment,kidney disease,heart disease,eye disease,and liver disease were risk factors for impaired self-care ability after stroke among rural elderly people in Henan province,while improved toilet environment,exercise habits,and healthy eating habits were protective factors for impaired self-care ability after stroke among rural elderly people in Henan province.Conclusion The impairment rate of self-care ability after stroke among rural elderly people in Henan province was higher than that among urban elderly people,and smoking status,presence or absence of exercise habits,kidney disease,heart disease,eye disease,and liver disease were common influencing factors for impaired self-care ability after stroke among urban and rural elderly people in the region.

Background Metabolic syndrome(MS)has become a global health problem,and most studies have focused on the correlation of MS and its components with alanine aminotransferase(ALT)and aspartate aminotransferase(AST),but whether there is a dose-response relationship of ALT and AST with MS needs to be further explored.Objective To explore the relationship of ALT and AST with the risk of MS in the elderly,and provide a reference basis for the prevention and control of MS.Methods A health examination with multi-stage sampling method was conducted to residents(≥60 years)from 162 townships(streets)under jurisdiction of 18 cities of Henan Province in 2022.The investigation was performed with physical examination and laboratory test.Logistic regression model combined with restricted cubic spline model was recruited to analyze the relationship of ALT and AST with the risk of MS.Results Totally,112 605 research participants were enrolled,of whome the prevalence of MS was 18.6％(20 935/112 605),ALT abnormality was 5.4％(6 132/112 605),and AST abnormality was 6.8％(7 661/112 605).The MS group showed a higher level of ALT and a lower level of AST than the non-MS group(P<0.05).The Logistic regression analysis and trend test results showed that the risk of MS increased with increasing ALT levels in both the total population and gender stratification,with a"U"shaped trend with AST level after adjustment for confounders(P<0.05).Restricted cubic spline model results showed a positive linear dose-response relationship between ALT and the risk of MS in both total population and gender stratification(P for overall<0.001,P for nonlinear>0.05),and a nonlinear dose-response relationship between AST and the risk of MS(P for overall<0.001,P for nonlinear<0.001),with an approximate"U"-shaped curve.Conclusion ALT,especially the elevated ALT level,and AST are conductive to be predictors for the development of MS.

Objective: This study aimed to develop a measurement scale with good reliability and validity to assess the reasonableness of resident healthcare-seeking culture. Methods: This investigation utilized a cross-sectional research design, employing a multi-stage random sampling technique to select adult inhabitants aged eighteen and above who possess fundamental literacy abilities. An online survey was conducted from March to April 2021 across 27 provinces in China, encompassing 911 questionnaires for scale development. This study primarily applied discriminant coefficients and exploratory factor analysis to refine the scale items. Scale reliability was assessed using Cronbach's alpha, and split-half reliability. Scale validity was determined through content validity and structural validity. Data analysis was performed using SPSS 21.0, and structural equation modeling was executed with AMOS 23.0 software. Statistical significance was defined at P< 0.05. Results: The Resident Healthcare-seeking Culture Scale (RHCS) ultimately comprised 5 dimensions and 20 items. The cumulative explained variance of the five common factors within this scale amounts to 55.24%, satisfactorily adhering to the established criterion of social science research that the extracted factors should explain between 50% and 60% of the total variance. The Cronbach's alpha coefficient for the total scale was 0.83. Split-half reliability was 0.87. The Pearson correlation coefficients associating the scores from the five dimensions with the overall scale score were 0.78, 0.65, 0.65, 0.64, and 0.42, respectively, all statistically significant with P-values less than 0.001. The results of confirmatory factor analysis suggested that RMR=0.045, GFI=0.952, AGFI=0.936, PGFI=0.712, NFI=0.917, IFI=0.944, TLI=0.931, CFI = 0.943, and RMSEA = 0.046. Conclusion: The measurement scale for healthcare-seeking culture among Chinese residents exhibits superior reliability and validity, serving as an effective instrument for hospital administrators to evaluate the reasonableness of demand-side healthcare culture.

ABSTRACT To investigate the associations between social jetlag and depressive symptoms and further analyze the interaction of social jetlag and chronic diseases on depressive symptoms among adults. Data were derived from a cross-sectional survey. Information on social jetlag, depressive symptoms, demographic characteristics, lifestyles, and health situations were collected via a structured self-administered questionnaire. The multivariable logistic regression analyses and restricted cubic splines regression were performed to test the association between social jetlag and depressive symptoms. The multiplicative model was applied to analyze the interaction of social jetlag and chronic disease on depressive symptoms. A total of 5818 adults were included and the prevalence of social jetlag was 22.95%. After multivariable adjustment, adults who experienced more than 2 hours of social jetlag had a significantly greater risk of depressive symptoms (OR = 1.43,95%CI:1.00–2.05, P = 0.049). Compared with participants having<1 hour of social jetlag and no chronic disease, participants having chronic disease were more likely to report depressive symptoms(OR = 3.22,95%CI = 2.59–4.00, P < 0.001). Moreover, among those who have chronic disease, the greater the social jetlag they reported, the greater risk of depressive symptoms they have (OR = 3.81,95%CI = 2.77–5.33, P < 0.001; OR = 4.08,95%CI = 2.24–7.43, P < 0.001). Social jetlag was linearly associated the with risk of depressive symptoms, according to restricted cubic splines. This study shows that 22.95% adults experience more than 1 hour of social jetlag. Social jetlag was positively associated with an increased risk of depressive symptoms. Among those who have chronic disease, the greater the social jetlag they reported, the greater risk of depressive symptoms they have.

目的:分析河南省老年人患慢性病与社会参与能力的相关性.方法:于2019年采用多阶段分层整群抽样法抽取河南省18个市的60岁及以上老年人进行现场访谈式问卷调查.使用一般资料调查表收集老年人患慢性病情况,通过《老年人能力评估标准:MZ/T 039-2013》对其社会参与能力进行评估.采用二分类Logistic回归模型分析患慢性病对老年人社会参与能力的影响.结果:河南省老年人的社会参与能力受损检出率为20.18％(1123/5565).患有慢性病的老年人社会参与能力受损检出率28.24％(844/2989),高于未患慢性病者[10.83％(279/2576)].Logistic回归分析显示老年人高血压、糖尿病、冠心病、慢性阻塞性肺疾病(慢阻肺)、其他慢性病、高血压+冠心病、高血压+糖尿病、冠心病+糖尿病、高血压+慢阻肺及高血压+冠心病+糖尿病与社会参与能力受损有关联;与未患慢性病的老年人相比,患1种或多种慢性病组合共病会增加社会参与能力受损的危险性.结论:河南省老年人患慢性病与社会参与能力受损相关,患慢性病以及多种慢性病情况会增加老年人社会参与能力受损的风险.

我国是全世界老年人口规模最大的国家,也是老年人口增加最快的国家[1].2000-2018年,60岁及以上老年人口从1.26亿人增加到2.49亿人,老年人口占总人口的比重从10.2％上升至17.9％[2].伴随人口老龄化的到来,中国老龄事业十二五发展规划提出了探索"医养结合"的新模式,医养结合机构是指兼具医疗卫生资质和养老服务能力的医疗机构或养老机构,主要为入住机构的老年人提供养老、医疗、护理、康复与心理精神支持等服务.

Cooking with biomass fuels has been reported to have adverse effects on health. This study aims to explore the association between cooking with biomass fuels and vision impairment among Chinese older adults aged 65 years and above. This cohort study drew on data from the 2011/2012 wave and the 2014 follow-up wave of the Chinese Longitudinal Healthy Longevity Survey. Participants’ visual function was examined through a vision screening test. Exposure to indoor biomass fuels was self-reported. Cox proportional hazards models were applied to explore the relationship between biomass fuel use and vision impairment. Additionally, we compared the risk of vision impairment between participants who switched cooking fuel types and those who did not. Subgroup and interaction analyses were conducted to explore the potential effect modifiers. A total of 4711 participants were included in this study. During the follow-up, 1053 (22.35

背景 代谢综合征（MS）已经成为全球性的健康问题，目前多数研究关注 MS 及其组分与丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）的相关性，但 ALT、AST 与 MS 之间是否存在剂量 - 反应关系还需进一步探索。目的 探讨老年人 ALT、AST 与 MS 患病风险的关系，为 MS 防控提供参考依据。方法 于 2022 年采用多阶段抽样的方法，抽取河南省 18 个省辖市共 162 个乡镇（街道）≥ 60 岁的居民进行健康体检。对其进行体格检查及实验室检测。利用 Logistic 回归模型及限制性立方样条模型分析 ALT、AST 与 MS 患病风险的关系。结果 共纳入 112605 名研究对象，其中 MS 患病率为 18.6%（20 935/112 605），ALT 异常率为 5.4%（6 132/112 605），AST 异常率为 6.8%（7 661/112 605）。MS 者 ALT 水平高于非 MS 者，AST 水平低于非 MS 者（P<0.05）。Logistic 回归分析及趋势性检验结果显示，调整混杂因素后，总人群及性别分层下 MS 患病风险均随着 ALT 水平的升高而升高，随着 AST 水平的变化呈“U”形变化趋势（P<0.05）。限制性立方样条结果显示，总人群及性别分层下 ALT 与 MS 患病风险均呈正向线性剂量 - 反应关系（P 总趋势 <0.001，P 非线性 >0.05）；AST 与 MS 患病风险均呈非线性剂量 - 反应关系（P 总趋势<0.001，P 非线性 <0.001），曲线近似呈“U”形。结论 ALT、AST 可作为 MS 发生的重要预测因子，尤其是 ALT 水平的升高。

目的:评价河南省70家三级公立医院住院医疗服务绩效,为提升河南省三级公立医院的医疗服务质量和医院管理提供参考.方法:选用疾病诊断相关分组指标从医疗服务能力、效率、质量、外科水平对医院进行分析,并使用加权非整秩次秩和比法对医院进行综合评价.结果:河南省三级公立综合医院医疗服务能力、效率、外科水平整体高于专科医院,服务质量低于专科医院.综合排名中有12家医院为"优",49家医院为"良",9家医院为"差".结论:基于疾病诊断相关分组指标的加权非整秩次秩和比法综合评价考核结果科学、客观.医院、卫生行政部门应相互协作,加强分级诊疗政策落实,控制不合理费用,提高部分医院危重症救治能力.

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.

目的 探究河南省二级以上公立医院住院病案首页主要诊断编码正确率状况及影响因素,为提高主要诊断编码正确率,提升病案管理质量提供参考.方法 对河南省参与2020年绩效考核的二级及以上公立医院病案科采取问卷调查获得病案科基本情况和人员信息并随机抽取2020年11月出院的200份病案调查其主要诊断编码状况,采用独立样本 t检验、方差分析来比较主要诊断编码正确率在各指标的不同分组状态下是否存在差异,并且采用因子分析和多重线性回归分析来探究其影响因素.结果 编码人员配置(t=2.503,P=0.013)、编码员工作负担(t=-3.604,P＜0.001)和医院类别(t=1.475,P＜0.001)是主要诊断编码正确率的影响因素(P＜0.05).病案科对外业务、病案科编码病案类型、病案编码、统计和供应工作、病案归档和质控工作不会对主要诊断编码正确率产生影响.结论 增加病案编码人员数量,优化编码人员配置,增强编码员整体素质有利于提升住院病案主要诊断病案编码质量,提高病案管理水平.