ObjectiveTo systematically evaluate the prevalence of diabetes in the elderly with frailty.MethodsPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect cross-sectional studies on the prevalence of diabetes in the elderly with frailty from inception to November 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; meta-analysis was then performed by using Stata 15.0 software.ResultsA total of 21 cross-sectional studies involving 22 403 subjects were included. The pooled prevalence of diabetes in the elderly with frailty was 34% (95%CI 26% to 43%). Subgroup analysis showed that the prevalence of diabetes in patients with frailty in Asia and South America was higher than those in Europe and North America. The prevalence of diabetes in patients with frailty using physical frailty measures to evaluate frailty was higher than using multidimensional frailty measures. The prevalence of diabetes in patients with frailty in outpatient and hospital were higher than those in the community.ConclusionsCurrent evidence suggests that the prevalence of diabetes is high in the elderly with frailty.
ObjectiveTo explore the association between hypertriglyceridemic waist (HTGW) and subclinical atherosclerosis among general Chinese population. MethodsPeople who took routine physical exam in the Sichuan Provincial People's Hospital were randomly selected from June 2011 to June 2012. We included those who received carotid artery ultrasonography and denied having symptoms of arterial ischemia, and screened the risk factors of cardiovascular disease (CVD) among them, including waist circumstance (WC) and triglycerides (TG). According to levels of WC and TG, the subjects were divided into three groups:Group I (those with normal levels of WC and TG); Group II (those with elevated levels of WC or TG); and Group Ⅲ (those with elevated WC and TG). ResultsA total of 484 subjects were included with average age of 47.3±11.3 years, of which, 72.1% of the subjects were male. The risk factors of CVD in Group I, Group II and Group III orderly increased, with significant differences. Then the subjects were stratified by age. For the elderly (no less than 60 years, n=75), the morbidities of subclinical atherosclerosis was 73.7% in Group I, 79.3% in Group II, and 70.4% in Group Ⅲ, respectively; and the results of univariate analysis and multivariate analysis showed that, HTGW was poorly associated with subclinical atherosclerosis in the elderly. For the young and middle-aged (less than 60 years, n=409), the morbidities were 19.8% in Group I, 35.1% in Group II, and 36.1% in Group III, respectively; after adjusting the confounding factors, Group II and Group III showed close association with subclinical atherosclerosis in the young and middle-aged when taking Group I as referent, with ORs (Group Ⅱ:1.987, 95%CI 1.073 to 3.679, P=0.029; and Group Ⅲ:2.060, 95%CI 1.020 to 4.161, P=0.044). ConclusionHTGW population has high-level risk factors of CVD which also present a tendency of aggregation. HTGW is closely associated with subclinical atherosclerosis in the young and middle-aged; while in the elderly, HTGW is poorly associated with subclinical atherosclerosis, but the morbidity of subclinical atherosclerosis is higher.
Objective To evaluate the clinical applicability of clinical practice guidelines in China in the past 5 years, and to provide suggestions for better development and implementation of guidelines. Methods A cross-sectional study was conducted. A total of 61 guidelines issued by the Chinese Medical Association and the Chinese Medical Doctor Association from 2015 to 2020 were selected randomly based on CNKI database. Each guideline was evaluated by medical staff from three regions using the instrument for evaluating clinical applicability of guidelines (version 2.0). Quantitative data were described by mean, standard deviation, median and interquartile range, while qualitative data were described by frequency and composition ratio. Results A total of 6 904 valid questionnaires were collected from 119 medical institutions in 26 provinces of China. The results showed that the standardized scores ranged from 54.4% to 72.7% (median 64.3%) for accessibility, from 66.1% to 83.3% (median 74.9%) for readability, from 53.7% to 94.7% (median 86.0%) for acceptability, and ranged from 61.4% to 81.0% (median 72.5%) for feasibility. Approximately 4.3% of the medical staff considered that there were obstacles to implement the guidelines, including environmental factors (32.1%), medical staff factors (26.5%), guidelines factors (22.5%), and patients or family factors (18.9%). Conclusion The overall clinical applicability of the guidelines selected in this study is satisfactory. However, it is necessary to improve the accessibility of clinical guidelines. In addition, to improve the clinical applicability, it is suggested that medical staff should be trained and provided with supporting resources.
ObjectiveTo systematically review the prevalence of osteoarthritis in Chinese aged 40 and above from January 2000 to December 2019.MethodsPubMed, ScienceDirect, Wiley Online Library, The Cochrane Library, CBM, VIP, CNKI and WanFang Data databases were electronically searched to collect cross-sectional studies on osteoarthritis in Chinese aged 40 and above from January 1st, 2000 to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using R 3.5.2 software.ResultsA total of 29 cross-sectional studies with a total sample of 60 711 cases and 19 707 patients were included. The results of meta-analysis showed that, the crude prevalence of osteoarthritis in Chinese aged 40 and over was 38.46% (95%CI 24.31% to 46.22%). Subgroup analysis results showed that the prevalence of lumbar osteoarthritis was the highest (24.79%, 95%CI 13.28% to 27.37%), followed by knee osteoarthritis prevalence (20.50%, 95%CI 14.51% to 27.23%) which increased with age. The prevalence of knee osteoarthritis in females (25.14%, 95%CI 19.54% to 31.19%) was higher than that in males (18.99%, 95%CI 13.86% to 24.71%). The prevalence of knee and lumbar osteoarthritis in rural areas was higher than that in urban areas. The prevalence of knee osteoarthritis in western China (23.59%, 95%CI 18.34% to 30.35%) was higher than that in eastern China (18.36%, 95%CI 12.43% to 27.92%) and central China (15.54%, 95%CI 11.22% to 21.53%). The prevalence of lumbar osteoarthritis in western China (31.17%, 95%CI 19.21% to 50.60%) was higher than that in eastern China (24.38%, 95%CI 16.26% to 36.54%). The incidence of cervical osteoarthritis in the eastern China (20.49%, 95%CI 13.90% to 30.21%) was higher than that in the western China (12.32% 95%CI 8.09% to 18.75%). The prevalence of hand osteoarthritis in western China (6.85%, 95%CI 2.71% to 8.13%) was higher than that in eastern China (2.7%, 95%CI 1.33% to 5.48%).ConclusionsCurrent evidence shows that the prevalence of osteoarthritis in Chinese aged 40 and above is high, and the prevalence of lumbar osteoarthritis is the highest, and the prevalence in western China is higher than that in eastern and central China, followed by knee osteoarthritis, in which the prevalence in females, rural areas, and western China is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo systematically review the satisfaction of Chinese residents with the contract services of family doctors. MethodsCNKI, WanFang Data, VIP, PubMed, Web of Science, and EMbase databases were electronically searched to collect cross-sectional studies related to the Chinese residents' satisfaction with the service of family doctors from January 2011 to May 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.1 software. ResultsA total of 42 cross-sectional studies were included. The results of meta-analysis showed that the overall satisfaction rate of residents with the contract services of family doctors was 77.7% (95%CI 73.7% to 81.7%). The results of subgroup analysis showed that the satisfaction rate of the male and female residents were 83.0% and 84.3%; <60 and ≥60 years old residents were 83.5% and 81.7%; junior high school or below, senior high school or technical secondary school, junior college or above educational level residents were 84.1%, 76.4% and 81.2%; the monthly income less than 4000 yuan and more than 4000 yuan residents were 78.5% and 79.3%; with and without diseases residents were 85.3% and 79.7%; with and without spouse residents were 80.6% and 82.4%; on and off the job residents were 77.7% and 73.9%; urban and rural residents were 78.7% and 80.0%; in 2011-2015 and 2016-2020 were 67.6% and 76.2%; eastern and western regions residents were 76.5% and 79.7%; relevant studies which were conducted by random sampling and nonrandom sampling were 80.5% and 73.5%. ConclusionsThere is still room for improvement in residents' satisfaction with family doctor contract service. Residents with different education levels, disease situations, on-the-job situations, time, regions and sampling methods have differences in their satisfaction with the contract services of family doctors.
ObjectiveTo evaluate the methodological quality of animal experiments published in high impact journals, in order to provide references for improving the quality of animal experiments.MethodsCSCD and Web of Science databases were electronically searched to collect intervening primordial animal experiments from 2014 to August, 2016. Four reviewers independently screened literatures, extracted data and assessed the methodological quality of included studies by using SYRCLE tool.ResultsA total of 1 999 animal experiments were included. The cited frequency of more than 90% studies were ≤5 times, and of which 52.53% studies were zero. The results of SYRCLE evaluation showed that 54.55% of sub items rated as "low risk" were less than 30%. And 84.62% of them were less than 10%.ConclusionThere are defeet in methodological quality of animal experiments either domestic or abroad. The problems of domestic researches in implementation bias, measurement bias and loss of access bias are particularly obvious. The coincidence rates of "low risk" are much lower than those of abroad studies. Therefore, we suggest that it is necessary to take specific measures to popularize SYRCLE tool to effectively guide the development of animal experiments and improve the design and implementation of animal experiments.
ObjectiveTo understand the guideline citation of papers published by West China Hospital of Sichuan University, and to provide references for evaluating quality of papers. MethodsWe searched Web of Science core collection database to identify the published papers with the first author's primary affiliation at West China Hospital of Sichuan University until December 31st, 2022. Two reviewers independently performed the screening process and identified eligible papers. Afterward, we extracted the data from the selected papers, obtained their citation papers, and then separately constructed two databases, the West China Paper Database and its Citation Database. The differences in guideline citation among different types of papers and different levels of papers were analyzed using the χ2 test and Mann-Whitney U test, respectively. ResultsA total of 22 681 papers and 252 336 citations were included, of which 18 026 (79.5) articles, 2 773 (12.2) systematic reviews and 1 882 (8.3) reviews. The rates of article, systematic review and review were 2.6%, 15.8% and 2.2%, respectively. There were significant differences in three types (P<0.001). The citation rates of papers among the top 10 disciplines were different apparently: the highest citation rate was 13.9%, while the lowest citation rate was 2.6%. The guideline citation among different levels of papers showed no significant difference, but Q1 papers were more likely to be cited by Q1 guidelines (P<0.05). ConclusionPapers cited by guidelines are unevenly distributed across their article types and subject areas. High-quality papers are more likely to be cited by high-quality guidelines. Therefore, the citation of papers by guidelines can be considered as one of the indicators to evaluate the quality of papers.
ObjectiveTo explore the prevalence and risk factors of hypertension and diabetes in floating population in Hubei province, so as to provide reference for the prevention of chronic disease of floating population. MethodA multi-stages sampling was performed among six counties in Hubei province in 2012, according to the different occupations. A questionnaire survey was conducted to collect the demography, sociology and health-related behavioral characteristics of subjects. Then a univariate analysis and a multivariate analysis were conducted by SPSS 20.0 software. ResultsA total of 1 800 individuals were surveyed, and the prevalence of hypertension and diabetes in floating population was 22.7% and 4.9%, respectively. Univariate analysis indicated that significant associations were found between hypertension and such factors as age, occupations, smoking and life satisfaction (all P values < 0.05); and significant associations were found between diabetes and such factors as occupations, educational level and BMI (all P values < 0.05). The results of further logistic regression analysis showed that age (OR=2.194, 95% CI 1.940 to 2.483, P=0.001) and life satisfaction (OR=0.291, 95% CI 0.248 to 0.341, P=0.002) were independent risk factors of hypertension, and educational level (OR=3.219, 95%CI 2.016 to 7.565, P=0.011) and gender (OR=0.568, 95% CI 0.323 to 0.999, P=0.049) were independent risk factors of diabetes. ConclusionsThe prevalence of hypertension and diabetes are relative high in floating population of Hubei Province. Increasing age and low life satisfaction are independent risk factors of hypertension in floating population, while male and low educational level are independent risks factors of diabetes.
ObjectivesTo systematically review the prevalence of asthma in adults (>14 years old) in China.MethodsPubMed, Web of Science, CENTRAL, CINAHL, WanFang Data, CBM, CNKI, and VIP databases were electronically searched to collect cross-sectional studies on the prevalence of asthma in Chinese adults from January 2000 to December 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 15.0 software.ResultsA total of 67 cross-sectional studies, involving 1 381 673 subjects and 19 871 adult asthma patients were included. The results of meta-analysis showed that the prevalence rate of asthma in adults in China was 1.81% (95%CI 1.59% to 2.01%). The subgroup analysis showed that the prevalence rates of asthma in males and females were 1.87% and 1.76%, respectively. The prevalence rates were 2.16% in the northeast region, 1.34% in the central region, 1.63% in the eastern region and 2.23% in the western region. The prevalence rates were 0.73%, 1.53%, and 2.81% in 15-40 years old, 41-60 years old, and >60 years old, respectively. The prevalence rates were 3.07% in illiteracy population, 1.69% in primary school population, 1.46% in junior middle school population, 1.01% in senior high school population and 0.98% in college and above population. The prevalence rates were 2.23%, 2.10%, 1.17%, 1.45%, 1.09%, and 1.41% in agriculture, forestry and animal husbandry personnel, workers, public officials, business and service personnel, military personnel, and other occupations, respectively. The prevalence rates were 1.41% and 1.59% in Han and other ethnic populations, respectively. The prevalence rates were 2.03% in cities and 1.99% in rural areas. And the prevalence rates were 1.22% in 2000 to 2005, 2.07% in 2006 to 2010, 2.25% in 2011 to 2015, and 2.62% in 2016 to 2019.ConclusionsThe prevalence rate of asthma in Chinese adults is higher, which is different due to the influence of age, sex, region, education, and occupation.
ObjectiveTo systematically review the current status of tooth loss among elderly individuals in China.MethodsDatabases including CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, and The Cochrane Library were searched to identify studies on the current status of tooth loss in the Chinese elderly from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software.ResultsA total of 26 studies with a sample size of 17 523 participants were included. The results of the meta-analysis showed that the prevalence rate of tooth loss among the Chinese elderly was 84.7% (95%CI 81.8% to 87.6%). Subgroup analysis showed that the tooth loss prevalence rates were higher in females, individuals aged over 75, and those living in rural areas or southwest China.ConclusionsThe current evidence shows that the prevalence rate of tooth loss among the Chinese elderly is high. Due to the quantity and quality of the included studies, the above conclusions are needed to be verified by more high-quality studies.