Shu Fang

Extracorporeal cardiopulmonary resuscitation (ECPR) is an advanced resuscitation method that has been associated with better outcomes after cardiac arrest compared with conventional cardiopulmonary resuscitation. This is a retrospective analysis of all patients who received ECPR for cardiac arrest in Hong Kong’s first ECPR program from 2012 to 2020. The primary outcome was favorable neurologic outcome at 3 months. A new risk prediction model was developed and its performance was compared with published risk scores. One-hundred two patients received ECPR and 19 (18.6%) patients survived with favorable neurologic outcome. Having a shockable rhythm was the strongest predictor of favorable neurologic outcome in multivariate analysis (odds ratio, 9.64; 95% confidence interval [CI], 1.49 to 62.30; P = 0.017). We developed a simple model with three parameters for the prediction of favorable neurologic outcomes – presence of shockable rhythm, mean arterial pressure after extracorporeal membrane oxygenation, and the Acute Physiology And Chronic Health Evaluation IV score, with an area under receiver operating characteristic curve of 0.85 (95% CI, 0.77 to 0.94). In Hong Kong’s first ECPR program, 18.6% patients survived with favorable neurologic outcomes, and having a shockable rhythm at presentation was the strongest predictor. Risk scores are useful in predicting important patient outcomes and should be included in clinical decision-making for patients who received ECPR.

Background: The study aimed to examine the association between daytime napping and successful aging (including its five dimensions, “low probability of disease,” “no disease-related disability,” “high cognitive functioning,” “high physical functioning,” and “active engagement with life”) among China’s older adults using data from the Chinese Health and Retirement Longitudinal Study conducted in 2015. Methods: Cross-sectional data were used in the analysis. Multivariable logistic regressions were conducted to investigate the association between daytime napping and successful aging, and stratified analyses were performed to explore differences in nighttime sleep duration. Results: A total of 7469 participants were included in the analysis. Daytime napping was prevalent in China’s older adults (59.3%). The proportion of study participants with “successful aging” was 13.7%. Additionally, 48.6, 91.7, 54.1, 78.5, and 49.1% participants achieved “low probability of disease,” “no disease-related disability,” “high cognitive functioning,” “high physical functioning,” and “active engagement with life,” respectively. Compared with the 0 min/day napping group, the > 60 min/day napping group was associated with a lower probability of achieving successful aging (OR, 0.762; 95% CI, 0.583–0.996). In the nighttime sleep duration stratification, the findings showed that in the ≥8 h/night group, napping > 60 min per day was associated with a lower likelihood of aging successfully (OR, 0.617; 95% CI, 0.387–0.984). Considering the five dimensions of successful aging, moderate and long daytime napping were negatively associated with “low probability of disease”; long daytime napping had negative associations with “no disease-related disability” and “high physical functioning”; moderate daytime napping had positive associations with “high cognitive functioning” and “active engagement with life.” Conclusions: Long daytime napping showed a lower likelihood of successful aging among the elderly in China. Special attention is necessary for elderly people who sleep for longer duration both during day and night. Biological and social factors affecting the relationship between daytime napping and successful aging need to be explored in depth in the future.

Purpose: To examine associations of daytime napping and diagnosed diabetes in middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal Chinese women. Design: Quantitative, cross-sectional. Setting: 2015 cross-sectional data from China Health and Retirement Longitudinal Study. Participants were recruited from 150 counties/districts and 450 villages/resident committees. Participants: Six thousand nine hundred and forty women aged 45 years and older (mean age = 61 years) stratified by age and menopausal status. Measures: The outcome was self-reported diagnosed diabetes. The exposure was self-reported daytime napping (0, >0-≤60, or >60 min/d). Participants were stratified to middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal women according to their age (≤60 or >60 years) and menopausal status. Analysis: One-way analysis of variance and χ ² tests were conducted to explore differences on characteristics of middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal women. Multiple logistic regressions were used to estimate adjusted odds ratios (ORs) for diagnosed diabetes according to daytime napping in the total sample, middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal Chinese women. Results: Participants’ mean self-reported daytime napping duration was 34 minutes. Women who napped more than 60 minutes were more likely to report diagnosed diabetes (OR = 1.39, 95% confidence interval (CI), 1.09-1.76) comparing to those who did not nap, after adjusting for potential confounders. No statistical significance of interaction term between daytime napping and age/menopausal status was detected ( P = .602 and P = .558) among total women. The stratified analysis revealed the significant association among middle-aged postmenopausal women napping more than 60 minutes (OR = 1.81, 95% CI, 1.18-2.77). The association, however, was found to be insignificant in middle-aged premenopausal women and older postmenopausal women. Conclusions: Long daytime nap (>60 min/d) was associated with diagnosed diabetes in middle-aged postmenopausal women in China.

Undiagnosed hypertension has resulted in significant health and economic burdens. This study sought to investigate the association between health factors and undiagnosed hypertension among hypertensive Chinese and to assess the urban-rural disparity. A total of 6455 diagnosed and undiagnosed hypertensive adults were included. Multivariable logistic regression was conducted to examine the association between health factors and undiagnosed hypertension. The urban–rural disparity was investigated through stratified analysis. Undiagnosed hypertension was prevalent (28.8%), and rural residents were more likely to have undiagnosed hypertension compared to their urban counterparts (30.1% versus 24.7%). Physical examination, healthcare service utilization, body mass index, chronic diseases, headache, and self-rated health status were found to be significantly associated with undiagnosed hypertension. In addition, healthcare service utilization, underweight in body mass index, headache, and self-rating health status were associated with undiagnosed hypertension among the rural sample but not in the urban sample. Undiagnosed hypertension was significantly related to health factors among hypertensive Chinese. The findings provided implications for future hypertension prevention programs. The use of physical examination (e.g., blood pressure measurements) is recommended; special attention may be given to those who are underweight and self-rate their health as good and fair, as they are more likely to be neglected.