Dayi Hu

Background: Seasonal retired migrants are mainly retired or semiretired people who migrate to warmer areas during the winter and then return to their original homes in the following year. Despite its increasing popularity, the evidence concerning the health status of Chinese seasonal retired migrants is controversial. Although some studies have shown that seasonal retired migrants have better health status, other studies note that migrants are driven involuntarily by health concerns and that their mental health suffers during migration. The objective of this study was to provide quantified evidence on the health-related quality of life (HRQoL) of seasonal retired migrants in China and to identify potential factors associated with HRQoL. Methods: This was a community-based cross-sectional study of seasonal retired migrants who lived in Wuzhishan, Hainan during the winter. The Chinese version of the EuroQol 5-Dimension 5-Level (EQ-5D-5L) was used to assess participants’ HRQoL. Data on demographic and behavioral characteristics, body mass index, and the presence of chronic diseases were collected using a self-administered survey. Logistic regressions were used to explore the factors associated with responses in each dimension of the EQ-5D-5L descriptive system, and a multiple linear regression model was used to explore the factors associated with EuroQol visual analogue scale (EQ-VAS) scores. Results: A total of 992 participants (female: 56.5%) were enrolled in the current study, with a mean age of 67.87 ± 6.98 years. Most participants reported problems in the pain/discomfort dimension (16.7%), followed by the anxiety/depression dimension (8.3%). Few participants reported problems in the first three dimensions of the EQ-5D-5L: mobility (5.4%), usual activities (2.0%), and self-care (1.2%). The median EQ-VAS score was 84 (interquartile range: 80–89). The regression results indicated that poor sleep quality, the presence of chronic diseases, and low-level physical activity were important factors that were negatively associated with multiple dimensions of the EQ-5D-5L. In addition, the EQ-VAS score was negatively associated with age, the presence of chronic diseases, poor sleep quality, and low-level physical activity. Conclusion: This study revealed that Chinese seasonal retired migrants have high HRQoL. In addition, this study revealed that sleep quality and physical activity are correlated with multiple dimensions of the EQ-5D-5L descriptive system and EQ-VAS. Therefore, lifestyle interventions related to sleep quality and physical activity are essential for improving HRQoL among Chinese seasonal retired migrants.

The study aimed to evaluate the current status of cardiac rehabilitation programs in China by registering and tracking patients undergoing CR programs in the database. Data were extracted from the online registry platform of the China Society of Cardiopulmonary Prevention and Rehabilitation from February 2012 to December 2021. Overall, data on 19,896 patients with cardiovascular diseases (CVDs) from 159 hospitals in 34 provinces of China were extracted. From a time point of view, the number of patients who had undergone CR and institutions that perform CR showed the first decline in 2009 and then increased until 2021. From a geographic point of view, the degree of participation varied greatly among regions, most of which were concentrated in eastern parts of China. A higher population of patients who underwent CR were male, aged less than 60 years, with low-a risk for coronary heart disease (CHD), and tended to choose the hospital-based CR program among all cases registered in the database. The top three diseases in the patients who participated in CR were CHD, hypertension, and metabolic syndrome (MS). Centers with CR were more likely to be tertiary-level hospitals. After adjusting for baseline values, there were significant differences in post-CR exercise capacity among the three groups (home-based CR group, hospital-based CR group, and hybrid CR group), which were in favor of the hybrid CR group compared with other groups. The underutilization of CR is a global issue, not just in China. Despite the number of CR programs showing an increasing trend in the past years, CR in China is still in the preliminary stage of development. Furthermore, the participation of CR in China shows wide diversity across geography, disease, age, sex, risk stratification, and hospital-level factors. These findings reinforce the importance of the implementation of effective measures to improve the participation, enrollment in, and uptake of cardiac rehabilitation.

Background: To determine the effects of inspiratory muscle training (IMT) alone on inspiratory muscle strength and endurance, pulmonary function, pulmonary complications, and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). Methods: We conducted a literature search across databases (Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily; Ovid Embase; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; and Scopus) from inception to December 2021. The eligibility criteria were randomized controlled trials that investigated the effects of IMT versus usual care or sham IMT in patients undergoing CABG. Results: A total of 12 randomized clinical trials with 918 patients were included in the meta-analysis. Postoperative IMT was associated with improved maximal inspiratory pressure (MIP), maximum inspiratory pressure (PImax), and six-minute walking test (6MWT) and with a decrease in length of hospital stay (LOS). For preoperative IMT, there was statistical significance between intervention and MIP, PImax, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), postoperative pulmonary complications (PPCs), and LOS. Pre- and postoperative IMT resulted in improvements in MIP. Conclusions: Isolated IMT in patients who underwent CABG improved their inspiratory muscle strength and endurance, pulmonary function, and 6MWT and helped decrease postoperative pulmonary complications and the length of hospital stay.

Aim: To describe a new model, the Support Life Club (SLC), for participants of Phase II cardiac rehabilitation (CR) programs and to evaluate this model for adherence, completion rates, and clinical outcomes. Methods: This retrospective study involved 391 consecutive patients who participated in an outpatient CR program between September 2016 and May 2020. The intervention group (SLC) was comprised of 198 patients who participated in education, WeChat-based group activity as well as outdoor activities, while the control group (non-intervention) was comprised of 193 cases. All patients attended a 12-week supervised outpatient CR program (three sessions per week, each lasting 40min). The intervention and control groups were compared for completion rates, Cardiopulmonary Exercise Test (CPET) results, Six-minute Walk Test (6MWT) distances, and Patient Health Questionnaire-9 (PHQ-9) scores. Results: Patients in the intervention group attended at least 75% of the exercise training sessions more often than those in the control group (72.5% vs 40.41%, adjusted odds ratio (OR): 27.385; 95% CI: 10.2 to 73.6; P = 0.0000). Analysis of variance (2 × 2 ANOVA) revealed a significant group-by-time interaction in PHQ9 and 6MWT test results (p = 0.000). Conclusion: The addition of SLC to a cardiac rehabilitation program resulted in better outcomes for PHQ9 and 6MWT tests and may be a useful strategy to improve exercise adherence.

Objective: To assess the clinical effectiveness of Yangxinshi (YXS) tablets on exercise capacity and symptoms of anxiety and depression in patients with coronary heart disease (CHD). Methods and Results: A randomized, double-blind, placebo-controlled, multicenter clinical trial was performed to assess the effects of YXS tablets on exercise capacity and quality of life in patients with CHD. A total of 82 patients were included in this trial. Compared with the placebo group, the YXS group showed significant improvement in peak VO2 (0.22 L/min vs 0.01 L/min; difference 0.1, 95% confidence interval (CI) 0.04–0.16, p = 0.000), peak Mets (0.58 vs 0.09; difference 0.3, 95% CI 0.12–0.47, p = 0.005), anaerobic threshold (AT) VO2 (0.23 L/min vs 0.04 L/min; difference 0.12, 95% CI 0.07–0.18, p = 0.000), AT Mets (0.62 vs 0.16; difference 0.35, 95% CI 0.2–0.5, p = 0.001), and 6 minutes walking test (6MWT) (50.05 m vs 11.91 m; difference 29.92, 95% CI 18.78–41.07, p = 0.000). There were no differences in Hamilton anxiety rating scale (HAM-A score (1.97 vs 2.07; difference 2.03, 95% CI 0.99–3.06, p = 0.926) and Hamilton depression rating scale (HAM-D) score (1.06 vs 1.7; difference1.42, 95% CI 0.24–2.6, p = 0.592). Conclusions: In patients with CHD, YXS tablets, compared with placebo, could improve exercise capacity, without beneficial effects on anxiety and depression symptoms.