Breast milk is a perfect food for infants; however, the rate of exclusive breastfeeding is low. The relationship between exclusive breastfeeding practices and influencing factors is complex and remains unclear. This cross-sectional study was conducted in Changsha County, China, and 414 mothers were enrolled. An online questionnaire was used to collect data on general information, obstetrics and gynecology characteristics, the initial breastfeeding intention, breastfeeding practice, frequency of attending conventional breastfeeding programs before delivery, the status of breastfeeding self-efficacy, and the status of perceived social support. Structural equation modeling (SEM) was used to estimate the association between exclusive breastfeeding and potential risk factors of failing to practice exclusive breastfeeding for 6 months. The rate of exclusive breastfeeding for 6 months was 46.1%. The median and interquartile range of the scores for breastfeeding self-efficacy and perceived social support were 51.0 (18.0) and 68.0 (20.0), respectively. Factors that were statistically significant in the univariate analysis were included in the SEM and model fitness was acceptable based on the results. Exclusive breastfeeding for 6 months was directly associated with intention and self-efficacy, while it was indirectly associated with perceived social support and frequency of attending a breastfeeding program. The findings support the recommendation that comprehensive breastfeeding promotion strategies should be implemented to call on the intention and self-efficacy of breastfeeding mothers through various measures, such as education or providing medical and health services.

This study aimed to investigate the prevalence of excessive daytime sleepiness (EDS) and explore the association between free sugars intake and EDS. In this cross-sectional study, a total of 1517 middle school students (808 boys and 707 girls) aged 12~14 years were recruited. The study was conducted in Changsha city, China. Adolescents completed an online questionnaire, including the Epworth Sleepiness Scale (ESS), sleep characteristics, a 12-item Food Frequency Questionnaire (FFQ), and other self-reported information. The ESS score ≥ ten was defined as EDS. The anthropometric indices, including height, weight, and waist circumference, were measured and recorded by uniformly trained assistants. Statistical analyses included the Chi-square test and binary logistic regression model. The mean ESS score and free sugars consumption were 6.8 ± 3.9 points and 53.1 ± 44.7 g/d, respectively. The prevalence of EDS among adolescents was 22.5%, and more girls than boys had EDS (26.1% vs. 19.4%, p < 0.05). An exceeded free sugars intake was positively associated with EDS, with the adjusted Odds Ratio (OR) with its 95% Confident Interval (95% CI) of 1.366 (1.060~1.761, p < 0.05). EDS and excessive consumption of free sugars are commonly found among Chinese adolescents. Further studies are needed to confirm whether free sugars restriction can be meaningful to improve daytime drowsiness in those with EDS.

Chronic obstructive pulmonary disease (COPD) is a significant global public health issue. Modern medical treatments have both benefits and limitations, prompting increasing attention from scholars worldwide on traditional ethnic medicine, and the Zangsiwei Qingfei Mixture is a newly developed formula derived from the effective components of classical Tibetan medicine to treat chronic respiratory diseases. This study aims to investigate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture combined with conventional treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Sixty AECOPD patients admitted to the Second Xiangya Hospital of Central South University from May 2021 to May 2023 were enrolled and randomly divided into 2 groups, with 30 patients in each group. The control group received conventional treatment, including bronchodilators, anti-infection agents, expectorants, and oxygen therapy. The experimental group received the Zangsiwei Qingfei Mixture in addition to conventional treatment. The treatment duration was 7 d for both groups. Baseline data such as gender, age, body mass index (BMI), smoking status, Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, COPD course, and the number of COPD exacerbations in the past year were collected. The primary efficacy indicators were assessed using the modified Medical Research Council (mMRC) dyspnea scale and the modified Borg scale. Secondary indicators included arterial lactic acid (LAC) and serum tumor necrosis factor alpha (TNF-α) levels. Safety indicators included liver and kidney function [alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (SCr), serum uric acid (SUA)], coagulation function [activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), and D-dimer]. The generalized linear mixed model (GLMM) was used to evaluate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture. Before treatment, there were no statistically significant differences in general baseline data, grading of mMRC dyspnea scale, score of modified Borg scale, arterial LAC, ALT, AST, SCr, SUA, APTT, FIB, and D-dimer between the 2 groups (all P>0.05). However, serum TNF-α and PT levels in the experimental group were significantly lower than those in the control group (both P<0.05). GLMM analysis showed that after adjusting for pre- and post-treatment, gender, age, BMI, smoking status, GOLD classification, COPD course, and the number of COPD exacerbations in the past year, the experimental group demonstrated significantly lower grading of mMRC dyspnea scale (coefficient=-0.329, P=0.036), score of modified Borg scale (coefficient=-1.077, P=0.001), serum TNF-α level (coefficient=-14.378, P0.05). The Zangsiwei Qingfei Mixture combined with conventional treatment can improve clinical symptoms and promote homeostasis in AECOPD patients, demonstrating safety and reliability. Combining modern medicine with traditional ethnic medicine offers a feasible approach to treating chronic respiratory diseases in the future.

Although previous studies have discussed the association between trajectories of blood pressure (BP) and risk of cardiovascular diseases (CVDs), the association among the non-hypertensive general population of youth and middle age has not been elucidated. We used the growth mixture model to explore the trajectories of BP among the non-hypertensive Chinese population and applied Cox regression to evaluate the association between trajectories of BP and the risk of stroke or myocardial infarction (MI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were categorized into three classes, respectively. Statistically significant associations were observed between SBP trajectories and stroke (range of adjusted hazard ratios (aHR): 1.369–3.837) or MI (rang of aHR = 6.047–13.017). Association between DBP trajectories and stroke (aHR: 3.685) or MI (range of aHR = 1.312–2.821) were also observed, although they did not reach statistical significance. Trajectories of SBP were more important risk factors than that of DBP in stroke and MI in our study population. BP management is important among pre-hypertensive adults to prevent stroke and MI when they age. Well-designed research with a larger sample size is required to confirm our findings and develop efficient methods to prevent CVDs.

There is a lack of evidence to show prevalence of laryngopharyngeal reflux (LPR) and the association between LPR and dietary factors. Adolescents consume the most amount of free sugars among the Chinese population. We conducted this study to investigate the prevalence of LPR in Chinese adolescents and explore the association between free sugars consumption and LPR. A cross-sectional study was conducted on 1517 middle school students in Hunan, China. An online questionnaire was applied to collect data on the condition of LPR, consumption of free sugars and other self-reported covariates. Height, weight and waist circumference were collected by anthropometric measurements. Logistic regression was applied to assess the association between LPR and free sugars consumption. The mean and standard deviation of free sugars consumption was 53.14 ± 44.75 (g/d). The prevalence of LPR was 8.11%. A positive association was observed between LPR and higher free sugars consumption after adjusted multiple covariates, with adjusted odds ratio (95% confident interval) of 1.656 (1.125–2.438). The prevalence of LPR among Chinese adolescents was high. Further analytic studies with strict design are required to test the association between LPR and free sugar consumption. Systematic strategies and policies should to be developed to reduce the intake of free sugars in order to prevent LPR.

Different lines of evidence indicate that knowledge of low-glycemic index (GI) foods and the practice of eating them play important roles in blood glucose management and preventing T2DM in women with prior gestational diabetes mellitus (GDM). According to the theory of planned behavior (TPB), intention is a critical factor in complying with health-related behaviors. However, an instrument for assessing the intention to eat low-GI foods is lacking in China. We aimed to (1) adapt and validate a Chinese version of the intentions to eat low-GI foods questionnaire (CIELQ) and (2) apply the CIELQ among rural Chinese women to explore the associations between CIELQ scores and glycemic status. A cross-sectional study was conducted on 417 nondiabetic, nonpregnant participants with a history of GDM in Hunan, China. After cultural adaptation and validation, the CIELQ was applied in a target population. Glycemic status, anthropometric variables, dietary intake, and physical activity were measured; a self-developed, standard questionnaire was applied to collect relevant information. The CIELQ showed good internal consistency; model fitness was acceptable based on the confirmatory factor analysis results. Awareness of the glycemic index was low among the study population. TPB factors were found to be associated with each other; education level and parents’ diabetes history were associated with specific factors. The score for instrumental attitude showed a positive association with the risk for a high level of the 2-h 75-g oral glucose tolerance test (odds ratio, OR = 1.330), while the score for perceived behavior control (PBC) showed a negative association with the risk for a high level (OR = 0.793). The CIELQ was determined to be a valid instrument for assessing the intention to eat a low-GI diet among the study population. The awareness of the GI was poor among the study population. The score for instrumental attitude showed a positive association with the risk of a high level on the 2-h 75-g oral glucose tolerance test (OGTT), and the score for PBC showed a negative association with the risk for a high level on OGTT.