Background and Objectives:We aimed to explore the relationship between dietary patterns and gestational diabetes mellitus(GDM)during pre-pregnancy six months using principal component analysis(PCA)and the geometric fr...Background and Objectives:We aimed to explore the relationship between dietary patterns and gestational diabetes mellitus(GDM)during pre-pregnancy six months using principal component analysis(PCA)and the geometric framework for nutrition(GFN).Methods and Study Design:We conducted a case-control study that included 210 GDM pregnant women and 210 controls.The dietary intake of all participants was assessed by a validated semi-quantitative food frequency questionnaire(FFQ).Major dietary patterns were extracted by PCA.A conditional logistic regression model was used to determine whether specific dietary patterns are associated with the risk of GDM.Meanwhile,the relationship between dietary patterns and GDM was visualized using GFN.Results:Four major dietary patterns were identified:“protein-rich pattern,”“plant-based pattern,”“oil-picklesdesserts pattern,”and“cereals-nuts pattern.”After adjustment for confounders,the“plant-based pattern”was associated with decreased risk of GDM(Q4 vs.Q1:OR=0.01,95%CI:0.00~0.08),whereas no significant association was found in other dietary patterns.Moreover,there was no dietary intake of ice cream cones and deep-fried dough sticks for the population,which would produce fewer patients with GDM.Deep-fried dough sticks had statistically significant differences in the case and control groups(p<0.001),while ice cream cones had the opposite result.Conclusions:The“plant-based pattern”may reduce the risk of GDM.Besides,although the“cerealsnuts pattern”had no association with GDM risk,avoiding the intake of deep-fried dough sticks could decrease GDM risk.展开更多
Background Mumps virus infection is a potentially serious viral infection of childhood and early adulthood. In China, live attenuated S79 mumps vaccine has been licensed for pediatric use since 1990. The objective of ...Background Mumps virus infection is a potentially serious viral infection of childhood and early adulthood. In China, live attenuated S79 mumps vaccine has been licensed for pediatric use since 1990. The objective of this study was to determine the effectiveness of live attenuated S79 mumps vaccine against clinical mumps in outbreaks. Methods Cases were selected from mumps outbreaks in schools in Guangzhou between 2004 and 2005. Each case was matched by gender, age and classroom. Vaccination information was obtained from Children＇s EPI Administrative Computerized System. Vaccine effectiveness （VE） was calculated for 1 or 2 doses of S79 vaccine with 95% confidence intervals （CI）. Results One hundred and ninety-four cases and 194 controls were enrolled into the study. VE of the S79 mumps vaccine for 1 dose versus 0 confer protection 80.4% （95% Cl, 60.0%-90.4%） and VEs against mumps in outbreaks for 1 dose of mumps vaccine are similar among those children aged 4-9 years and aged over 10 years old. Conclusion The live attenuated S79 mumps vaccine can be effective in preventing clinical mumps outbreaks.展开更多
Background:Copper and zinc are involved in the development of multiple malignancies;yet,epidemiological evidence on hepatocellular carcinoma(HCC)is limited.This study aimed to investigate the association between dieta...Background:Copper and zinc are involved in the development of multiple malignancies;yet,epidemiological evidence on hepatocellular carcinoma(HCC)is limited.This study aimed to investigate the association between dietary intake and serum levels of copper and zinc with the risk of HCC.Methods:A total of 434 case-control pairs matched for sex and age(±1 year)were included in this study.Cases with newly diagnosed HCC were from the Guangdong Liver Cancer Cohort(GLCC)study,and healthy controls were from the Guangzhou Nutrition and Health Study(GNHS).A semi-quantitative 79-item food frequency questionnaire(FFQ)was used to assess habitual dietary intakes of copper and zinc.Serum levels of copper and zinc were measured by using inductively coupled plasma mass spectrometry.The copper(Cu)/zinc(Zn)ratio was computed by dividing copper levels by zinc levels.Conditional logistic regression models were performed to calculate the odds ratio(OR)and 95%confidence intervals(CI)for per 1 standard deviation increase(per-SD increase)in copper and zinc levels.Results:Higher dietary intake(OR_(per-SD increase)=0.65,95%CI:0.44,0.96,P_(trend)=0.029)and serum levels of zinc(OR_(per-SD increase)=0.11,95%CI:0.04,0.30,P_(trend)<0.001)were both associated with a lower risk of HCC.Subgroup analyses showed that the inverse association was only pronounced in men but not in women(P_(interaction)=0.041 for dietary zinc intake and 0.010 for serum zinc levels).Serum copper levels(OR_(per-SD increase)=2.05,95%CI:1.39,3.03,P_(trend)=0.020)and serum Cu/Zn ratio(OR_(per-SD increase)=6.53,95%CI:2.52,16.92,P_(trend)<0.001)were positively associated with HCC risk,while dietary copper intake and dietary Cu/Zn ratio were not associated with HCC risk.Conclusion:Zinc may be a protective factor for HCC,especially among men,but the effects of copper on HCC risk are not clear.展开更多
Microcystin-LR(MC-LR),the most prevalent and diverse cyanotoxin produced by harmful cyanobacterial blooms,has been linked to gastrointestinal toxicity.Therefore,we conducted a case-control study across four regions in...Microcystin-LR(MC-LR),the most prevalent and diverse cyanotoxin produced by harmful cyanobacterial blooms,has been linked to gastrointestinal toxicity.Therefore,we conducted a case-control study across four regions in China to investigate this relationship.Inflammatory bowel disease(IBD)cases(219)were matched with healthy controls(438)based on age and gender and conditional logistic regression models and Restricted cubic splines were used to evaluate the association between MC-LR exposure and IBD risk.We used quantitative real-time polymerase chain reaction to measure the expression levels of inflammatory factors.The levels of protein expression in the colorectum were determined using Western blotting(WB).Compared to the lowest quartile of serum MC-LR levels,the adjusted odds ratios and 95%confidence intervals(CI)for the highest quartiles of serum MC-LR levels were 5.51(2.70,11.21).The RCS was shown the association between serum MC-LR levels and IBD risk was nonlinear(Pnonlinear<0.001).In the animal experiments,MC-LR resulted in colorectal injury via the PI3K/AKT signaling pathway.Our study provides the evidence that serum MC-LR exposure is significantly associated with the risk of IBD in China.Animal study results indicate that MC-LR probably causes IBD via the PI3K/AKT signaling pathway.展开更多
Objective To indicate the deficiency of the classical method for analyzing data on individual matching case-control study in consideration of the interaction between the study factor (exposure) and the matching factor...Objective To indicate the deficiency of the classical method for analyzing data on individual matching case-control study in consideration of the interaction between the study factor (exposure) and the matching factor, and to find out a proper method for handling this deficiency. Method First, experimental data with 50 pairs of cases and controls were used for strata analysis according to the values of a matching factor to illustrate the possible interaction between a risk factor (exposure) and the matching factor. Second, a detailed procedure was proposed for analyzing such data. Results Interaction between the study factor and matching factor was demonstrated by using strata analysis and unconditional logistic regression analysis. Therefore the results from the classical analysis for such data might be incorrect. Conclusion Data from individual matching case-control study design should be dealt with strata analysis or multivariate analysis to explore and evaluate the possible interaction between the s展开更多
BACKGROUND Proton pump inhibitors(PPIs)are among the most commonly prescribed medications globally.While concerns exist regarding their association with adverse infection-related outcomes,their impact on coronavirus d...BACKGROUND Proton pump inhibitors(PPIs)are among the most commonly prescribed medications globally.While concerns exist regarding their association with adverse infection-related outcomes,their impact on coronavirus disease 2019(COVID-19)severity remains uncertain.Emerging preclinical data suggest immunomodulatory and antiviral properties of PPIs,yet clinical evidence is conflicting.AIM To investigate whether chronic pre-hospital PPI use is associated with improved outcomes in patients hospitalized with COVID-19.METHODS We conducted a retrospective case-control study of adult inpatients with severe acute respiratory syndrome coronavirus 2 infection admitted to a racially and ethnically diverse communityhospital in Massachusetts from July 2021 to March 2022. Patients were stratified by documented pre-hospital PPIuse. The primary outcomes were intensive care unit (ICU) admission, need for invasive mechanical ventilation, andin-hospital mortality. Multivariable logistic regression was used to adjust for demographics, comorbidities, andtreatment variables. Significance was set at P < 0.05.RESULTSAmong 248 patients, 83 (33.4%) were on PPIs prior to hospitalization. Compared to non-users, PPI users hadsignificantly lower rates of ICU admission (13.3% vs 24.8%, P = 0.034), mechanical ventilation (13.3% vs 25.5%, P =0.027), and in-hospital mortality (6.0% vs 17.6%, P = 0.013). Multivariable analysis confirmed these associations:ICU admission [adjusted odds ratios (aOR): 0.462, 95%CI: 0.223–0.955], mechanical ventilation (aOR: 0.447, 95%CI:0.216–0.923), and mortality (aOR: 0.144, 95%CI: 0.031–0.677). Findings were consistent across demographic andcomorbidity strata.CONCLUSIONIn this diverse, real-world United States cohort, chronic pre-hospital PPI use was independently associated withlower odds of intensive care unit admission, mechanical ventilation, and mortality among COVID-19 inpatients.These findings highlight a potentially protective role of PPIs and support continued therapy in eligible patients.展开更多
This case-control study evaluated the frequency of Glutathione S-transferase Mu 1(GSTM1)deletion and Glutathione S-transferase Alpha 1(GSTA1)mutation in chronic obstructive pulmonary disease(COPD)patients,whether they...This case-control study evaluated the frequency of Glutathione S-transferase Mu 1(GSTM1)deletion and Glutathione S-transferase Alpha 1(GSTA1)mutation in chronic obstructive pulmonary disease(COPD)patients,whether they had concomitant lung squamous cell carcinoma(LSCC)or not,to assess their connection with cancer susceptibility.By means of multivariate logistic regression analysis,the GSTM1 null genotype serves as a significant standalone risk factor for LSCC,in addition to variables like age,smoking history,emphysema,body mass index(BMI),albumin level,and neutrophil-to-lymphocyte ratio(NLR).A predictive model incorporating these factors demonstrated superior discriminative ability compared to the established COPD Lung Cancer Screening Score(COPD-LUCSS).展开更多
Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become...Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become the major study design used in surgical research when RCTs are unable to be conducted and definitely replacing case series which offer little insight into surgical outcomes and disease processes.展开更多
Background: Binary as well as polytomous logistic models are widely used for estimating odds ratios when the exposure of prime interest assumes unordered multiple levels under matched pairs case-control design. In our...Background: Binary as well as polytomous logistic models are widely used for estimating odds ratios when the exposure of prime interest assumes unordered multiple levels under matched pairs case-control design. In our previous studies, we have shown that the use of a polytomous logistic model for estimating cumulative odds ratios when the outcome (response) variable is ordinal (in addition to being polytomous) under matched pairs case-control design. The cumulative odds ratios were estimated based on separate fitting of the model at each of the cutpoint level as compared to less than equal to that level. In this paper we propose an alternative method of estimating the cumulative odds ratios and reanalyze the Los Angeles Endometrial Cancer data in the context of dose levels of conjugated oestrogen exposure and development of endometrial cancer under the matched pair case-control design. Methods: In the present study, the cumulative logit model is fitted using a single multinomial logit model for the data. For this, the full maximum likelihood estimation procedure is adopted. A test for equality of the cumulative odds ratios across the exposure levels is proposed. Results: The analysis revealed that there is a strong evidence of risk for developing endometrial cancer due to oestrogen exposure above each of the three dose level as compared to less than equal to that level. The estimated values at the three cutpoint levels were found to be 6.17, 3.60 and 5.16 respectively. Conclusions: The odds of developing endometrial cancer are very high for the users of any amount of oestrogen, even if it is the least dose, as compared to the non-users.展开更多
AIM: To compare shortand long-term outcomes of laparoscopy-assisted and open distal gastrectomy for gastric cancer. METHODS: A retrospective study was performed by comparing the outcomes of 54 patients who underwent l...AIM: To compare shortand long-term outcomes of laparoscopy-assisted and open distal gastrectomy for gastric cancer. METHODS: A retrospective study was performed by comparing the outcomes of 54 patients who underwent laparoscopy-assisted distal gastrectomy (LADG) with those of 54 patients who underwent open distal gastrectomy (ODG) between October 2004 and October 2007. The patients' demographic data (age and gender), date of surgery, extent of lymphadenectomy, and differentiation and tumor-node-metastasis stage of the tumor were examined. The operative time, intraoperative blood loss, postoperative recovery, complications, pathological findings, and follow-up data were compared between the two groups.RESULTS: The mean operative time was significantly longer in the LADG group than in the ODG group (259.3 ± 46.2 min vs 199.8 ± 40.85 min; P < 0.05), whereas intraoperative blood loss and postoperative complications were significantly lower (160.2 ± 85.9 mL vs 257.8 ± 151.0 mL; 13.0% vs 24.1%, respectively, P < 0.05). In addition, the time to first flatus, time to initiate oral intake, and postoperative hospital stay were significantly shorter in the LADG group than in the ODG group (3.9 ± 1.4 d vs 4.4 ± 1.5 d; 4.6 ± 1.2 d vs 5.6 ± 2.1 d; and 9.5 ± 2.7 d vs 11.1 ± 4.1 d, respectively; P < 0.05). There was no significant difference between the LADG group and ODG group with regard to the number of harvested lymph nodes. The median followup was 60 mo (range, 5-97 mo). The 1-, 3-, and 5-year disease-free survival rates were 94.3%, 90.2%, and 76.7%, respectively, in the LADG group and 89.5%, 84.7%, and 82.3%, respectively, in the ODG group. The 1-, 3-, and 5-year overall survival rates were 98.0%, 91.9%, and 81.1%, respectively, in the LADG group and 91.5%, 86.9%, and 82.1%, respectively, in the ODG group. There was no significant difference between the two groups with regard to the survival rate. CONCLUSION: LADG is suitable and minimally invasive for treating distal gastric cancer and can achieve similar long-term results to ODG.展开更多
AIM:To evaluate potential risk factors in the development of ulcerative colitis(UC) in China.METHODS:A total of 1308 patients with UC and 1308 age-matched and sex-matched controls were prospectively studied in China.T...AIM:To evaluate potential risk factors in the development of ulcerative colitis(UC) in China.METHODS:A total of 1308 patients with UC and 1308 age-matched and sex-matched controls were prospectively studied in China.The UC cases were collected from 17 hospitals in China from April 2007 to April 2010.Uniform questionnaires were designed to investigate risk factors including smoking,appendectomy,stress,socio-economic conditions,nonsteroidal antiinflammatory drugs(NSAIDs),oral contraceptives,diet,breastfeeding,infections and family sanitary conditions.Group comparisons by each factor were done using simple logistic regression analysis.Conditional logistic regression was used for multivariate analysis.RESULTS:By univariate analysis,the variables predictive of UC included feeling stress,light and heavy alcoholic drinking,spicy food,sugar consumption and infectious diarrhea,while heavy tea intake and tap water consumption were protective against UC.On multivariate analysis,the protective factor for UC was tap water consumption [odds ratios(OR) = 0.424,95%CI:0.302-0.594,P < 0.001];while the potential risk factors for UC were heavy sugar consumption(OR = 1.632,95%CI:1.156-2.305,P < 0.001),spicy food(light intake:OR = 3.329,95%CI:2.282-4.857,P < 0.001;heavy intake:OR = 3.979,95%CI:2.700-5.863,P < 0.001),and often feeling stress(OR = 1.981,95%CI:1.447-2.711,P < 0.001).Other factors,such as smoking habit,appendectomy,breastfeeding,a history of measles,rural or urban residence,education,oral contraceptives,and NSAID use have not been found to have a significant association with the development of UC in the present study.CONCLUSION:Our study showed tap water consumption was a protective factor for UC,while spicy food,heavy sugar consumption and often feeling stress were risk factors for UC in this Chinese population.展开更多
AIM:To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of Ch...AIM:To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of China.METHODS:Randomized multistage stratified cluster sampling from the island population of China was used in the population-based case-control study. Then interview, physical examination, laboratory assessments and ultrasonography were done. RESULTS:Daily alcohol intake ≥ 20 g, duration of drinking ≥ 5 years and obesity were closely related to alcohol-related liver injury (P < 0.05). The odds-ratio (OR) (95% CI) was 1.965 (1.122-3.442), 3.412 (1.789-6.507) and 1.887 (1.261-2.824), respectively. The prevalence rate of alcohol-related liver injury in ≥ 20 g daily alcohol intake group and < 20 g daily alcohol intake group was 37.14% and 12.06%, respectively. The prevalence rate of alcohol-related liver injury in ≥ 5 years drinking group and < 5 years drinking group was 34.44% and 8.53%, respectively. No significant dose-response relation was found between daily alcohol intake and abnormal alcohol-related liver injury indicators as well as between duration of drinking and abnormal alcohol-related liver injury indicators. There was no significant difference in the prevalence of alcohol-related liver injury between beer drinking group and yellow rice wine drinking group, hard liquor drinking group, multiple drinking group.CONCLUSION:The risk threshold of daily alcohol intake is 20 g and duration of drinking inducing alcohol-related liver injury 5 years in the island population of China. Liver injury induced by obesity should be concerned.展开更多
Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to ...Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to identify the association between facial dermatosis and Demodex.Amongst the patients,539 suffered from facial dermatosis and 321 suffered from non-facial dermatosis.Demodex mites were sampled and examined using the skin pressurization method.Multivariate regression analysis was applied to analyze the association between facial dermatosis and Demodex infestation,and to identify the risk factors of Demodex infestation.The results showed that total detection rate of Demodex was 43.0%.Patients aged above 30 years had higher odds of Demodex infestation than those under 30 years.Compared to patients with neutral skin,patients with mixed,oily,or dry skin were more likely to be infested with Demodex(odds ratios(ORs) were 2.5,2.4,and 1.6,respectively).Moreover,Demodex infestation was found to be statistically associated with rosacea(OR=8.1),steroid-induced dermatitis(OR=2.7),seborrheic dermatitis(OR=2.2),and primary irritation dermatitis(OR=2.1).In particular,ORs calculated from the severe infestation(≥5 mites/cm2) rate were significantly higher than those of the total rate.Therefore,we concluded that Demodex is associated with rosacea,steroid-induced dermatitis,seborrheic dermatitis,and primary irritation dermatitis.The rate of severe infestation is found to be more correlated with various dermatosis than the total infestation rate.The risk factors of Demodex infestation,age,and skin types were identified.Our study also suggested that good hygiene practice might reduce the chances of demodicosis and Demodex infestation.展开更多
BACKGROUND:Why 3.3% to 10% of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma (ICC) remains unknown.We carried out a hospital-based case-control study to identify risk factors for the develop...BACKGROUND:Why 3.3% to 10% of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma (ICC) remains unknown.We carried out a hospital-based case-control study to identify risk factors for the development of ICC in patients with hepatolithiasis in China.METHODS:Eighty-seven patients with pathologically diagnosed hepatolithiasis associated with ICC and 228 with hepatolithiasis alone matched by sex,age (±2 years),hospital admittance and place of residence were interviewed during the period of 2000-2008.Odds ratios (OR) and 95% confidence intervals (CI) were calculated for each risk factor.RESULTS:Among the patients with hepatolithiasis associated with ICC,the mean age was 57.7 years and 61.0% were female Univariate analysis showed that the significant risk factors for ICC development in hepatolithiasis were smoking,family history of cancer,appendectomy during childhood (under age 20),and duration of symptoms >10 years.In multivariate stepwise logistic regression analysis,smoking (OR=1.931,95% CI:1.000-3.731),family history of cancer (OR=5.175,95% CI:1.216-22.022),and duration of symptoms >10 years (OR=2.348 95% CI:1.394-3.952) were independent factors.CONCLUSION:Smoking,family history of cancer and duration of symptoms >10 years may be risk factors for ICC in patients with hepatolithiasis.展开更多
AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to Sep...AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.展开更多
Abstract Objective To assess the association of TNF-α and IL-1RA SNPs with the risk of silicosis in Chinese workers exposed to silica particles. Methods Case-control study design was used to enroll 68 silicotic patie...Abstract Objective To assess the association of TNF-α and IL-1RA SNPs with the risk of silicosis in Chinese workers exposed to silica particles. Methods Case-control study design was used to enroll 68 silicotic patients induced by silica particles and 68 healthy workers matched for length of silica particle exposure as controls. Both cases and controls were from the same company in southwest China, and each of them was requested to complete a questionnaire. Blood samples were drawn for genomic DNA extraction from each participant. The genotyping of TNF-α （-238 and -308） and IL-1RA （＋2018） was performed using polymerase chain reaction-based restriction fragment length polymorphism （PCR-RFLP） and SYBR green-based quantitative polymerase chain reaction {qPCR）, respectively. Unconditional logistic regression model was used to estimate odds ratios （ORs） and their 95% confidential intervals （Cl） for SNPs. Results No significant differences were found between cases and controls in particles exposure length, body mass index （BMI）, and status of smoking and alcohol consumption except for age （P=O.O01） and blood type （P=0.042）. The frequencies of TNF-c（（-238） and IL-1RA （＋2018） genotypes in cases were significantly different from those in controls, （P=O.O01 and P=0.O02, respectively）, while a borderline significant difference was found in the frequencies of TNF-α（-308） between cases and controls （P=0.063）. The variants of three SNPs increased the risk of silicosis in the Chinese workers exposed to silica particles. The adjusted ORs of TNFα（-308）, TNF-α（-238） and IL-1RA （＋2018） were 2.8 （95% Ch 2.1-7.5）, 20.9 （95% Ch 2.8-236.4） and 4.0 （95% CI： 2.6-10.2）, respectively. Conclusion It is suggested that cytokine polymorphisms of TNF-ct （-238, -308） and IL-1RA （＋2018） are associated with the risk of silicosis in the Chinese workers exposed to silica particles. Further independent studies on the interaction between SNPs and exposure to silica particles with a larger sample size are therefore warranted.展开更多
AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected f...AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.展开更多
The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A match...The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.展开更多
Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled fro...Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.展开更多
BACKGROUND When opportunistic infections occur, patients with inflammatory bowel disease(IBD) commonly display a significantly increased rate of morbidity and mortality.With increasing use of immunosuppressive agents ...BACKGROUND When opportunistic infections occur, patients with inflammatory bowel disease(IBD) commonly display a significantly increased rate of morbidity and mortality.With increasing use of immunosuppressive agents and biological agents,opportunistic infections are becoming a hot topic in the perspective of drug safety in IBD patients. Despite the well-established role of opportunistic infections in the prognosis of IBD patients, there are few epidemiological data investigating the incidence of opportunis-tic infections in IBD patients in China. Besides, the risk factors for opportunistic infection in Chinese IBD patients remain unclear.AIM To predict the incidence of opportunistic infections related to IBD in China, and explore the risk factors for opportunistic infections.METHODS A single-center, prospective study of IBD patients was conducted. The patients were followed for up to 12 mo to calculate the incidence of infections. For each infected IBD patient, two non-infected IBD patients were selected as controls. A conditional logistic regression analysis was used to assess associations between putative risk factors and opportunistic infections, which are represented as odds ratios(OR) and 95% confidence intervals(CIs).RESULTS Seventy(28.11%) out of 249 IBD patients developed opportunistic infections.Clostridium difficile infections and respiratory syncytial virus infections were found in 24 and 16 patients, respectively. In a univariate analysis, factors such as the severity of IBD, use of an immunosuppressant or immunosuppressants, high levels of fecal calprotectin, and C-reactive protein or erythrocyte sedimentation rate were individually related to a significantly increased risk of opportunistic infection. Multivariate analysis indicated that the use of any immunosuppressant yielded an OR of 3.247(95%CI: 1.128-9.341), whereas the use of any two immunosuppressants yielded an OR of 6.457(95%CI: 1.726-24.152) for opportunistic infection. Interestingly, when immunosuppressants were used in combination with infliximab(IFX) or 5-aminosalicylic acid, a significantly increased risk of opportunistic infection was also observed. The relative risk of opportunistic infection was greatest in IBD patients with severe disease activity(OR = 9.090; 95%CI: 1.532-53.941, relative to the remission stage). However, the use of IFX alone did not increase the risk of opportunistic infection.CONCLUSION Factors such as severe IBD, elevated levels of fecal calprotectin, and the use of immunosuppressive medications, especially when used in combination, are major risk factors for opportunistic infections in IBD patients. The use of IFX alone does not increase the risk of opportunistic infection.展开更多
基金funded and supported by the Chinese Nutrition Society-Feihe Physical Nutrition and Health Research Fund project(Project No.CNS-Feihe2019A34).
文摘Background and Objectives:We aimed to explore the relationship between dietary patterns and gestational diabetes mellitus(GDM)during pre-pregnancy six months using principal component analysis(PCA)and the geometric framework for nutrition(GFN).Methods and Study Design:We conducted a case-control study that included 210 GDM pregnant women and 210 controls.The dietary intake of all participants was assessed by a validated semi-quantitative food frequency questionnaire(FFQ).Major dietary patterns were extracted by PCA.A conditional logistic regression model was used to determine whether specific dietary patterns are associated with the risk of GDM.Meanwhile,the relationship between dietary patterns and GDM was visualized using GFN.Results:Four major dietary patterns were identified:“protein-rich pattern,”“plant-based pattern,”“oil-picklesdesserts pattern,”and“cereals-nuts pattern.”After adjustment for confounders,the“plant-based pattern”was associated with decreased risk of GDM(Q4 vs.Q1:OR=0.01,95%CI:0.00~0.08),whereas no significant association was found in other dietary patterns.Moreover,there was no dietary intake of ice cream cones and deep-fried dough sticks for the population,which would produce fewer patients with GDM.Deep-fried dough sticks had statistically significant differences in the case and control groups(p<0.001),while ice cream cones had the opposite result.Conclusions:The“plant-based pattern”may reduce the risk of GDM.Besides,although the“cerealsnuts pattern”had no association with GDM risk,avoiding the intake of deep-fried dough sticks could decrease GDM risk.
文摘Background Mumps virus infection is a potentially serious viral infection of childhood and early adulthood. In China, live attenuated S79 mumps vaccine has been licensed for pediatric use since 1990. The objective of this study was to determine the effectiveness of live attenuated S79 mumps vaccine against clinical mumps in outbreaks. Methods Cases were selected from mumps outbreaks in schools in Guangzhou between 2004 and 2005. Each case was matched by gender, age and classroom. Vaccination information was obtained from Children＇s EPI Administrative Computerized System. Vaccine effectiveness （VE） was calculated for 1 or 2 doses of S79 vaccine with 95% confidence intervals （CI）. Results One hundred and ninety-four cases and 194 controls were enrolled into the study. VE of the S79 mumps vaccine for 1 dose versus 0 confer protection 80.4% （95% Cl, 60.0%-90.4%） and VEs against mumps in outbreaks for 1 dose of mumps vaccine are similar among those children aged 4-9 years and aged over 10 years old. Conclusion The live attenuated S79 mumps vaccine can be effective in preventing clinical mumps outbreaks.
基金supported by the grants from the National Natural Science Foundation of China(No.81803219)the Natural Science Foundation of Guangdong Province,China(Nos.2022A1515011744,2020A1515110682,and 2018A030310335)the China Postdoctoral Science Foundation(No.2020M683135)
文摘Background:Copper and zinc are involved in the development of multiple malignancies;yet,epidemiological evidence on hepatocellular carcinoma(HCC)is limited.This study aimed to investigate the association between dietary intake and serum levels of copper and zinc with the risk of HCC.Methods:A total of 434 case-control pairs matched for sex and age(±1 year)were included in this study.Cases with newly diagnosed HCC were from the Guangdong Liver Cancer Cohort(GLCC)study,and healthy controls were from the Guangzhou Nutrition and Health Study(GNHS).A semi-quantitative 79-item food frequency questionnaire(FFQ)was used to assess habitual dietary intakes of copper and zinc.Serum levels of copper and zinc were measured by using inductively coupled plasma mass spectrometry.The copper(Cu)/zinc(Zn)ratio was computed by dividing copper levels by zinc levels.Conditional logistic regression models were performed to calculate the odds ratio(OR)and 95%confidence intervals(CI)for per 1 standard deviation increase(per-SD increase)in copper and zinc levels.Results:Higher dietary intake(OR_(per-SD increase)=0.65,95%CI:0.44,0.96,P_(trend)=0.029)and serum levels of zinc(OR_(per-SD increase)=0.11,95%CI:0.04,0.30,P_(trend)<0.001)were both associated with a lower risk of HCC.Subgroup analyses showed that the inverse association was only pronounced in men but not in women(P_(interaction)=0.041 for dietary zinc intake and 0.010 for serum zinc levels).Serum copper levels(OR_(per-SD increase)=2.05,95%CI:1.39,3.03,P_(trend)=0.020)and serum Cu/Zn ratio(OR_(per-SD increase)=6.53,95%CI:2.52,16.92,P_(trend)<0.001)were positively associated with HCC risk,while dietary copper intake and dietary Cu/Zn ratio were not associated with HCC risk.Conclusion:Zinc may be a protective factor for HCC,especially among men,but the effects of copper on HCC risk are not clear.
基金National Natural Science Foundation of China(U23A20492)Hunan Province Key Research and Development Projects(2022SK2089)Huxiang Youth Talent Program(2021RC3107).
文摘Microcystin-LR(MC-LR),the most prevalent and diverse cyanotoxin produced by harmful cyanobacterial blooms,has been linked to gastrointestinal toxicity.Therefore,we conducted a case-control study across four regions in China to investigate this relationship.Inflammatory bowel disease(IBD)cases(219)were matched with healthy controls(438)based on age and gender and conditional logistic regression models and Restricted cubic splines were used to evaluate the association between MC-LR exposure and IBD risk.We used quantitative real-time polymerase chain reaction to measure the expression levels of inflammatory factors.The levels of protein expression in the colorectum were determined using Western blotting(WB).Compared to the lowest quartile of serum MC-LR levels,the adjusted odds ratios and 95%confidence intervals(CI)for the highest quartiles of serum MC-LR levels were 5.51(2.70,11.21).The RCS was shown the association between serum MC-LR levels and IBD risk was nonlinear(Pnonlinear<0.001).In the animal experiments,MC-LR resulted in colorectal injury via the PI3K/AKT signaling pathway.Our study provides the evidence that serum MC-LR exposure is significantly associated with the risk of IBD in China.Animal study results indicate that MC-LR probably causes IBD via the PI3K/AKT signaling pathway.
文摘Objective To indicate the deficiency of the classical method for analyzing data on individual matching case-control study in consideration of the interaction between the study factor (exposure) and the matching factor, and to find out a proper method for handling this deficiency. Method First, experimental data with 50 pairs of cases and controls were used for strata analysis according to the values of a matching factor to illustrate the possible interaction between a risk factor (exposure) and the matching factor. Second, a detailed procedure was proposed for analyzing such data. Results Interaction between the study factor and matching factor was demonstrated by using strata analysis and unconditional logistic regression analysis. Therefore the results from the classical analysis for such data might be incorrect. Conclusion Data from individual matching case-control study design should be dealt with strata analysis or multivariate analysis to explore and evaluate the possible interaction between the s
文摘BACKGROUND Proton pump inhibitors(PPIs)are among the most commonly prescribed medications globally.While concerns exist regarding their association with adverse infection-related outcomes,their impact on coronavirus disease 2019(COVID-19)severity remains uncertain.Emerging preclinical data suggest immunomodulatory and antiviral properties of PPIs,yet clinical evidence is conflicting.AIM To investigate whether chronic pre-hospital PPI use is associated with improved outcomes in patients hospitalized with COVID-19.METHODS We conducted a retrospective case-control study of adult inpatients with severe acute respiratory syndrome coronavirus 2 infection admitted to a racially and ethnically diverse communityhospital in Massachusetts from July 2021 to March 2022. Patients were stratified by documented pre-hospital PPIuse. The primary outcomes were intensive care unit (ICU) admission, need for invasive mechanical ventilation, andin-hospital mortality. Multivariable logistic regression was used to adjust for demographics, comorbidities, andtreatment variables. Significance was set at P < 0.05.RESULTSAmong 248 patients, 83 (33.4%) were on PPIs prior to hospitalization. Compared to non-users, PPI users hadsignificantly lower rates of ICU admission (13.3% vs 24.8%, P = 0.034), mechanical ventilation (13.3% vs 25.5%, P =0.027), and in-hospital mortality (6.0% vs 17.6%, P = 0.013). Multivariable analysis confirmed these associations:ICU admission [adjusted odds ratios (aOR): 0.462, 95%CI: 0.223–0.955], mechanical ventilation (aOR: 0.447, 95%CI:0.216–0.923), and mortality (aOR: 0.144, 95%CI: 0.031–0.677). Findings were consistent across demographic andcomorbidity strata.CONCLUSIONIn this diverse, real-world United States cohort, chronic pre-hospital PPI use was independently associated withlower odds of intensive care unit admission, mechanical ventilation, and mortality among COVID-19 inpatients.These findings highlight a potentially protective role of PPIs and support continued therapy in eligible patients.
基金Anhui Province’s Clinical Medical Research Transformation Special Initiative(Project No.:202204295107020016)。
文摘This case-control study evaluated the frequency of Glutathione S-transferase Mu 1(GSTM1)deletion and Glutathione S-transferase Alpha 1(GSTA1)mutation in chronic obstructive pulmonary disease(COPD)patients,whether they had concomitant lung squamous cell carcinoma(LSCC)or not,to assess their connection with cancer susceptibility.By means of multivariate logistic regression analysis,the GSTM1 null genotype serves as a significant standalone risk factor for LSCC,in addition to variables like age,smoking history,emphysema,body mass index(BMI),albumin level,and neutrophil-to-lymphocyte ratio(NLR).A predictive model incorporating these factors demonstrated superior discriminative ability compared to the established COPD Lung Cancer Screening Score(COPD-LUCSS).
文摘Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become the major study design used in surgical research when RCTs are unable to be conducted and definitely replacing case series which offer little insight into surgical outcomes and disease processes.
文摘Background: Binary as well as polytomous logistic models are widely used for estimating odds ratios when the exposure of prime interest assumes unordered multiple levels under matched pairs case-control design. In our previous studies, we have shown that the use of a polytomous logistic model for estimating cumulative odds ratios when the outcome (response) variable is ordinal (in addition to being polytomous) under matched pairs case-control design. The cumulative odds ratios were estimated based on separate fitting of the model at each of the cutpoint level as compared to less than equal to that level. In this paper we propose an alternative method of estimating the cumulative odds ratios and reanalyze the Los Angeles Endometrial Cancer data in the context of dose levels of conjugated oestrogen exposure and development of endometrial cancer under the matched pair case-control design. Methods: In the present study, the cumulative logit model is fitted using a single multinomial logit model for the data. For this, the full maximum likelihood estimation procedure is adopted. A test for equality of the cumulative odds ratios across the exposure levels is proposed. Results: The analysis revealed that there is a strong evidence of risk for developing endometrial cancer due to oestrogen exposure above each of the three dose level as compared to less than equal to that level. The estimated values at the three cutpoint levels were found to be 6.17, 3.60 and 5.16 respectively. Conclusions: The odds of developing endometrial cancer are very high for the users of any amount of oestrogen, even if it is the least dose, as compared to the non-users.
基金Supported by The key project Grant from the Science and Technology Department of Zhejiang Province,China,No.2011C13036-2
文摘AIM: To compare shortand long-term outcomes of laparoscopy-assisted and open distal gastrectomy for gastric cancer. METHODS: A retrospective study was performed by comparing the outcomes of 54 patients who underwent laparoscopy-assisted distal gastrectomy (LADG) with those of 54 patients who underwent open distal gastrectomy (ODG) between October 2004 and October 2007. The patients' demographic data (age and gender), date of surgery, extent of lymphadenectomy, and differentiation and tumor-node-metastasis stage of the tumor were examined. The operative time, intraoperative blood loss, postoperative recovery, complications, pathological findings, and follow-up data were compared between the two groups.RESULTS: The mean operative time was significantly longer in the LADG group than in the ODG group (259.3 ± 46.2 min vs 199.8 ± 40.85 min; P < 0.05), whereas intraoperative blood loss and postoperative complications were significantly lower (160.2 ± 85.9 mL vs 257.8 ± 151.0 mL; 13.0% vs 24.1%, respectively, P < 0.05). In addition, the time to first flatus, time to initiate oral intake, and postoperative hospital stay were significantly shorter in the LADG group than in the ODG group (3.9 ± 1.4 d vs 4.4 ± 1.5 d; 4.6 ± 1.2 d vs 5.6 ± 2.1 d; and 9.5 ± 2.7 d vs 11.1 ± 4.1 d, respectively; P < 0.05). There was no significant difference between the LADG group and ODG group with regard to the number of harvested lymph nodes. The median followup was 60 mo (range, 5-97 mo). The 1-, 3-, and 5-year disease-free survival rates were 94.3%, 90.2%, and 76.7%, respectively, in the LADG group and 89.5%, 84.7%, and 82.3%, respectively, in the ODG group. The 1-, 3-, and 5-year overall survival rates were 98.0%, 91.9%, and 81.1%, respectively, in the LADG group and 91.5%, 86.9%, and 82.1%, respectively, in the ODG group. There was no significant difference between the two groups with regard to the survival rate. CONCLUSION: LADG is suitable and minimally invasive for treating distal gastric cancer and can achieve similar long-term results to ODG.
基金Supported by A Grant from Chinese Medical Association Re-search Special Funds,No. 07040490057 (to Professor Ou-yang Q)
文摘AIM:To evaluate potential risk factors in the development of ulcerative colitis(UC) in China.METHODS:A total of 1308 patients with UC and 1308 age-matched and sex-matched controls were prospectively studied in China.The UC cases were collected from 17 hospitals in China from April 2007 to April 2010.Uniform questionnaires were designed to investigate risk factors including smoking,appendectomy,stress,socio-economic conditions,nonsteroidal antiinflammatory drugs(NSAIDs),oral contraceptives,diet,breastfeeding,infections and family sanitary conditions.Group comparisons by each factor were done using simple logistic regression analysis.Conditional logistic regression was used for multivariate analysis.RESULTS:By univariate analysis,the variables predictive of UC included feeling stress,light and heavy alcoholic drinking,spicy food,sugar consumption and infectious diarrhea,while heavy tea intake and tap water consumption were protective against UC.On multivariate analysis,the protective factor for UC was tap water consumption [odds ratios(OR) = 0.424,95%CI:0.302-0.594,P < 0.001];while the potential risk factors for UC were heavy sugar consumption(OR = 1.632,95%CI:1.156-2.305,P < 0.001),spicy food(light intake:OR = 3.329,95%CI:2.282-4.857,P < 0.001;heavy intake:OR = 3.979,95%CI:2.700-5.863,P < 0.001),and often feeling stress(OR = 1.981,95%CI:1.447-2.711,P < 0.001).Other factors,such as smoking habit,appendectomy,breastfeeding,a history of measles,rural or urban residence,education,oral contraceptives,and NSAID use have not been found to have a significant association with the development of UC in the present study.CONCLUSION:Our study showed tap water consumption was a protective factor for UC,while spicy food,heavy sugar consumption and often feeling stress were risk factors for UC in this Chinese population.
文摘AIM:To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of China.METHODS:Randomized multistage stratified cluster sampling from the island population of China was used in the population-based case-control study. Then interview, physical examination, laboratory assessments and ultrasonography were done. RESULTS:Daily alcohol intake ≥ 20 g, duration of drinking ≥ 5 years and obesity were closely related to alcohol-related liver injury (P < 0.05). The odds-ratio (OR) (95% CI) was 1.965 (1.122-3.442), 3.412 (1.789-6.507) and 1.887 (1.261-2.824), respectively. The prevalence rate of alcohol-related liver injury in ≥ 20 g daily alcohol intake group and < 20 g daily alcohol intake group was 37.14% and 12.06%, respectively. The prevalence rate of alcohol-related liver injury in ≥ 5 years drinking group and < 5 years drinking group was 34.44% and 8.53%, respectively. No significant dose-response relation was found between daily alcohol intake and abnormal alcohol-related liver injury indicators as well as between duration of drinking and abnormal alcohol-related liver injury indicators. There was no significant difference in the prevalence of alcohol-related liver injury between beer drinking group and yellow rice wine drinking group, hard liquor drinking group, multiple drinking group.CONCLUSION:The risk threshold of daily alcohol intake is 20 g and duration of drinking inducing alcohol-related liver injury 5 years in the island population of China. Liver injury induced by obesity should be concerned.
基金Project supported by the National Natural Science Foundation of China (No. 30872199)the Natural Science Foundation of Shaanxi Province (No. 2006C247),China
文摘Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to identify the association between facial dermatosis and Demodex.Amongst the patients,539 suffered from facial dermatosis and 321 suffered from non-facial dermatosis.Demodex mites were sampled and examined using the skin pressurization method.Multivariate regression analysis was applied to analyze the association between facial dermatosis and Demodex infestation,and to identify the risk factors of Demodex infestation.The results showed that total detection rate of Demodex was 43.0%.Patients aged above 30 years had higher odds of Demodex infestation than those under 30 years.Compared to patients with neutral skin,patients with mixed,oily,or dry skin were more likely to be infested with Demodex(odds ratios(ORs) were 2.5,2.4,and 1.6,respectively).Moreover,Demodex infestation was found to be statistically associated with rosacea(OR=8.1),steroid-induced dermatitis(OR=2.7),seborrheic dermatitis(OR=2.2),and primary irritation dermatitis(OR=2.1).In particular,ORs calculated from the severe infestation(≥5 mites/cm2) rate were significantly higher than those of the total rate.Therefore,we concluded that Demodex is associated with rosacea,steroid-induced dermatitis,seborrheic dermatitis,and primary irritation dermatitis.The rate of severe infestation is found to be more correlated with various dermatosis than the total infestation rate.The risk factors of Demodex infestation,age,and skin types were identified.Our study also suggested that good hygiene practice might reduce the chances of demodicosis and Demodex infestation.
文摘BACKGROUND:Why 3.3% to 10% of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma (ICC) remains unknown.We carried out a hospital-based case-control study to identify risk factors for the development of ICC in patients with hepatolithiasis in China.METHODS:Eighty-seven patients with pathologically diagnosed hepatolithiasis associated with ICC and 228 with hepatolithiasis alone matched by sex,age (±2 years),hospital admittance and place of residence were interviewed during the period of 2000-2008.Odds ratios (OR) and 95% confidence intervals (CI) were calculated for each risk factor.RESULTS:Among the patients with hepatolithiasis associated with ICC,the mean age was 57.7 years and 61.0% were female Univariate analysis showed that the significant risk factors for ICC development in hepatolithiasis were smoking,family history of cancer,appendectomy during childhood (under age 20),and duration of symptoms >10 years.In multivariate stepwise logistic regression analysis,smoking (OR=1.931,95% CI:1.000-3.731),family history of cancer (OR=5.175,95% CI:1.216-22.022),and duration of symptoms >10 years (OR=2.348 95% CI:1.394-3.952) were independent factors.CONCLUSION:Smoking,family history of cancer and duration of symptoms >10 years may be risk factors for ICC in patients with hepatolithiasis.
基金Supported by Hunan Ministry of Science and Technology,No.06FJ3177,China
文摘AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.
文摘Abstract Objective To assess the association of TNF-α and IL-1RA SNPs with the risk of silicosis in Chinese workers exposed to silica particles. Methods Case-control study design was used to enroll 68 silicotic patients induced by silica particles and 68 healthy workers matched for length of silica particle exposure as controls. Both cases and controls were from the same company in southwest China, and each of them was requested to complete a questionnaire. Blood samples were drawn for genomic DNA extraction from each participant. The genotyping of TNF-α （-238 and -308） and IL-1RA （＋2018） was performed using polymerase chain reaction-based restriction fragment length polymorphism （PCR-RFLP） and SYBR green-based quantitative polymerase chain reaction {qPCR）, respectively. Unconditional logistic regression model was used to estimate odds ratios （ORs） and their 95% confidential intervals （Cl） for SNPs. Results No significant differences were found between cases and controls in particles exposure length, body mass index （BMI）, and status of smoking and alcohol consumption except for age （P=O.O01） and blood type （P=0.042）. The frequencies of TNF-c（（-238） and IL-1RA （＋2018） genotypes in cases were significantly different from those in controls, （P=O.O01 and P=0.O02, respectively）, while a borderline significant difference was found in the frequencies of TNF-α（-308） between cases and controls （P=0.063）. The variants of three SNPs increased the risk of silicosis in the Chinese workers exposed to silica particles. The adjusted ORs of TNFα（-308）, TNF-α（-238） and IL-1RA （＋2018） were 2.8 （95% Ch 2.1-7.5）, 20.9 （95% Ch 2.8-236.4） and 4.0 （95% CI： 2.6-10.2）, respectively. Conclusion It is suggested that cytokine polymorphisms of TNF-ct （-238, -308） and IL-1RA （＋2018） are associated with the risk of silicosis in the Chinese workers exposed to silica particles. Further independent studies on the interaction between SNPs and exposure to silica particles with a larger sample size are therefore warranted.
基金Supported by The National Scientific and Technological Program in the 11th "Five-Year Plan", the Grant number is 2006BAI02A08
文摘AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.
基金supported by the Research program on occupational poisoning and occupational lung disease[2014BAI12B01]
文摘The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.
基金supported by the Research Fund from National Science and Technology Infrastructure Program of the People's Republic of China, 2006BA106B08
文摘Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.
基金National Natural Science Foundation of China,No.81473506Natural Science Foundation of Zhejiang Province,No.LY16H290001 and No.LY17H290009+1 种基金Project of Department of Construction of Zhejiang Province,No.WKJ-ZJ-1531Zhejiang TCM Science and Technology Project,No.2016ZB047 and No.2017ZA056
文摘BACKGROUND When opportunistic infections occur, patients with inflammatory bowel disease(IBD) commonly display a significantly increased rate of morbidity and mortality.With increasing use of immunosuppressive agents and biological agents,opportunistic infections are becoming a hot topic in the perspective of drug safety in IBD patients. Despite the well-established role of opportunistic infections in the prognosis of IBD patients, there are few epidemiological data investigating the incidence of opportunis-tic infections in IBD patients in China. Besides, the risk factors for opportunistic infection in Chinese IBD patients remain unclear.AIM To predict the incidence of opportunistic infections related to IBD in China, and explore the risk factors for opportunistic infections.METHODS A single-center, prospective study of IBD patients was conducted. The patients were followed for up to 12 mo to calculate the incidence of infections. For each infected IBD patient, two non-infected IBD patients were selected as controls. A conditional logistic regression analysis was used to assess associations between putative risk factors and opportunistic infections, which are represented as odds ratios(OR) and 95% confidence intervals(CIs).RESULTS Seventy(28.11%) out of 249 IBD patients developed opportunistic infections.Clostridium difficile infections and respiratory syncytial virus infections were found in 24 and 16 patients, respectively. In a univariate analysis, factors such as the severity of IBD, use of an immunosuppressant or immunosuppressants, high levels of fecal calprotectin, and C-reactive protein or erythrocyte sedimentation rate were individually related to a significantly increased risk of opportunistic infection. Multivariate analysis indicated that the use of any immunosuppressant yielded an OR of 3.247(95%CI: 1.128-9.341), whereas the use of any two immunosuppressants yielded an OR of 6.457(95%CI: 1.726-24.152) for opportunistic infection. Interestingly, when immunosuppressants were used in combination with infliximab(IFX) or 5-aminosalicylic acid, a significantly increased risk of opportunistic infection was also observed. The relative risk of opportunistic infection was greatest in IBD patients with severe disease activity(OR = 9.090; 95%CI: 1.532-53.941, relative to the remission stage). However, the use of IFX alone did not increase the risk of opportunistic infection.CONCLUSION Factors such as severe IBD, elevated levels of fecal calprotectin, and the use of immunosuppressive medications, especially when used in combination, are major risk factors for opportunistic infections in IBD patients. The use of IFX alone does not increase the risk of opportunistic infection.
