Objective To explore the clinical characteristics and methods for syndrome differentiation prediction,as well as to construct a predictive model for Qi deficiency and blood stasis syndrome in patients with acute ische...Objective To explore the clinical characteristics and methods for syndrome differentiation prediction,as well as to construct a predictive model for Qi deficiency and blood stasis syndrome in patients with acute ischemic stroke(AIS).Methods This study employed a retrospective case-control design to analyze patients with AIS who received inpatient treatment at the Neurology Department of The First Hospital of Hunan University of Chinese Medicine from January 1,2013 to December 31,2022.AIS patients meeting the diagnostic criteria for Qi deficiency and blood stasis syndrome were stratified into case group,while those without Qi deficiency and blood stasis syndrome were stratified into control group.The demographic characteristics(age and gender),clinical parameters[time from onset to admission,National Institutes of Health Stroke Scale(NIHSS)score,and blood pressure],past medical history,traditional Chinese medicine(TCM)diagnostic characteristics(tongue and pulse),neurological symptoms and signs,imaging findings[magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)],and biochemical indicators of the two groups were collected and compared.The indicators with statistical difference(P<0.05)in univariate analysis were included in multivariate logistic regression analysis to evaluate their predictive value for the diagnosis of Qi deficiency and blood stasis syndrome,and the predictive model was constructed by receiver operating characteristic(ROC)curve analysis.Results The study included 1035 AIS patients,with 404 cases in case group and 631 cases in control group.Compared with control group,patients in case group were significantly older,had extended onset-to-admission time,lower diastolic blood pressure,and lower NIHSS scores(P<0.05).Case group showed lower incidence of hypertension history(P<0.05).Regarding tongue and pulse characteristics,pale and dark tongue colors,white tongue coating,fine pulse,astringent pulse,and sinking pulse were more common in case group.Imaging examinations demonstrated higher proportions of centrum semiovale infarction,cerebral atrophy,and vertebral artery stenosis in case group(P<0.05).Among biochemical indicators,case group showed higher proportions of elevated fasting blood glucose and glycated hemoglobin(HbA1c),while lower proportions of elevated white blood cell count,reduced hemoglobin,and reduced high-density lipoprotein cholesterol(HDL-C)(P<0.05).Multivariate logistic regression analysis identified significant predictors for Qi deficiency and blood stasis syndrome including:fine pulse[odds ratio(OR)=4.38],astringent pulse(OR=3.67),superficial sensory abnormalities(OR=1.86),centrum semiovale infarction(OR=1.57),cerebral atrophy(OR=1.55),vertebral artery stenosis(OR=1.62),and elevated HbA1c(OR=3.52).The ROC curve analysis of the comprehensive prediction model yielded an area under the curve(AUC)of 0.878[95%confidence interval(CI)=0.855-0.900].Conclusion This study finds out that Qi deficiency and blood stasis syndrome represents one of the primary types of AIS.Fine pulse,astringent pulse,superficial sensory abnormalities,centrum semiovale infarction,cerebral atrophy,vertebral artery stenosis,elevated blood glucose,elevated HbA1c,pale and dark tongue colors,and white tongue coating are key objective diagnostic indicators for the syndrome differentiation of AIS with Qi deficiency and blood stasis syndrome.Based on these indicators,a syndrome differentiation prediction model has been developed,offering a more objective basis for clinical diagnosis,and help to rapidly identify this syndrome in clinical practice and reduce misdiagnosis and missed diagnosis.展开更多
Objective Lipid oxidation is involved in the pathogenesis of atherosclerosis and may be contribute to the development of Ischemic stroke(IS).However,the lipid profiles associated with IS have been poorly studied.We co...Objective Lipid oxidation is involved in the pathogenesis of atherosclerosis and may be contribute to the development of Ischemic stroke(IS).However,the lipid profiles associated with IS have been poorly studied.We conducted a pilot study to identify potential IS-related lipid molecules and pathways using lipidomic profiling.Methods Serum lipidomic profiling was performed using LC-MS in 20 patients with IS and 20 age-and sex-matched healthy controls.Univariate and multivariate analyses were simultaneously performed to identify the differential lipids.Multiple testing was controlled for using a false discovery rate(FDR)approach.Enrichment analysis was performed using MetaboAnalyst software.Results Based on the 294 lipids assayed,principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)models were used to distinguish patients with IS from healthy controls.Fifty-six differential lipids were identified with an FDR-adjusted P less than 0.05 and variable influences in projection(VIP)greater than 1.0.These lipids were significantly enriched in glycerophospholipid metabolism(FDR-adjusted P=0.009,impact score=0.216).Conclusions Serum lipid profiles differed significantly between patients with IS and healthy controls.Thus,glycerophospholipid metabolism may be involved in the development of IS.These results provide initial evidence that lipid molecules and their related metabolites may serve as new biomarkers and potential therapeutic targets for IS.展开更多
Objective:This study aimed to determine the correlation between the incidence of acute mountain sickness(AMS)and the body constitution of Tibetan medicine and other relevant factors to provide a reference for the pred...Objective:This study aimed to determine the correlation between the incidence of acute mountain sickness(AMS)and the body constitution of Tibetan medicine and other relevant factors to provide a reference for the prediction and prevention of AMS.Methods:A caseecontrol study was conducted to recruit participants who experienced or did not experience AMS after entering a plateau.The data was collected through online questionnaires for convenient sampling.Demographic characteristics,body constitution,and related states or behaviors were investigated before and after entering the plateau.The participants were divided into case and control groups based on the incidence of AMS.The distributions of relevant factors were compared.Binary logistic regression analysis was used to screen for risk and protective factors.Results:There were 167 participants who completed the questionnaire.A total of 54 cases were excluded,and 113 participants were included,including 52 in the case group and 61 in the control group.In the case group,37,13,and 2 patients had mild,moderate,and severe AMS,respectively.In terms of the Tibetan medicine constitution,the case group had the highest proportion of Bad-rlung(25.0%)and Rlung types(21.2%),whereas the control group had the highest proportion of Bad-rlung(29.5%)and Mkhrisbad types(24.6%).There was no significant difference in the distribution of the constitutional types between the two groups.Insomnia or insufficient sleep within the week prior to entering the plateau and fatigue after arrival were risk factors for AMS,with odds ratios(OR)and 95%confidence intervals(CI)of 5.012(1.871e13.426)and 3.387(1.393e8.236),respectively.A history of short-term plateau travel is a protective factor for AMS(OR:0.32,95%CI:0.129 to 0.792).Conclusion:Insomnia or lack of sleep before ascending to a plateau and fatigue after arrival are risk factors for AMS.The Rlung constitution might be related to the incidence of AMS;however,this still needs to be verified in large-sample observational studies.The risk factors identified in this study can provide a reference for the prevention practice and research of AMS.展开更多
Pharmaceuticals and personal care products(PPCPs)have been considered as potential contributors to thyroid nodule(TN)and abnormal thyroid homeostasis,but epidemiological evidence is scarce.A total of 1261 individuals ...Pharmaceuticals and personal care products(PPCPs)have been considered as potential contributors to thyroid nodule(TN)and abnormal thyroid homeostasis,but epidemiological evidence is scarce.A total of 1261 individuals comprised of 367 TN patients and 895 controls were recruited from Sichuan,China.The urinary concentrations of fourteen PPCPs were measured.Five thyroid hormones(THs)in serum were determined as indicators of thyroid homeostasis,including thyroid-stimulating hormone,triiodothyronine(T3),thyroxine(T4),free-T3 and free-T4.Serum levels of thyroglobulin antibody(TGAb)and thyroperoxidase antibody(TPOAb)were quantified to identify individual thyroid antibody(TA)statuses.TN patients exhibited higher propyl-paraben(PrP)(median:1.30μg/g Cr)level than controls(0.64μg/g Cr).PrP were significantly associated with TN risk with ORs of 1.060(95%CI:1.002,1.122).The relationship of methyl-paraben with TN risk was nonlinear(p=0.049).PPCP exposurewas significantwith TN risk only in females and TA positive(TPOAb or TGAb)groups,indicating that PPCP susceptibility to TN differs by sex and TA status.Linear regression models showed ethyl-paraben was significantly negatively associated with T4(β:-0.005,95%CI:-0.011,-0.002)and T3(β:-0.007,95%CI:-0.015,-0.002),and positively associated with TPOAb(β:0.059,95%CI:0.000,0.119),suggesting that certain PPCP exposure could affect thyroid homeostasis and autoimmunity.The effects of PPCP exposure on TH and TA levels presented sex-specific.Our findings suggest that PPCP exposure increases TN risk and affects thyroid homeostasis,exhibiting sex and antibody status dependence.展开更多
Objective:To identify the risk factors for acquiring scrub typhus infection among all age group.Methods:A case-control study was carried out from June to December 2019 in collaboration with the Department of Health Se...Objective:To identify the risk factors for acquiring scrub typhus infection among all age group.Methods:A case-control study was carried out from June to December 2019 in collaboration with the Department of Health Services,Kerala.136 Of serologically confirmed scrub typhus reported during 2018 were included and 270 age and sex-matched healthy controls were selected randomly from different locations in the same area where the cases were reported.The risk factors identified were compared between cases and controls,using univariate and multivariable logistic regression analysis to identify the risk factors for scrub typhus infection.Results:Some key factors like house type with individuals residing in houses with concrete roofs are associated with a higher risk of scrub typhus infection compared to tiled roofs(aOR 0.14,95%CI 0.36-0.56,P=0.005).Housewives exhibit a significantly higher risk(aOR 3.97,95%CI 2.15-8.94,P=0.038)of scrub typhus infection.Environmental factors,including the presence of rats(aOR 3.48,95%CI 1.19-6.53,P=0.023),the presence of domestic animals(aOR 2.98,95%CI 1.67-5.19,P<0.001),wet agricultural fields around the house(aOR 3.64,95%CI 1.50-6.54,P<0.001),and hygiene practices like not changing clothes after work(aOR 2.64,95%CI 1.37-4.68,P=0.024),and disposing of the wastes in their own yard(aOR 4.79,95%CI 3.78-9.55,P=0.043)are identified as significant high-risk factors for scrub typhus infection.Conclusions:These findings will be very useful to create awareness among the public and to undertake a detailed control strategy for scrub typhus.展开更多
BACKGROUND Hepatitis B virus(HBV)infection is a leading cause of global hepatocellular carcinoma(HCC).Conventional biomarkers such as alpha-fetoprotein(AFP)demonstrate suboptimal sensitivity and specificity.Emerging e...BACKGROUND Hepatitis B virus(HBV)infection is a leading cause of global hepatocellular carcinoma(HCC).Conventional biomarkers such as alpha-fetoprotein(AFP)demonstrate suboptimal sensitivity and specificity.Emerging evidence suggests that serum extra spindle pole bodies like 1(ESPL1)protein and p53 antibody may improve diagnostic accuracy.AIM To assess and compare the diagnostic performance of serum ESPL1 protein and p53 antibody in HBV-related HCC(HBV-HCC).METHODS This case-control study from the First Affiliated Hospital of Guangxi Medical University enrolled 30 patients with chronic hepatitis B(CHB),30 with HBV-related liver cirrhosis(HBV-LC),55 with HBV-HCC,and 30 healthy controls.Serum ESPL1 protein and p53 antibody levels were quantified via ELISA.Diagnostic performance was evaluated using receiver operating characteristic(ROC)curve analysis,including sensitivity,specificity,and correlation with AFP.RESULTS Serum ESPL1 protein levels progressively increased across disease stages(CHB:89.9 ng/L;HBV-LC:188.83 ng/L;HBV-HCC:317.63 ng/L),with a significantly higher area under the ROC curve(AUC=0.917)than either p53 antibody(AUC=0.725)or AFP(AUC=0.678).p53 antibody levels were significantly elevated only in the HBVHCC group.ESPL1 demonstrated superior sensitivity and concordance with histopathological findings.A significant correlation between ESPL1 and p53 antibody levels was observed exclusively in the HBV-HCC group(r=0.320,P=0.017),suggesting potential interplay in malignant transformation.CONCLUSION Serum ESPL1 protein,a promising biomarker for early HBV-HCC detection,outperforms p53 antibody in diagnostic reliability.Higher ESPL1 levels correlate with increased HCC risk in chronic HBV patients.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
Two common polymorphisms of the peroxisome proliferator-activated receptor gamma(PPARG) gene, rs1801282 and rs3856806, may be important candidate gene loci affecting the susceptibility to ischemic stroke. This case-co...Two common polymorphisms of the peroxisome proliferator-activated receptor gamma(PPARG) gene, rs1801282 and rs3856806, may be important candidate gene loci affecting the susceptibility to ischemic stroke. This case-control study sought to identify the relationship between these two single-nucleotide polymorphisms and ischemic stroke risk in a northern Chinese Han population. A total of 910 ischemic stroke participants were recruited from the First Hospital of China Medical University, Shenyang, China as a case group, of whom 895 completed the study. The 883 healthy controls were recruited from the Health Check Center of the First Hospital of China Medical University, Shenyang, China. All participants or family members provided informed consent. The study protocol was approved by the Ethics Committee of the First Hospital of China Medical University, China on February 20, 2012(approval No. 2012-38-1). The protocol was registered with the Chinese Clinical Trial Registry(registration number: ChiCTR-COC-17013559). Plasma genomic DNA was extracted from all participants and analyzed for rs1801282 and rs3856806 single nucleotide polymorphisms using a SNaPshot Multiplex sequencing assay. Odds ratios(ORs) and 95% confidence intervals(CIs) were calculated using unconditional logistic regression to estimate the association between ischemic stroke and a particular genotype. Results demonstrated that the G allele frequency of the PPARG gene rs1801282 locus was significantly higher in the case group than in the control group(P < 0.001). Individuals carrying the G allele had a 1.844 fold increased risk of ischemic stroke(OR = 1.844, 95% CI: 1.286–2.645, P < 0.001). Individuals carrying the rs3856806 T allele had a 1.366 fold increased risk of ischemic stroke(OR = 1.366, 95% CI: 1.077–1.733, P = 0.010). The distribution frequencies of the PPARG gene haplotypes rs1801282-rs3856806 in the control and case groups were determined. The frequency of distribution in the G-T haplotype case group was significantly higher than that in the control group. The risk of ischemic stroke increased to 2.953 times in individuals carrying the G-T haplotype(OR = 2.953, 95% CI: 2.082–4.190, P < 0.001). The rs1801282 G allele and rs3856806 T allele had a multiplicative interaction(OR = 3.404, 95% CI: 1.631–7.102, P < 0.001) and additive interaction(RERI = 41.705, 95% CI: 14.586–68.824, AP = 0.860;95% CI: 0.779–0.940;S = 8.170, 95% CI: 3.772–17.697) on ischemic stroke risk, showing a synergistic effect. Of all ischemic stroke cases, 86% were attributed to the interaction of the G allele of rs1801282 and the T allele of rs3856806. The effect of the PPARG rs1801282 G allele on ischemic stroke risk was enhanced in the presence of the rs3856806 T allele(OR = 8.001 vs. 1.844). The effect of the rs3856806 T allele on ischemic stroke risk was also enhanced in the presence of the rs1801282 G allele(OR = 2.546 vs. 1.366). Our results confirmed that the G allele of the PPARG gene rs1801282 locus and the T allele of the rs3856806 locus may be independent risk factors for ischemic stroke in the Han population of northern China, with a synergistic effect between the two alleles.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
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
AIM: Glutathione S-transferases (GSTs) are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutath...AIM: Glutathione S-transferases (GSTs) are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutathione S-transferases M1 and T1 genotypes to susceptibility to the risk of gastric cancer and their interaction with cigarette smoking are still unclear. The aim of this study was to determine whether there was any relationship between genetic polymorphisms of GSTT1 and GSTT1 and gastric cancer. METHODS: A population based case-control study was carried out in a high-risk area, Changle County, Fujian Province, China. The epidemiological data were collected by a standard questionnaire and blood samples were obtained from 95 incidence gastric cancer cases and 94 healthy controls. A polymerase chain reaction method was used to detect the presence or absence of the GSTT1 and GSTT1 genes in genomic DNA. Logistic regression model was employed in the data analysis. RESULTS: An increase in risk for gastric cancer was found among carriers of GSTT1 null genotype. The adjusted odds ratio (OR) was 2.63 95% Confidence Interval (95% CI) 1.17-5.88, after controlling for age, gender, cigarette smoking, alcohol drinking, and fish sauce intake. The frequency of GSTT1 null genotype in cancer cases (43.16%) was not significantly different from that in controls (50.00%). However, the risk for gastric cancer in those with GSTT1 null and GSTT1 non-null genotype was significantly higher than in those with both GSTT1 and GSTT1 non-null genotype (OR = 2.77, 95% CI 1.15-6.77). Compared with those subjects who never smoked and had normal GSTT1 genotype, ORs were 1.60 (95% CI:0.62-4.19) for never smokers with GSTT1 null type, 2.33 (95% CI 0.88-6.28) for smokers with normal GSTT1, and 8.06 (95% CI 2.83-23.67) for smokers with GSTT1 null type. CONCLUSIONS: GSTT1 gene polymorphisms may be associated with genetic susceptibility of stomach cancer and may modulate tobacco-related carcinogenesis of gastric cancer.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 assess the risk of colonic polyps,adenomas and advanced neoplastic lesions(ANL) in patients with sporadic gastric polyps,especially those with fundic gland polyps(FGP).METHODS:Clinical records of patients who h...AIM:To assess the risk of colonic polyps,adenomas and advanced neoplastic lesions(ANL) in patients with sporadic gastric polyps,especially those with fundic gland polyps(FGP).METHODS:Clinical records of patients who had performed an upper and a lower digestive endoscopy between September 2007 and August 2008 were retrospectively analyzed.A case-control study was carried out,calling patients with gastric polyps as 'cases' and patients without gastric polyps as 'controls'.The risk of colonic polyps,adenomas and ANL(villous component ≥ 25%,size ≥ 10 mm,or high grade dysplasia) was assessed [odds ratio(OR) and its corresponding 95%CI].RESULTS:Two hundred and forty seven patients were analyzed:78 with gastric polyps(cases) and 169 without gastric polyps(controls).Among the cases,the majority of gastric polyps were FGP(80%,CI:69-88) and hyperplastic(20%,CI:12-31);25% had colonic polyps(25% hyperplastic and 68% adenomas,from which 45% were ANL).Among the controls,20% had colonic polyps(31% hyperplastic and 63% adenomas,from which 41% were ANL).The patients with sporadic FGP had an OR of 1.56(CI:0.80-3.04) for colonic polyps,an OR of 1.78(CI:0.82-3.84) for colonic adenomas,and an OR of 0.80(CI:0.21-2.98) for ANL.Similar results were found in patients with gastric polyps in general.CONCLUSION:The results of this study did not show more risk of colorectal adenomas or ANL neither in patients with sporadic gastric polyps nor in those with FGP.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National Natural Science Foundation of China(U22A20377)Natural Science Foundation of Hunan Province of China(23C0168).
文摘Objective To explore the clinical characteristics and methods for syndrome differentiation prediction,as well as to construct a predictive model for Qi deficiency and blood stasis syndrome in patients with acute ischemic stroke(AIS).Methods This study employed a retrospective case-control design to analyze patients with AIS who received inpatient treatment at the Neurology Department of The First Hospital of Hunan University of Chinese Medicine from January 1,2013 to December 31,2022.AIS patients meeting the diagnostic criteria for Qi deficiency and blood stasis syndrome were stratified into case group,while those without Qi deficiency and blood stasis syndrome were stratified into control group.The demographic characteristics(age and gender),clinical parameters[time from onset to admission,National Institutes of Health Stroke Scale(NIHSS)score,and blood pressure],past medical history,traditional Chinese medicine(TCM)diagnostic characteristics(tongue and pulse),neurological symptoms and signs,imaging findings[magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)],and biochemical indicators of the two groups were collected and compared.The indicators with statistical difference(P<0.05)in univariate analysis were included in multivariate logistic regression analysis to evaluate their predictive value for the diagnosis of Qi deficiency and blood stasis syndrome,and the predictive model was constructed by receiver operating characteristic(ROC)curve analysis.Results The study included 1035 AIS patients,with 404 cases in case group and 631 cases in control group.Compared with control group,patients in case group were significantly older,had extended onset-to-admission time,lower diastolic blood pressure,and lower NIHSS scores(P<0.05).Case group showed lower incidence of hypertension history(P<0.05).Regarding tongue and pulse characteristics,pale and dark tongue colors,white tongue coating,fine pulse,astringent pulse,and sinking pulse were more common in case group.Imaging examinations demonstrated higher proportions of centrum semiovale infarction,cerebral atrophy,and vertebral artery stenosis in case group(P<0.05).Among biochemical indicators,case group showed higher proportions of elevated fasting blood glucose and glycated hemoglobin(HbA1c),while lower proportions of elevated white blood cell count,reduced hemoglobin,and reduced high-density lipoprotein cholesterol(HDL-C)(P<0.05).Multivariate logistic regression analysis identified significant predictors for Qi deficiency and blood stasis syndrome including:fine pulse[odds ratio(OR)=4.38],astringent pulse(OR=3.67),superficial sensory abnormalities(OR=1.86),centrum semiovale infarction(OR=1.57),cerebral atrophy(OR=1.55),vertebral artery stenosis(OR=1.62),and elevated HbA1c(OR=3.52).The ROC curve analysis of the comprehensive prediction model yielded an area under the curve(AUC)of 0.878[95%confidence interval(CI)=0.855-0.900].Conclusion This study finds out that Qi deficiency and blood stasis syndrome represents one of the primary types of AIS.Fine pulse,astringent pulse,superficial sensory abnormalities,centrum semiovale infarction,cerebral atrophy,vertebral artery stenosis,elevated blood glucose,elevated HbA1c,pale and dark tongue colors,and white tongue coating are key objective diagnostic indicators for the syndrome differentiation of AIS with Qi deficiency and blood stasis syndrome.Based on these indicators,a syndrome differentiation prediction model has been developed,offering a more objective basis for clinical diagnosis,and help to rapidly identify this syndrome in clinical practice and reduce misdiagnosis and missed diagnosis.
基金supported by the National Natural Science Foundation of China (Nos. 81903384and 82173596)Suzhou Municipal Science and Technology Bureau (No. SKY2023041 and SKY2023180)+3 种基金the Inner Mongolia Autonomous Region Science and Technology Program (Nos.2022YFSH0054 and 2023GLLH0387)the Clinical Research Center of Neurological Disease of The Second Affiliated Hospital of Soochow University(ND2023B06)the Shaanxi Provincial Natural Science Basic Research Program (2025JC-YBMS-1020)Undergraduate Extracurricular Academic Research Funding of Soochow University (KY2023442B)
文摘Objective Lipid oxidation is involved in the pathogenesis of atherosclerosis and may be contribute to the development of Ischemic stroke(IS).However,the lipid profiles associated with IS have been poorly studied.We conducted a pilot study to identify potential IS-related lipid molecules and pathways using lipidomic profiling.Methods Serum lipidomic profiling was performed using LC-MS in 20 patients with IS and 20 age-and sex-matched healthy controls.Univariate and multivariate analyses were simultaneously performed to identify the differential lipids.Multiple testing was controlled for using a false discovery rate(FDR)approach.Enrichment analysis was performed using MetaboAnalyst software.Results Based on the 294 lipids assayed,principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)models were used to distinguish patients with IS from healthy controls.Fifty-six differential lipids were identified with an FDR-adjusted P less than 0.05 and variable influences in projection(VIP)greater than 1.0.These lipids were significantly enriched in glycerophospholipid metabolism(FDR-adjusted P=0.009,impact score=0.216).Conclusions Serum lipid profiles differed significantly between patients with IS and healthy controls.Thus,glycerophospholipid metabolism may be involved in the development of IS.These results provide initial evidence that lipid molecules and their related metabolites may serve as new biomarkers and potential therapeutic targets for IS.
基金funded by the institutional program of China Tibetology Research Center(CTRC20236JS08).
文摘Objective:This study aimed to determine the correlation between the incidence of acute mountain sickness(AMS)and the body constitution of Tibetan medicine and other relevant factors to provide a reference for the prediction and prevention of AMS.Methods:A caseecontrol study was conducted to recruit participants who experienced or did not experience AMS after entering a plateau.The data was collected through online questionnaires for convenient sampling.Demographic characteristics,body constitution,and related states or behaviors were investigated before and after entering the plateau.The participants were divided into case and control groups based on the incidence of AMS.The distributions of relevant factors were compared.Binary logistic regression analysis was used to screen for risk and protective factors.Results:There were 167 participants who completed the questionnaire.A total of 54 cases were excluded,and 113 participants were included,including 52 in the case group and 61 in the control group.In the case group,37,13,and 2 patients had mild,moderate,and severe AMS,respectively.In terms of the Tibetan medicine constitution,the case group had the highest proportion of Bad-rlung(25.0%)and Rlung types(21.2%),whereas the control group had the highest proportion of Bad-rlung(29.5%)and Mkhrisbad types(24.6%).There was no significant difference in the distribution of the constitutional types between the two groups.Insomnia or insufficient sleep within the week prior to entering the plateau and fatigue after arrival were risk factors for AMS,with odds ratios(OR)and 95%confidence intervals(CI)of 5.012(1.871e13.426)and 3.387(1.393e8.236),respectively.A history of short-term plateau travel is a protective factor for AMS(OR:0.32,95%CI:0.129 to 0.792).Conclusion:Insomnia or lack of sleep before ascending to a plateau and fatigue after arrival are risk factors for AMS.The Rlung constitution might be related to the incidence of AMS;however,this still needs to be verified in large-sample observational studies.The risk factors identified in this study can provide a reference for the prevention practice and research of AMS.
基金supported by the National Natural Science Foundation of China(Nos.21976046 and 42177412)the Ministry of Education of China(No.B17025).
文摘Pharmaceuticals and personal care products(PPCPs)have been considered as potential contributors to thyroid nodule(TN)and abnormal thyroid homeostasis,but epidemiological evidence is scarce.A total of 1261 individuals comprised of 367 TN patients and 895 controls were recruited from Sichuan,China.The urinary concentrations of fourteen PPCPs were measured.Five thyroid hormones(THs)in serum were determined as indicators of thyroid homeostasis,including thyroid-stimulating hormone,triiodothyronine(T3),thyroxine(T4),free-T3 and free-T4.Serum levels of thyroglobulin antibody(TGAb)and thyroperoxidase antibody(TPOAb)were quantified to identify individual thyroid antibody(TA)statuses.TN patients exhibited higher propyl-paraben(PrP)(median:1.30μg/g Cr)level than controls(0.64μg/g Cr).PrP were significantly associated with TN risk with ORs of 1.060(95%CI:1.002,1.122).The relationship of methyl-paraben with TN risk was nonlinear(p=0.049).PPCP exposurewas significantwith TN risk only in females and TA positive(TPOAb or TGAb)groups,indicating that PPCP susceptibility to TN differs by sex and TA status.Linear regression models showed ethyl-paraben was significantly negatively associated with T4(β:-0.005,95%CI:-0.011,-0.002)and T3(β:-0.007,95%CI:-0.015,-0.002),and positively associated with TPOAb(β:0.059,95%CI:0.000,0.119),suggesting that certain PPCP exposure could affect thyroid homeostasis and autoimmunity.The effects of PPCP exposure on TH and TA levels presented sex-specific.Our findings suggest that PPCP exposure increases TN risk and affects thyroid homeostasis,exhibiting sex and antibody status dependence.
文摘Objective:To identify the risk factors for acquiring scrub typhus infection among all age group.Methods:A case-control study was carried out from June to December 2019 in collaboration with the Department of Health Services,Kerala.136 Of serologically confirmed scrub typhus reported during 2018 were included and 270 age and sex-matched healthy controls were selected randomly from different locations in the same area where the cases were reported.The risk factors identified were compared between cases and controls,using univariate and multivariable logistic regression analysis to identify the risk factors for scrub typhus infection.Results:Some key factors like house type with individuals residing in houses with concrete roofs are associated with a higher risk of scrub typhus infection compared to tiled roofs(aOR 0.14,95%CI 0.36-0.56,P=0.005).Housewives exhibit a significantly higher risk(aOR 3.97,95%CI 2.15-8.94,P=0.038)of scrub typhus infection.Environmental factors,including the presence of rats(aOR 3.48,95%CI 1.19-6.53,P=0.023),the presence of domestic animals(aOR 2.98,95%CI 1.67-5.19,P<0.001),wet agricultural fields around the house(aOR 3.64,95%CI 1.50-6.54,P<0.001),and hygiene practices like not changing clothes after work(aOR 2.64,95%CI 1.37-4.68,P=0.024),and disposing of the wastes in their own yard(aOR 4.79,95%CI 3.78-9.55,P=0.043)are identified as significant high-risk factors for scrub typhus infection.Conclusions:These findings will be very useful to create awareness among the public and to undertake a detailed control strategy for scrub typhus.
基金Supported by National Natural Science Foundation of China,No.81960115,No.82160123 and No.82260124Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor(Guangxi Medical University),Ministry of Education,No.GKEZZ202107+1 种基金Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor,No.GKE-ZZ202218Guangxi Science and Technology Program,No.AD25069077.
文摘BACKGROUND Hepatitis B virus(HBV)infection is a leading cause of global hepatocellular carcinoma(HCC).Conventional biomarkers such as alpha-fetoprotein(AFP)demonstrate suboptimal sensitivity and specificity.Emerging evidence suggests that serum extra spindle pole bodies like 1(ESPL1)protein and p53 antibody may improve diagnostic accuracy.AIM To assess and compare the diagnostic performance of serum ESPL1 protein and p53 antibody in HBV-related HCC(HBV-HCC).METHODS This case-control study from the First Affiliated Hospital of Guangxi Medical University enrolled 30 patients with chronic hepatitis B(CHB),30 with HBV-related liver cirrhosis(HBV-LC),55 with HBV-HCC,and 30 healthy controls.Serum ESPL1 protein and p53 antibody levels were quantified via ELISA.Diagnostic performance was evaluated using receiver operating characteristic(ROC)curve analysis,including sensitivity,specificity,and correlation with AFP.RESULTS Serum ESPL1 protein levels progressively increased across disease stages(CHB:89.9 ng/L;HBV-LC:188.83 ng/L;HBV-HCC:317.63 ng/L),with a significantly higher area under the ROC curve(AUC=0.917)than either p53 antibody(AUC=0.725)or AFP(AUC=0.678).p53 antibody levels were significantly elevated only in the HBVHCC group.ESPL1 demonstrated superior sensitivity and concordance with histopathological findings.A significant correlation between ESPL1 and p53 antibody levels was observed exclusively in the HBV-HCC group(r=0.320,P=0.017),suggesting potential interplay in malignant transformation.CONCLUSION Serum ESPL1 protein,a promising biomarker for early HBV-HCC detection,outperforms p53 antibody in diagnostic reliability.Higher ESPL1 levels correlate with increased HCC risk in chronic HBV patients.
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 the National Natural Science Foundation of China,No.81070913(to ZYH)
文摘Two common polymorphisms of the peroxisome proliferator-activated receptor gamma(PPARG) gene, rs1801282 and rs3856806, may be important candidate gene loci affecting the susceptibility to ischemic stroke. This case-control study sought to identify the relationship between these two single-nucleotide polymorphisms and ischemic stroke risk in a northern Chinese Han population. A total of 910 ischemic stroke participants were recruited from the First Hospital of China Medical University, Shenyang, China as a case group, of whom 895 completed the study. The 883 healthy controls were recruited from the Health Check Center of the First Hospital of China Medical University, Shenyang, China. All participants or family members provided informed consent. The study protocol was approved by the Ethics Committee of the First Hospital of China Medical University, China on February 20, 2012(approval No. 2012-38-1). The protocol was registered with the Chinese Clinical Trial Registry(registration number: ChiCTR-COC-17013559). Plasma genomic DNA was extracted from all participants and analyzed for rs1801282 and rs3856806 single nucleotide polymorphisms using a SNaPshot Multiplex sequencing assay. Odds ratios(ORs) and 95% confidence intervals(CIs) were calculated using unconditional logistic regression to estimate the association between ischemic stroke and a particular genotype. Results demonstrated that the G allele frequency of the PPARG gene rs1801282 locus was significantly higher in the case group than in the control group(P < 0.001). Individuals carrying the G allele had a 1.844 fold increased risk of ischemic stroke(OR = 1.844, 95% CI: 1.286–2.645, P < 0.001). Individuals carrying the rs3856806 T allele had a 1.366 fold increased risk of ischemic stroke(OR = 1.366, 95% CI: 1.077–1.733, P = 0.010). The distribution frequencies of the PPARG gene haplotypes rs1801282-rs3856806 in the control and case groups were determined. The frequency of distribution in the G-T haplotype case group was significantly higher than that in the control group. The risk of ischemic stroke increased to 2.953 times in individuals carrying the G-T haplotype(OR = 2.953, 95% CI: 2.082–4.190, P < 0.001). The rs1801282 G allele and rs3856806 T allele had a multiplicative interaction(OR = 3.404, 95% CI: 1.631–7.102, P < 0.001) and additive interaction(RERI = 41.705, 95% CI: 14.586–68.824, AP = 0.860;95% CI: 0.779–0.940;S = 8.170, 95% CI: 3.772–17.697) on ischemic stroke risk, showing a synergistic effect. Of all ischemic stroke cases, 86% were attributed to the interaction of the G allele of rs1801282 and the T allele of rs3856806. The effect of the PPARG rs1801282 G allele on ischemic stroke risk was enhanced in the presence of the rs3856806 T allele(OR = 8.001 vs. 1.844). The effect of the rs3856806 T allele on ischemic stroke risk was also enhanced in the presence of the rs1801282 G allele(OR = 2.546 vs. 1.366). Our results confirmed that the G allele of the PPARG gene rs1801282 locus and the T allele of the rs3856806 locus may be independent risk factors for ischemic stroke in the Han population of northern China, with a synergistic effect between the two alleles.
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 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.
基金Natural Science Foundation of Fujian Province,China,No.C001009
文摘AIM: Glutathione S-transferases (GSTs) are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutathione S-transferases M1 and T1 genotypes to susceptibility to the risk of gastric cancer and their interaction with cigarette smoking are still unclear. The aim of this study was to determine whether there was any relationship between genetic polymorphisms of GSTT1 and GSTT1 and gastric cancer. METHODS: A population based case-control study was carried out in a high-risk area, Changle County, Fujian Province, China. The epidemiological data were collected by a standard questionnaire and blood samples were obtained from 95 incidence gastric cancer cases and 94 healthy controls. A polymerase chain reaction method was used to detect the presence or absence of the GSTT1 and GSTT1 genes in genomic DNA. Logistic regression model was employed in the data analysis. RESULTS: An increase in risk for gastric cancer was found among carriers of GSTT1 null genotype. The adjusted odds ratio (OR) was 2.63 95% Confidence Interval (95% CI) 1.17-5.88, after controlling for age, gender, cigarette smoking, alcohol drinking, and fish sauce intake. The frequency of GSTT1 null genotype in cancer cases (43.16%) was not significantly different from that in controls (50.00%). However, the risk for gastric cancer in those with GSTT1 null and GSTT1 non-null genotype was significantly higher than in those with both GSTT1 and GSTT1 non-null genotype (OR = 2.77, 95% CI 1.15-6.77). Compared with those subjects who never smoked and had normal GSTT1 genotype, ORs were 1.60 (95% CI:0.62-4.19) for never smokers with GSTT1 null type, 2.33 (95% CI 0.88-6.28) for smokers with normal GSTT1, and 8.06 (95% CI 2.83-23.67) for smokers with GSTT1 null type. CONCLUSIONS: GSTT1 gene polymorphisms may be associated with genetic susceptibility of stomach cancer and may modulate tobacco-related carcinogenesis of gastric cancer.
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.
文摘AIM:To assess the risk of colonic polyps,adenomas and advanced neoplastic lesions(ANL) in patients with sporadic gastric polyps,especially those with fundic gland polyps(FGP).METHODS:Clinical records of patients who had performed an upper and a lower digestive endoscopy between September 2007 and August 2008 were retrospectively analyzed.A case-control study was carried out,calling patients with gastric polyps as 'cases' and patients without gastric polyps as 'controls'.The risk of colonic polyps,adenomas and ANL(villous component ≥ 25%,size ≥ 10 mm,or high grade dysplasia) was assessed [odds ratio(OR) and its corresponding 95%CI].RESULTS:Two hundred and forty seven patients were analyzed:78 with gastric polyps(cases) and 169 without gastric polyps(controls).Among the cases,the majority of gastric polyps were FGP(80%,CI:69-88) and hyperplastic(20%,CI:12-31);25% had colonic polyps(25% hyperplastic and 68% adenomas,from which 45% were ANL).Among the controls,20% had colonic polyps(31% hyperplastic and 63% adenomas,from which 41% were ANL).The patients with sporadic FGP had an OR of 1.56(CI:0.80-3.04) for colonic polyps,an OR of 1.78(CI:0.82-3.84) for colonic adenomas,and an OR of 0.80(CI:0.21-2.98) for ANL.Similar results were found in patients with gastric polyps in general.CONCLUSION:The results of this study did not show more risk of colorectal adenomas or ANL neither in patients with sporadic gastric polyps nor in those with FGP.
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.
