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
AIM: To investigate whether the use of statins is associated with colorectal cancer risk. METHODS: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan Nati...AIM: To investigate whether the use of statins is associated with colorectal cancer risk. METHODS: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan National Health Insurance Research Database. Cases consisted of all patients who were aged 50 years and older and had a first-time diagnosis of colorectal cancer between the period 2005 and 2008. The controls were matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. RESULTS: We examined 1156 colorectal cancer cases and 4624 controls. The unadjusted ORs for any statin prescription was 1.10 (95% CI = 0.94-1.30) and the adjusted OR was 1.09 (95% CI = 0.91-1.30). When statin use was categorized by cumulative dose, the adjusted ORs were 0.99 (95% CI = 0.78-1.27) for the group with cumulative statin use below 105 defined daily doses (DDDs); 1.07 (95% CI = 0.78-1.49) for the group with cumulative statin use between 106 and 298.66 DDDs; and 1.30 (95% CI = 0.96-1.75) for the group with cumulative statin use of 298.66 DDDs or more compared with nonusers. CONCLUSION: This study does not provide support for a protective effect of statins against colorectal cancer.展开更多
Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association...Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association of leiomyoma in pregnancy (LP) with pregnancy complications and birth outcomes including structural birth defects, i.e. congenital abnormalities (CA) in the offspring. Design Cases with CA and matched controls without CA in the population-based Hungarian Case-Control Surveillan- ce System of Congenital Abnormalities (HCC SCA) were evaluated. Only women with prospectively and medically recorded LP in prenatal maternity logbook and medically recorded birth outcomes (gestational age, birth weight, CA) were included to the study. Setting the HCCSCA, 1980-1996 contained 22,843 cases with CA and 38,151 matched controls without CA. Population Hungarian pregnant women and their informative offspring: live births, stillbirths and prenatally diagnosed malformed fetuses. Methods Comparison of birth outcomes of ca- ses with matched controls and pregnancy com- plications of pregnant women with or without LP. Main outcome measures Pregnancy complications, mean gestational age at delivery and birth weight, rate of preterm birth, low birthweight, CA. Results A total of 34 (0.15%) cases had mothers with LP compared to 71 (0.19%) controls. There was a higher incidence of threatened abortion, placental disorders, mainly abruption placentae and anaemia in mothers with LP. There was no significantly higher rate of preterm birth in the newborns of women with LP but their mean birth weight was higher and it associated with a higher rate of large birthweight newborns. A higher risk of total CA was not found in cases born to mothers with LP (adjusted OR with 95% CI = 0.7, 0.5-1.1), the spe- cified groups of CAs were also assessed versus controls, but a higher occurrence of women with LP was not revealed in any CA group. Con- clusions Women with LP have a higher risk of threatened abortion, placental disorders and anaemia, but a higher rate of adverse birth outcomes including CAs was not found in their offspring.展开更多
Objective To estimate the association of driver sleepiness with the risk of car crashes. Methods A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and...Objective To estimate the association of driver sleepiness with the risk of car crashes. Methods A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively. Results There was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sleepiness score≥10 vs <10; adjusted odds ratio 2.07, 95% confidence interval 1.30 to 3.29), but no increased risk was associated with measures of acute sleepiness. Conclusions Chronic sleepiness in car drivers significantly increases the risk of car crash. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy.展开更多
Background:Second primary malignancies(SPMs)account for over 30%of total deaths in head and neck cancer(HNC)patients.The increasing use of radiotherapy raises concerns about the elevated risk of radiation-associated S...Background:Second primary malignancies(SPMs)account for over 30%of total deaths in head and neck cancer(HNC)patients.The increasing use of radiotherapy raises concerns about the elevated risk of radiation-associated SPMs.This study aimed to investigate the age-stratified association between radiotherapy and SPM risk in survivors of non-metastatic primary HNC.Methods:Using data from the Surveillance,Epidemiology,and End Results program(2004-2015),incidence rate ratios(IRRs)and standardized incidence ratios(SIRs)were evaluated for solid and hematologic SPMs associated with radiotherapy within different age groups.Follow-up for hematologic and solid SPMs began 2 and 5 years,respectively,after the diagnosis of first primary HNC.The IRRs for SPMs were compared between radiotherapy-exposed and unexposed groups using multivariable modified Poisson regression.The SIRs were computed as the ratio of observed cancers in the cohort to expected cases derived from sex-,age-,and calendar year-matched general population incidence rates.Results:The study included 75,2092-year survivors,with 73.2%being male and a median age of 60 years.Of these,58,063 had survived 5 years or more.Radiotherapy was associated with an increased risk of solid SPMs[IRR=1.16,95%confidence interval(CI)1.08-1.24;P<0.001].The associations varied significantly among young(aged 15-39 years),middle-aged(aged 40-64 years),and elderly(aged 65-89 years)patients.Specifically,radiotherapy was associated with an increased risk of solid SPMs in middle-aged patients(IRR=1.21,95%CI 1.11-1.32;P<0.001),and a decreased risk of hematologic SPMs in elderly patients(IRR=0.77,95%CI 0.60-0.99;P=0.045).Compared with the general population,young patients had an elevated risk of radiotherapy-associated second primary non-Hodgkin lymphoma(SIR=4.01,95%CI 1.47-8.74).Middle-aged patients showed the highest SIR for SPMs in the bones/joints(SIR=7.72,95%CI 4.32-12.73),while elderly patients had the highest SIR for second primary esophageal malignancies(SIR=3.87,95%CI 2.91-5.05).Males were more likely to develop solid SPMs compared to females.Conclusions:This study reveals an age-stratified association between radiotherapy and the risk of SPMs in HNC patients.These findings highlight the importance of considering patient age when making treatment decisions for HNC and suggest that long-term surveillance is necessary for high-risk groups.展开更多
Background:Early detection of gastric cancer(GC)has been the topic of major efforts in China.This study aimed to explore the risk factors associated with GC and to provide evidence for the selection of a high-risk pop...Background:Early detection of gastric cancer(GC)has been the topic of major efforts in China.This study aimed to explore the risk factors associated with GC and to provide evidence for the selection of a high-risk population of GC.Methods:Based on the cancer screening cohort of the National Cancer Screening Program in Urban China,GC patients diagnosed by endoscopy and pathological examinations constituted the case group,and controls were 1:3 matched by sex and age(±5 years)individually.The variables were selected by univariable analysis of factors such as body mass index(BMI),dietary habits,lifestyle,stomach disease history,and family history of GC;and multivariable logistic regression was used to analyze the influencing factors of GC and to calculate the odds ratio(OR)of related factors and its 95%confidence interval(CI).Results:A total of 215 GC cases and 645 matched healthy controls were included in the final analysis,with a median age of 61 years for the case and control groups.Overall analysis showed that high educational level(above primary school)(OR=0.362,95%CI=0.219–0.599,P<0.001),overweight/obesity(BMI≥24 kg/m2;OR=0.489,95%CI=0.329–0.726,P<0.001),cigarette smoking(OR=3.069,95%CI=1.700–5.540,P<0.001),alcohol consumption(OR=1.661,95%CI=1.028–2.683,P=0.038),history of stomach disease(OR=6.917,95%CI=4.594–10.416,P<0.001),and family history of GC in first-degree relatives(OR=4.291,95%CI=1.661–11.084,P=0.003)were significantly correlated with the occurrence of GC.Subgroup analyses by age and gender indicated that GC risk was still increased in the presence of a history of stomach disease.A history of chronic gastritis,gastric ulcer,or gastric polyposis was positively associated with GC,with adjusted ORs of 4.155(95%CI=2.711–6.368),1.839(95%CI=1.028–3.288),and 2.752(95%CI=1.197–6.326).Conclusions:Subjects who smoke,drink,with history of stomach disease and family history of GC in first-degree relatives are the high-risk populations for GC.Therefore,attention should be paid to these subjects for GC screening.展开更多
Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-ris...Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs. Methods： There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions. Nomograms were used for visualization of those models, and receiver operating characteristic （ROC） curve analysis was used to present the predictive accuracy. Resu Its： We detected 8 （0.11% ） gastric adenocarcinomas, 17 （0.23 %） dysplasia cases, 14 （0.19%） hyperplasia cases, 52 （0.71%） intestinal metaplasia cases, 217 （2.97%） inflammatory lesions, 141 （1.93%） gastric ulcers, 10 （0.14%） atrophic gastritis cases, 1,365 （18.69%） erosive gastritis cases, and 5,957 （81.58%） superficial gastritis cases in 7,302 patients. The age （P〈0.001）, gender （P=0.086）, labor intensity （P=0.018） and leek food intake （P=0.143） were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve （AUC） [95% confidence interval （95% CI）] of 0.82 （0.74-0.89） for the modeling group and 0.80 （0.75-0.85） for the validation group. The age （P=0.002）, gender （P=0.024）, smoldng （P=0.002） and leek food intake （P=0.039） were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC （95% CI） of 0.62 （0.60-0.65） for the modeling group and 0.61 （0.59-0.63） for the validation group. Conclusions： We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.展开更多
AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40...AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients.展开更多
AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time a...AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.展开更多
AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-base...AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.展开更多
The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the ...The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.展开更多
Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different inte...Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.展开更多
This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.
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
AIM： To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease （IBD） patients and to investigate the ...AIM： To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease （IBD） patients and to investigate the influence of demographic and disease related patient characteristics on response rates. METHODS： Thirteen years ago, the European Collaborative study group of IBD （EC-IBD） initiated a population-based prospective inception cohort of 2 201 uniformly diagnosed IBD patients within 20 well- described geographical areas in 11 European countries and Israel. For the 10-year follow-up of this cohort, an electronic patient questionnaire （ePQ） and electronic physician per patient follow-up form （ePpPFU） were designed as two separate data collecting instruments and made available through an Internet-based website. Independent demographic and clinical determinants of ePQ participation were analyzed using multivariate logistic regression.total number of 1 505 （64%） available IBD patients, originating from 13 participating centers from nine different countries, both ePQ and ePpPFU were completed. Patients older than 40 years at ePQ completion （OR： 1.53 （95% CI： 1.14-2.05）） and those with active disease during the 3 mo previous to ePQ completion （OR： 3.32 （95%CI： 1.57-7.03）） were significantly more likely to respond. CONCLUSION： An Internet-based data acquisition tool appeared successful in sustaining a unique Western- European and Israelian multi-center 10-year clinical follow-up study project in patients afflicted with IBD.展开更多
The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive...The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.Methods:Patients were identified from SEER database.Variables were selected by a backward stepwise selection method in a Cox regression model.A nomogram was used to predict cancer-specific survival rates for 3,5 and 10 years in patients with GSCC.Several basic features of model validation were used to evaluate the performance of the survival model:consistency index(C-index),receiver operating characteristic(ROC)curve,calibration chart,net weight classification improvement(NRI),comprehensive discriminant improvement(IDI)and decision curve analysis(DCA).Results:Multivariate analyses revealed that age,race,marital status,insurance,AJCC stage,pathology grade and surgery were risk factors for survival.In particular,the C-index,the area under the ROC curve(AUC)and the calibration plots showed good performance of the nomogram.Compared to the AJCC system,NRI and IDI showed that the nomogram has improved performance.Finally,the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC,whether training set or a validation set.Conclusion:We developed and validated the first GSCC prognosis nomogram,which has a better prognostic value than the separate AJCC staging system.Overall,the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3,5 and 10 years.展开更多
There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diab...There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.展开更多
BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric c...BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric cancer incidence according to age,sex,and Helicobacter pylori(H.pylori)treatment in Taiwan.METHODS In this population-based study,we used the national Taiwan Cancer Registry database.Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan.Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H.pylori infection.RESULTS The annual percent changes showed continuously decreasing rates of gastric cancer among both males and females.However,the decreasing trends differed by sex,with an annual percent change of-2.58%in males and-2.14%in females.The age-specific incidence rates increased with age.Within the same age group,more recent time periods showed lower incidence rates than greater time periods.Similarly,the sex ratio was lower in later birth cohorts than in earlier birth cohorts.Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H.pylori infection during 2005 to 2016(r=0.72).CONCLUSION We observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan.These results support H.pylori eradication programs in Taiwan.展开更多
AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES...AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES):a population-based crosssectional study conducted on individuals 60 years of age and above living in Tehran,Iran using the multi-stage stratified random cluster sampling method.Cognitive status was assessed using the Persian version of the Mini-Mental State Examination(MMSE).All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,cover testing,NPC measurement,and slit-lamp biomicroscopy.RESULTS:The data of 1190 individuals were analyzed for this report.The mean age of the participants analyzed was 66.82±5.42(60-92y)and 728(61.2%)of them were female.Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status(10.89±3.58 vs 7.76±2.71 cm,P<0.001).In the multivariable logistic regression model and in the presence of confounding variables,a receded NPC was statistically significantly associated with an increased risk of MCI(odds ratio:1.334,95%confidence interval:1.263 to 1.410,P<0.001).According to receiver operating characteristic(ROC)analysis,a cut point NPC>8.5 cm(area under the curve:0.764,P<0.001)could predict the presence of MCI with a sensitivity and specificity of 70.9%and 69.5%,respectively.CONCLUSION:A receded NPC can be clinically proposed as a predictor of MCI in older adults.It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI.In this case,the necessary interventions can be carried out to slow down MCI progression to dementia.展开更多
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Supported by A grant from the National Science Council, Executive Yuan, Taiwan, No. NSC97-2314-B-037-006-MY3
文摘AIM: To investigate whether the use of statins is associated with colorectal cancer risk. METHODS: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan National Health Insurance Research Database. Cases consisted of all patients who were aged 50 years and older and had a first-time diagnosis of colorectal cancer between the period 2005 and 2008. The controls were matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. RESULTS: We examined 1156 colorectal cancer cases and 4624 controls. The unadjusted ORs for any statin prescription was 1.10 (95% CI = 0.94-1.30) and the adjusted OR was 1.09 (95% CI = 0.91-1.30). When statin use was categorized by cumulative dose, the adjusted ORs were 0.99 (95% CI = 0.78-1.27) for the group with cumulative statin use below 105 defined daily doses (DDDs); 1.07 (95% CI = 0.78-1.49) for the group with cumulative statin use between 106 and 298.66 DDDs; and 1.30 (95% CI = 0.96-1.75) for the group with cumulative statin use of 298.66 DDDs or more compared with nonusers. CONCLUSION: This study does not provide support for a protective effect of statins against colorectal cancer.
文摘Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association of leiomyoma in pregnancy (LP) with pregnancy complications and birth outcomes including structural birth defects, i.e. congenital abnormalities (CA) in the offspring. Design Cases with CA and matched controls without CA in the population-based Hungarian Case-Control Surveillan- ce System of Congenital Abnormalities (HCC SCA) were evaluated. Only women with prospectively and medically recorded LP in prenatal maternity logbook and medically recorded birth outcomes (gestational age, birth weight, CA) were included to the study. Setting the HCCSCA, 1980-1996 contained 22,843 cases with CA and 38,151 matched controls without CA. Population Hungarian pregnant women and their informative offspring: live births, stillbirths and prenatally diagnosed malformed fetuses. Methods Comparison of birth outcomes of ca- ses with matched controls and pregnancy com- plications of pregnant women with or without LP. Main outcome measures Pregnancy complications, mean gestational age at delivery and birth weight, rate of preterm birth, low birthweight, CA. Results A total of 34 (0.15%) cases had mothers with LP compared to 71 (0.19%) controls. There was a higher incidence of threatened abortion, placental disorders, mainly abruption placentae and anaemia in mothers with LP. There was no significantly higher rate of preterm birth in the newborns of women with LP but their mean birth weight was higher and it associated with a higher rate of large birthweight newborns. A higher risk of total CA was not found in cases born to mothers with LP (adjusted OR with 95% CI = 0.7, 0.5-1.1), the spe- cified groups of CAs were also assessed versus controls, but a higher occurrence of women with LP was not revealed in any CA group. Con- clusions Women with LP have a higher risk of threatened abortion, placental disorders and anaemia, but a higher rate of adverse birth outcomes including CAs was not found in their offspring.
文摘Objective To estimate the association of driver sleepiness with the risk of car crashes. Methods A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively. Results There was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sleepiness score≥10 vs <10; adjusted odds ratio 2.07, 95% confidence interval 1.30 to 3.29), but no increased risk was associated with measures of acute sleepiness. Conclusions Chronic sleepiness in car drivers significantly increases the risk of car crash. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy.
基金supported by the National Natural Science Foundation of China(82101069)the Beijing Natural Science Foundation(7242279),the Beijing Nova Program(20230484283)+2 种基金the Beijing Municipal Science&Technology Commission(Z221100007422130)the Open Project of State Key Laboratory of Trauma and Chemical Poisoning(SKLO202401)the Logistics Independent Research Project of PLA(C24LBJ032).
文摘Background:Second primary malignancies(SPMs)account for over 30%of total deaths in head and neck cancer(HNC)patients.The increasing use of radiotherapy raises concerns about the elevated risk of radiation-associated SPMs.This study aimed to investigate the age-stratified association between radiotherapy and SPM risk in survivors of non-metastatic primary HNC.Methods:Using data from the Surveillance,Epidemiology,and End Results program(2004-2015),incidence rate ratios(IRRs)and standardized incidence ratios(SIRs)were evaluated for solid and hematologic SPMs associated with radiotherapy within different age groups.Follow-up for hematologic and solid SPMs began 2 and 5 years,respectively,after the diagnosis of first primary HNC.The IRRs for SPMs were compared between radiotherapy-exposed and unexposed groups using multivariable modified Poisson regression.The SIRs were computed as the ratio of observed cancers in the cohort to expected cases derived from sex-,age-,and calendar year-matched general population incidence rates.Results:The study included 75,2092-year survivors,with 73.2%being male and a median age of 60 years.Of these,58,063 had survived 5 years or more.Radiotherapy was associated with an increased risk of solid SPMs[IRR=1.16,95%confidence interval(CI)1.08-1.24;P<0.001].The associations varied significantly among young(aged 15-39 years),middle-aged(aged 40-64 years),and elderly(aged 65-89 years)patients.Specifically,radiotherapy was associated with an increased risk of solid SPMs in middle-aged patients(IRR=1.21,95%CI 1.11-1.32;P<0.001),and a decreased risk of hematologic SPMs in elderly patients(IRR=0.77,95%CI 0.60-0.99;P=0.045).Compared with the general population,young patients had an elevated risk of radiotherapy-associated second primary non-Hodgkin lymphoma(SIR=4.01,95%CI 1.47-8.74).Middle-aged patients showed the highest SIR for SPMs in the bones/joints(SIR=7.72,95%CI 4.32-12.73),while elderly patients had the highest SIR for second primary esophageal malignancies(SIR=3.87,95%CI 2.91-5.05).Males were more likely to develop solid SPMs compared to females.Conclusions:This study reveals an age-stratified association between radiotherapy and the risk of SPMs in HNC patients.These findings highlight the importance of considering patient age when making treatment decisions for HNC and suggest that long-term surveillance is necessary for high-risk groups.
基金the National Science&Technology Fundamental Resources Investigation Program of China(No.2019FY101105)the Nonprofit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019PT320027)the National Key Public Health Program of China(Cancer Screening Program in Urban China).
文摘Background:Early detection of gastric cancer(GC)has been the topic of major efforts in China.This study aimed to explore the risk factors associated with GC and to provide evidence for the selection of a high-risk population of GC.Methods:Based on the cancer screening cohort of the National Cancer Screening Program in Urban China,GC patients diagnosed by endoscopy and pathological examinations constituted the case group,and controls were 1:3 matched by sex and age(±5 years)individually.The variables were selected by univariable analysis of factors such as body mass index(BMI),dietary habits,lifestyle,stomach disease history,and family history of GC;and multivariable logistic regression was used to analyze the influencing factors of GC and to calculate the odds ratio(OR)of related factors and its 95%confidence interval(CI).Results:A total of 215 GC cases and 645 matched healthy controls were included in the final analysis,with a median age of 61 years for the case and control groups.Overall analysis showed that high educational level(above primary school)(OR=0.362,95%CI=0.219–0.599,P<0.001),overweight/obesity(BMI≥24 kg/m2;OR=0.489,95%CI=0.329–0.726,P<0.001),cigarette smoking(OR=3.069,95%CI=1.700–5.540,P<0.001),alcohol consumption(OR=1.661,95%CI=1.028–2.683,P=0.038),history of stomach disease(OR=6.917,95%CI=4.594–10.416,P<0.001),and family history of GC in first-degree relatives(OR=4.291,95%CI=1.661–11.084,P=0.003)were significantly correlated with the occurrence of GC.Subgroup analyses by age and gender indicated that GC risk was still increased in the presence of a history of stomach disease.A history of chronic gastritis,gastric ulcer,or gastric polyposis was positively associated with GC,with adjusted ORs of 4.155(95%CI=2.711–6.368),1.839(95%CI=1.028–3.288),and 2.752(95%CI=1.197–6.326).Conclusions:Subjects who smoke,drink,with history of stomach disease and family history of GC in first-degree relatives are the high-risk populations for GC.Therefore,attention should be paid to these subjects for GC screening.
基金supported by the National Natural Science Foundation of China(Grant No.81302160 and 81272447)Beijing Natural Science Foundation ProgramScientific Research Key Program of Beijing Municipal Commission of Education(Grant No.KZ201410025024)
文摘Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs. Methods： There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions. Nomograms were used for visualization of those models, and receiver operating characteristic （ROC） curve analysis was used to present the predictive accuracy. Resu Its： We detected 8 （0.11% ） gastric adenocarcinomas, 17 （0.23 %） dysplasia cases, 14 （0.19%） hyperplasia cases, 52 （0.71%） intestinal metaplasia cases, 217 （2.97%） inflammatory lesions, 141 （1.93%） gastric ulcers, 10 （0.14%） atrophic gastritis cases, 1,365 （18.69%） erosive gastritis cases, and 5,957 （81.58%） superficial gastritis cases in 7,302 patients. The age （P〈0.001）, gender （P=0.086）, labor intensity （P=0.018） and leek food intake （P=0.143） were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve （AUC） [95% confidence interval （95% CI）] of 0.82 （0.74-0.89） for the modeling group and 0.80 （0.75-0.85） for the validation group. The age （P=0.002）, gender （P=0.024）, smoldng （P=0.002） and leek food intake （P=0.039） were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC （95% CI） of 0.62 （0.60-0.65） for the modeling group and 0.61 （0.59-0.63） for the validation group. Conclusions： We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.
基金Supported by Chung Shan Medical University Hospital,Taichung,Taiwan,No.CSH-2013-C-032
文摘AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients.
基金Supported by the grants from the Cheng Hsin Rehabilitation Medical Center, No. 93-25
文摘AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.
基金Supported by The establishment of the NI Barrett's Register was assisted by a grant from the Ulster Cancer Foundation
文摘AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.
文摘The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.
基金financed in part by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior-Brasil (CAPES) (Finance Code 001)by the Science and Technology Department of the Brazilian Ministry of Health,with resources transferred through the Brazilian National Council for Scientific and Technological Development (CNPq) (400943/2013-1)+1 种基金Helen Gon?alves (305759/2017-5),Ana Menezes (302029/ 2017-6),Fernando Barros,and Fernando C.Wehrmeister (309236/2018-5) received funding through a CNPq research productivity grantAndrea Wendt was funded by a CAPES PhD scholarship (Finance Code 001)。
文摘Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.
基金supported by the National Natural Science Foundation of China[Grant No.81773509][Grant No.81102190]
文摘This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.
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).
基金Supported by the European Commission as a fifth framework shared cost action (QLG4-CT-2000-01414)
文摘AIM： To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease （IBD） patients and to investigate the influence of demographic and disease related patient characteristics on response rates. METHODS： Thirteen years ago, the European Collaborative study group of IBD （EC-IBD） initiated a population-based prospective inception cohort of 2 201 uniformly diagnosed IBD patients within 20 well- described geographical areas in 11 European countries and Israel. For the 10-year follow-up of this cohort, an electronic patient questionnaire （ePQ） and electronic physician per patient follow-up form （ePpPFU） were designed as two separate data collecting instruments and made available through an Internet-based website. Independent demographic and clinical determinants of ePQ participation were analyzed using multivariate logistic regression.total number of 1 505 （64%） available IBD patients, originating from 13 participating centers from nine different countries, both ePQ and ePpPFU were completed. Patients older than 40 years at ePQ completion （OR： 1.53 （95% CI： 1.14-2.05）） and those with active disease during the 3 mo previous to ePQ completion （OR： 3.32 （95%CI： 1.57-7.03）） were significantly more likely to respond. CONCLUSION： An Internet-based data acquisition tool appeared successful in sustaining a unique Western- European and Israelian multi-center 10-year clinical follow-up study project in patients afflicted with IBD.
基金supported by grants from National Natural Science Foundation of China(No.81702708)Natural Science Foundation of Hunan Province(No.2018JJ3862,No.2017JJ2392,and No.2019JJ50979)+1 种基金Scientific Research Project of Hunan Provincial Health Commission(No.B20180054)Changsha Science and Technology Project(No.kq1706072).
文摘The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.Methods:Patients were identified from SEER database.Variables were selected by a backward stepwise selection method in a Cox regression model.A nomogram was used to predict cancer-specific survival rates for 3,5 and 10 years in patients with GSCC.Several basic features of model validation were used to evaluate the performance of the survival model:consistency index(C-index),receiver operating characteristic(ROC)curve,calibration chart,net weight classification improvement(NRI),comprehensive discriminant improvement(IDI)and decision curve analysis(DCA).Results:Multivariate analyses revealed that age,race,marital status,insurance,AJCC stage,pathology grade and surgery were risk factors for survival.In particular,the C-index,the area under the ROC curve(AUC)and the calibration plots showed good performance of the nomogram.Compared to the AJCC system,NRI and IDI showed that the nomogram has improved performance.Finally,the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC,whether training set or a validation set.Conclusion:We developed and validated the first GSCC prognosis nomogram,which has a better prognostic value than the separate AJCC staging system.Overall,the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3,5 and 10 years.
基金supported by the MST of Taiwan under Grant No.101-2221-E-008-125-MY3
文摘There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.
文摘BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric cancer incidence according to age,sex,and Helicobacter pylori(H.pylori)treatment in Taiwan.METHODS In this population-based study,we used the national Taiwan Cancer Registry database.Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan.Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H.pylori infection.RESULTS The annual percent changes showed continuously decreasing rates of gastric cancer among both males and females.However,the decreasing trends differed by sex,with an annual percent change of-2.58%in males and-2.14%in females.The age-specific incidence rates increased with age.Within the same age group,more recent time periods showed lower incidence rates than greater time periods.Similarly,the sex ratio was lower in later birth cohorts than in earlier birth cohorts.Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H.pylori infection during 2005 to 2016(r=0.72).CONCLUSION We observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan.These results support H.pylori eradication programs in Taiwan.
基金Supported by Iran University of Medical Sciences (IUMS)。
文摘AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES):a population-based crosssectional study conducted on individuals 60 years of age and above living in Tehran,Iran using the multi-stage stratified random cluster sampling method.Cognitive status was assessed using the Persian version of the Mini-Mental State Examination(MMSE).All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,cover testing,NPC measurement,and slit-lamp biomicroscopy.RESULTS:The data of 1190 individuals were analyzed for this report.The mean age of the participants analyzed was 66.82±5.42(60-92y)and 728(61.2%)of them were female.Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status(10.89±3.58 vs 7.76±2.71 cm,P<0.001).In the multivariable logistic regression model and in the presence of confounding variables,a receded NPC was statistically significantly associated with an increased risk of MCI(odds ratio:1.334,95%confidence interval:1.263 to 1.410,P<0.001).According to receiver operating characteristic(ROC)analysis,a cut point NPC>8.5 cm(area under the curve:0.764,P<0.001)could predict the presence of MCI with a sensitivity and specificity of 70.9%and 69.5%,respectively.CONCLUSION:A receded NPC can be clinically proposed as a predictor of MCI in older adults.It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI.In this case,the necessary interventions can be carried out to slow down MCI progression to dementia.
