Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approache...Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use.For targeting risk factors of drug initiation in Chinese adolescents,a school-based health intervention program named "Cognition-Motivation-Emotional IntelligenceResistance Skills" (CMER) was developed to enhance cognition upon drug use,to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study.A total of 798 students from 3 senior high schools in Wuhan,a city in central China,were assigned randomly to intervention and control groups.The intervention group received the CMER program in which knowledge,development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements.The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session.Students from both groups were asked to complete a self-administered questionnaire.The questionnaire included demographic items,self-reported drug use behavior,cognition,attitude,and motivation associated with the initiation of drug use and resistance skills.Three months after the intervention,significant effects were found on "illegal substance use at least once" (P【0.05) between the intervention and control groups.Immediate effects of the intervention were also found on knowledge,motivation and peer resistance skills (P【0.05),but there was no clear evidence for any effects on attitude towards substance use (P】0.05).It was concluded that the CMER program,which significantly increased the knowledge of drugs and peer resistance skills,was effective in the drug abuse prevention in a sample of school students in Wuhan,China.展开更多
BACKGROUND Intestinal mucositis is a severe and common complication of chemotherapy,characterized by disruption of the gut microbiota,intestinal inflammation,and epithelial barrier damage.Intestinal stem cells(ISCs)ar...BACKGROUND Intestinal mucositis is a severe and common complication of chemotherapy,characterized by disruption of the gut microbiota,intestinal inflammation,and epithelial barrier damage.Intestinal stem cells(ISCs)are essential for epithelial renewal and barrier maintenance,yet chemotherapy impairs ISC proliferation and function,delaying mucosal repair.We hypothesized that Wumei Pills(WMP)could protect against chemotherapy-induced intestinal mucositis by modulating gut microbiota-particularly Lactobacillus reuteri(L.reuteri)-to restore ISC activity,preserve microbial balance,reduce inflammation,and promote epithelial regeneration.AIM To characterize these changes and the safety of WMP via a 5-fluorouracil(5-FU)induced intestinal mucositis mouse model.METHODS In this study,we established a 5-FU induced intestinal mucositis mouse model,to explore the protective effect of WMP regulating L.reuteri on integrity of intestinal mucosa.RESULTS We found that intestinal flora is an important mechanism causing chemotherapyinduced intestinal mucositis,but WMP and live L.reuteri were effective in protecting the morphology of intestinal mucositis and normal proliferation of epithelial.L.reuteri colonized in the intestinal mucosa and WMP ameliorated intestinal mucosa damage caused by 5-FU treatment,including improvement of body weight,pathological change,and proliferation level,reducement proinflammatory cytokine secretion(tumor necrosis factor-α,interleukin-6)and the lipopolysaccharides concentration in serum.The repair process stimulated by both L.reuteri and WMP were also accompanied with increased leucine-richrepeat-containing G-protein-coupled receptor 5(+)and proliferating cell nuclear antigen of mice intestine.Furthermore,we demonstrated that WMP and L.reuteri activated the Wingless-type/β-catenin pathway to accelerate proliferation of intestinal epithelial,thus recovering damaged intestinal mucosa.However,the relieving effect of L.reuteri on intestinal mucosa was inferior to that of WMP.CONCLUSION Our findings indicate that WMP regulating L.reuteri protects intestinal barrier and activates intestinal epithelial proliferation,which sheds light on treatment approaches for intestinal inflammation based on ISCs with traditional Chinese medicine and probiotics L.reuteri.展开更多
AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province,China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sa...AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province,China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province,China. Questionnaires,designed by co-working of epidemiologists and hepatologists,included demographic characteristics,current medication use,medical history and health-relevant behaviors,i.e. alcohol consumption,smoking habits,dietary habits and physical activities. Anthropometric measurements,biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects,609 (17.2%) were diagnosed having FLD (18.0% males,16.7% females,P > 0.05). Among them,the prevalence of confirmed alcoholic liver disease (ALD),suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%,1.8%,and 15.0%,respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age,gender and residency,the standardized prevalence of FLD in adults was 14.5%. Among them,confirmed ALD,suspected ALD and NAFLD were 0.5%,2.3%,and 11.7%,respectively,in adults and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%,P < 0.001). However,the opposite phenomenon was found over the age of 50 years (20.6% vs 27.6%,P < 0.05). Multivariate and logistic regression analysis indicated that male gender,urban residency,low education,high blood pressure,body mass index,waist circumference,waist to hip ratio,serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD,especially NAFLD,is prevalent in South China. There are many risk factors for FLD.展开更多
Given the analysis of underground pressure, a stress calculation model of coal floor stress has been established based on a theory of elasticity. The model presents the law of stress distribution on the relatively fix...Given the analysis of underground pressure, a stress calculation model of coal floor stress has been established based on a theory of elasticity. The model presents the law of stress distribution on the relatively fixed position of the mining coal floor： the extent of stress variation in a fixed floor position decreases gradually along with depth, the decreasing rate of the vertical stress is clearly larger than that of the horizontal stress at a specific depth. The direction of the maximum principal stress changes gradually from a vertical direction to a horizontal direction with the advance of the working face. The deformation and permeability of the rock mass of the coal floor are obtained by contrasting the difference of the principal stress established from theoretical calculations with curves of stress-strain and permeability-strain from tests, which is an important mechanical basis for preventing water inrush from confined aauifers.展开更多
Background In China,lack of evidence remains a significant challenge for the national initiative to promote physical activity(PA).We aimed to quantify the beneficial effects of meeting or maintaining the recommended P...Background In China,lack of evidence remains a significant challenge for the national initiative to promote physical activity(PA).We aimed to quantify the beneficial effects of meeting or maintaining the recommended PA level[150 minutes per week(min/wk)of moderate PA or 75 min/wk of vigorous PA or an equivalent combination]on incident cardiovascular disease(CVD)among Chinese population.Methods We included 100,560 participants without history of CVD from three cohorts in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR)project.Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)for CVD events and its subtypes,including stroke,coronary heart disease,heart failure,and CVD death.Results During a median follow-up of 7.3 years(range:6–15 years),777,163 person-years and 4693 incident CVD events were observed.Compared with participants who were inactive at baseline,the multivariable adjusted HR(95%CI)of developing CVD was 0.74(0.69–0.79)for those who met recommended moderate to vigorous physical activity(MVPA)level at baseline.Furthermore,the risk of CVD incidence was reduced with increment of MVPA(Ptrend<0.001),and the HR(95%CI)of highly-active versus inactive category was 0.62(0.56–0.68).Compared with individuals who were inactive both at the baseline and follow-up,those keeping active over the period of follow-up had a substantial lower risk of incident CVD with the HR(95%CI)of 0.57(0.43–0.77).Conclusions The findings demonstrated that meeting and maintaining the recommended MVPA level could reduce the cardiovascular risk.Wider adoption of the PA recommendations would have considerable health impacts to the Chinese population.展开更多
AIM: To evaluate variation of the concentration of thiopurine metabolites after 5-aminosalicylate(5-ASA) interruption and the role of genetic polymorphisms of N-acetyl transferase(NAT) 1 and 2. METHODS: Concentrations...AIM: To evaluate variation of the concentration of thiopurine metabolites after 5-aminosalicylate(5-ASA) interruption and the role of genetic polymorphisms of N-acetyl transferase(NAT) 1 and 2. METHODS: Concentrations of thioguanine nucleotides(TGN) and methymercaptopurine nucleotides(MMPN), metabolites of thiopurines, were measured by high performance liquid chromatography in 12 young patients(3 females and 9 males, median age 16 years) with inflammatory bowel disease(6 Crohn's disease and 6 ulcerative colitis) treated with thiopurines(7 mercaptopurine and 5 azathioprine) and 5-ASA. Blood samples were collected one month before and one month after the interruption of 5-ASA. DNA was extracted and genotyping of NAT1, NAT2, inosine triphosphate pyrophosphatase(ITPA) and thiopurine methyl transferase(TPMT) genes was performed using PCR assays. RESULTS: Median TGN concentration before 5-ASA interruption was 270 pmol/8 x 108 erythrocytes(range: 145-750); after the interruption of the aminosalicylate, a 35% reduction in TGN mean concentrations(absolutemean reduction 109 pmol/8 × 108 erythrocytes) was observed(median 221 pmol/8 × 108 erythrocytes, range: 96-427, P value linear mixed effects model 0.0011). Demographic and clinical covariates were not related to thiopurine metabolites concentrations. All patients were wild-type for the most relevant ITPA and TPMT variants. For NAT1 genotyping, 7 subjects presented an allele combination corresponding to fast enzymatic activity and 5 to slow activity. NAT1 genotypes corresponding to fast enzymatic activity were associated with reduced TGN concentration(P value linear mixed effects model 0.033), putatively because of increased 5-ASA inactivation and consequent reduced inhibition of thiopurine metabolism. The effect of NAT1 status on TGN seems to be persistent even after one month since the interruption of the aminosalicylate. No effect of NAT1 genotypes was shown on MMPN concentrations. NAT2 genotyping revealed that 6 patients presented a genotype corresponding to fast enzymatic activity and 6 to slow activity; NAT2 genotypes were not related to thiopurine metabolites concentration in this study. CONCLUSION: NAT1 genotype affects TGN levels in patients treated with thiopurines and aminosalicylates and could therefore influence the toxicity and efficacy of these drugs; however the number of patients evaluated is limited and this has to be considered a pilot study.展开更多
Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kaz...Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kazaks of Xinjiang Uyghur Autonomous Region,China.Methods These loci were analyzed by PCR-restriction fragment length polymorphism （PCR-PFLP）.Two hundred and five patients with CHD and two hundred and thirty six controls were involved.Results There were significant distinctions among low-density lipoprotein cholesterol （LDL-C）,triglyceride （TG） and the ApoAI/ApoB ratio between the two groups,but no significant distinction among the polymorphism frequencies of the four sites between the two groups.The polymorphism coalition frequency of X-/Ms＋＋/M1＋-/M2＋＋ （named Coalition 11） was significantly higher in CHD compared to the control group （14.6％ vs.7.2％,P ＜ 0.05）.The level of total cholesterol （TC） in Coalition 1 1 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1～10 in CHD patients.The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1～10 in control group.The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups,respectively.The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group.The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group.The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1～10 of the two groups,respectively.The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group.The ratio of ApoAI/ApoB was negatively related to TC,LDL-C and was positively related to HDL-C,both in CHD and control groups.Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks,and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters.CHD may also be associated with Coalition 5,and,perhaps,Coalition 3 may have been confirmed as a protection factor against CHD,if more samples were enrolled.展开更多
An enhanced cascade of care should include a younger population,helping to achieve the goal of the World Health Organization with a focus on elimination in the pediatric population.Furthermore,enhanced screening and a...An enhanced cascade of care should include a younger population,helping to achieve the goal of the World Health Organization with a focus on elimination in the pediatric population.Furthermore,enhanced screening and awareness efforts and continued education of health care providers will improve the outcomes of chronic hepatitis C virus(HCV)infection in the pediatric population.The present work discusses and comments on the topic"cascade of care in HCV chronic pediatric patients".展开更多
Background The relationships between dietary intake of soybean products and incident hypertension were still uncertain.This study aimed to illustrate the associations between intake of soybean products with risks of i...Background The relationships between dietary intake of soybean products and incident hypertension were still uncertain.This study aimed to illustrate the associations between intake of soybean products with risks of incident hypertension and longitudinal changes of blood pressure in a prospective cohort study.Methods We included 67,499 general Chinese adults from the Project of Prediction for Atherosclerosis Cardiovascular Disease Risk in China(China-PAR).Information about soybean products consumption was collected by standardized questionnaires,and study participants were categorized into the ideal(≥125 g/day)or non-ideal(<125 g/day)group.Hazard ratios(HRs)and corresponding 95%confidence intervals(95%CIs)for incident hypertension were calculated using Cox proportional hazard models.Among participants with repeated measures of blood pressure,generalized linear models were used to examine the relationships between soybean products consumption and blood pressure changes.Results During a median follow-up of 7.4 years,compared with participants who consumed<125 g of soybean products per day,multivariable adjusted HR for those in the ideal group was 0.73(0.67-0.80).This inverse association remained robust across most subgroups while significant interactions were tested between soybean products intake and age,sex,urbanization and geographic region(P values for interaction<0.05).The mean systolic and diastolic blood pressure levels were 1.05(0.71-1.39)mmHg and 0.44(0.22-0.66)mmHg lower among participants in the ideal group than those in the non-ideal group.Conclusions Our study showed that intake of soybean products might reduce the long-term blood pressure levels and hypertension incidence among Chinese population,which has important public health implications for primary prevention of hypertension.展开更多
BACKGROUND The Cariostat caries activity test(CAT)was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral h...BACKGROUND The Cariostat caries activity test(CAT)was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral health status of pregnant women.AIM To investigate whether personalized oral hygiene management enhances the oral health status of pregnant women.METHODS A total of 114 pregnant women who were examined at Dalian Women’s and Children’s Medical Center were divided into four groups:High-risk experimental group(n=29;CAT score≥2;received personalized oral hygiene management training),low-risk experimental group(n=29;CAT score≤1;received oral health education),high-risk control group(n=28;CAT score≥2),and low-risk control group(n=28;CAT score≤1).No hygiene intervention was provided to control groups.CAT scores at different times were compared using independent samples t-test and least significant difference t-test.RESULTS No significant difference in baseline CAT scores was observed between the experimental and control groups,either in the high-risk or low-risk groups.CAT scores were reduced significantly after 3(1.74±0.47 vs 2.50±0.38,P<0.0001)and 6 months(0.53±0.50 vs 2.45±0.42,P<0.0001)of personalized oral hygiene management intervention but not after oral health education alone(0.43±0.39 vs 0.46±0.33,P>0.05 and 0.45±0.36 vs 0.57±0.32,P>0.05,respectively).Within groups,the decrease in CAT scores was significant(2.43±0.44 vs 1.74±0.47 vs 0.53±0.50,P<0.0001)for only the high-risk experimental group.CONCLUSION Personalized oral hygiene management is effective in improving the oral health of pregnant women and can improve pregnancy outcomes and the oral health of the general population.展开更多
Dementia is increasing dramatically and imposes a huge burden on society. To date, there is a lack of data on the health status of patients with dementia in China. In an attempt to investigate the comorbidity burden o...Dementia is increasing dramatically and imposes a huge burden on society. To date, there is a lack of data on the health status of patients with dementia in China. In an attempt to investigate the comorbidity burden of dementia patients in China at the national level, we enrolled 2,938 patients with Alzheimer＇s disease（AD）, vascular dementia（Va D）, or other types of dementia, who were admitted to tertiary hospitals in seven regions of China from January2003 to December 2012. The Charlson Comorbidity Index（CCI） was used to evaluate the comorbidity burden of the patients with dementia. Among these patients, 53.4% had AD, 26.3% had Va D, and 20.3% had other types of dementia. The CCI was 3.0 ± 1.9 for all patients,3.4 ± 1.8 for those with Va D, and 3.0 ± 2.1 for those with AD. The CCI increased with age in all patients, andthe length of hospital stay and daily expenses rose with age and CCI. Males had a higher CCI and a longer stay than females. Moreover, patients admitted in the last 5 years of the study had a higher CCI than those admitted in the first 5 years. We found that the comorbidity burden of patients with dementia is heavy. These findings provide a better understanding of the overall health status of dementia patients, and help to increase the awareness of clinicians and policy-makers to improve medical care for patients.展开更多
The aim of this study was to describe the intensive care unit (ICU) nurses’ knowledge, attitude, and practice of mouth care for their patients. This is a cross sectional hospital based study. A total of 154 ICU nurse...The aim of this study was to describe the intensive care unit (ICU) nurses’ knowledge, attitude, and practice of mouth care for their patients. This is a cross sectional hospital based study. A total of 154 ICU nurses were randomly selected from seven governmental hospitals in Khartoum state and were invited to take part in this study. 97.4% of ICU nurses had high knowledge of the importance of mouth care for ICU patients and similarly for the priority of mouth care. However, only 20% of nurses were found to apply good practice. 64.5% of the nurses received training in mouth care provision, and (81%) indicated that further training would be beneficial. The oral care practice of ICU nurses ranged between average among 57% and poor among 23%. The study highlighted the need for setting of ICU protocols and adoption of advanced training for ICU nurses.展开更多
Objective: This study examines risk perceptions, nutrition practices, and physical activity among ever pregnant South Asian American women, and explores differences by history of GDM, a significant risk factor for the...Objective: This study examines risk perceptions, nutrition practices, and physical activity among ever pregnant South Asian American women, and explores differences by history of GDM, a significant risk factor for the development of type 2 diabetes. Methods: The Diabetes Prevention Study (DPS) recruited a convenience sample of South Asian adults living in the metropolitan Washington DC region. Specific eligibility criteria included English proficiency;having at least one child between the ages of 5 and 15;no current diagnosis of type 2 diabetes mellitus (T2DM);and having a family history of T2DM. The present study utilizes a subset of the DPS dataset and includes 109 ever pregnant women, including 58% with a history of GDM. Results: Mean scores for perceptions of risk showed that both worry and personal control are slightly greater than “neutral” with 3.5 out 5. Therefore, women worry about T2DM yet also perceive personal control for their risk. 40.2% of all respondents use ghee (clarified butter) to cook meals and 41.7% re-use cooking oil. 35% of respondents report no physical activity in an average week. Only 39.8% of women meet the recommended guidelines for adults in the US There are no significant differences between women with or without a history of GDM for nutrition practices and physical activity. Conclusions: This study adds to the literature on GDM and missed opportunities for the prevention of future T2DM.Future research ought to explore knowledge levels on T2DM during and after pregnancy, as well as what types of intervenetions would be effective and acceptable to South Asian women.展开更多
This cohort study was designed to evaluate the association of transcription factor 7-like 2 （TCF7L2） and proglucagon gene （GCG） variants with disordered glucose metabolism and the incidence of type 2 diabetes mell...This cohort study was designed to evaluate the association of transcription factor 7-like 2 （TCF7L2） and proglucagon gene （GCG） variants with disordered glucose metabolism and the incidence of type 2 diabetes mellitus （T2DM） in a rural adult Chinese population. A total of 7,751 non-T2DM participants 〉18 years old genotyped at baseline were recruited. The same questionnaire interview and physical and blood biochemical examinations were performed at both baseline and follow-up. During a median 6 years of follow-up, T2DM developed in 227 participants. After adjustment for potential contributory factors, nominally significant associations were seen between 3T genotype and the recessive model of TCFTI.2 rs7903146 and increased risk of T2DM [hazard ratio （HR）=4.068, 95% confidence interval （CI）： 1.270-13.026; HR=4.051, 95% CI： 1.268-12.946, respectively]. The TT genotype of rs7903146 was also significantly associated with higher fasting plasma insulin level and the homeostasis model assessment of insulin resistance in case of new-onset diabetes. In addition, the TCF7L2 rs290487 TT genotype was associated with abdominal obesity and the GCG rs12104705 CC genotype was associated with both general obesity and abdominal obesity in case of new-onset diabetes.展开更多
Objective: As the literature on conventional criteria for discriminating early-onset (EO) from late-onset (LO) Alzheimer’s disease (AD) is sparse and controversial, the aim of this study was to establish a precise ag...Objective: As the literature on conventional criteria for discriminating early-onset (EO) from late-onset (LO) Alzheimer’s disease (AD) is sparse and controversial, the aim of this study was to establish a precise age at onset (AAO) criterion, by using a specific statistical procedure, and to describe the clinical characteristics of the two sub-groups. Methods: Admixture analysis was performed to establish the AAO cut-off in a multi-center study including 2000 AD patients consecutively recruited in eight Italian Memory Clinics. None of the patients were taking acetylcholinesterase inhibitors, antipsychoticor anti-depressant drugs. At the first diagnosticvisit, they were administered the Mini Mental StateExamination, the Basic and Instrumental Activities of Daily Living and the Neuropsychiatric Inventorytoassess clinical phenomenology. Results: Using a specific statistical procedure, we established that AAO that discriminated EO-from LO-AD was 66. Compared with the LO-AD group, the EO-AD group showed longer duration of illness and a higher educational level as well as less severe functional impairment and delusions. Conclusions: Differences in sociodemographic and clinical characteristics, such as duration of illness, education and delusion severity, suggested the involvement of different pathogenic processes. Additional studies are needed to further investigate the mechanisms underlying the disorder in the two sub-groups of AD patients.展开更多
BACKGROUND Transhepatic arterial chemoembolization(TACE),as a local treatment,has been widely used in the treatment of unresectable liver cancer.The introduction of drug carrier microspheres has brought new hope for t...BACKGROUND Transhepatic arterial chemoembolization(TACE),as a local treatment,has been widely used in the treatment of unresectable liver cancer.The introduction of drug carrier microspheres has brought new hope for the therapeutic effect of TACE.Microspheres can realize the slow release and directional delivery of drugs,reduce systemic toxicity and improve local curative effect.AIM To compare the effectiveness of traditional transcatheter arterial chemoembolization against microsphere-assisted transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma that is incurable.METHODS We searched the PubMed,Embase,Cochrane Library,and CNKI databases for clinical trials of drug-luting beads TACE(DEB-TACE)vs conventional TACE(cTACE)for the treatment of unresectable liver cancer.We screened references based on inclusion and exclusion criteria and then selected valid data for meta-analysis using RevMan 53 software.The complete response(CR)rate,partial response(PR)rate,postoperative stable disease(SD)rate,and 6-month and 12-month survival rates were compared.RESULTS A total of 12 articles were included,including 1177 patients,519 of whom received DEB-TACE and 658 of whom received cTACE.The CR rate in the DEB-TACE group was much greater than that in the cTACE group[relative risk(RR)=1.42,95%CI:1.18-1.72,P=0.0002].The 12-month survival rate significantly increased(RR=1.09;95%CI:1.01-1.17,P=0.03);the PR rate(RR=1.13;95%CI:0.97-1.30,P=0.12);the SD rate(RR=0.82;95%CI:0.64-1.05,P=0.12);and the 6-month survival rate(RR=1.05;95%CI:1.00-1.10,P=0.07).There was no significant difference(P<0.05).CONCLUSION Compared with those of iodized oil TACE,the drug-loaded microspheres tended to have therapeutic advantages.展开更多
AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional co...AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional cohort design.We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units.Information in the case report forms included main demographic data,blood chemistry data,viral hepatitis markers,instrumental evaluations,and eligibility for treatment or ongoing therapy and liver transplantation.RESULTS Of 4015 chronic viral hepatitis patients,1096(27.3%)were HBV infected.The case report form was correctly completed for only 833 patients(64%males,36%females;mean age 50.1±15.4).Of these HBV-infected patients,73%were Caucasian,21%Asian,4%Central African,1%North African and 1%American.Stratifying patients by age and nationality,we found that 21.7%of HBV-infected patients were aged<34 years(only 2.8%were Italian).The most represented routes of transmission were nosocomial/dental procedures(23%),mother-to-child(17%)and sexual transmission(12%).The most represented HBV genotypes were D(72%)and A(14%).Of the patients,24.7%of patients were HBe Ag positive,and 75.3%were HBe Ag negative.Of the HBV patients 7%were anti-HDV positive.In the whole cohort,26.9%were cirrhotic(35.8%aged<45 years),and 47%were eligible for or currently undergoing treatment,of whom 41.9%were cirrhotic.CONCLUSION Only 27.3%of chronic viral hepatitis patients were HBV infected.Our results provide evidence of HBV infection in people aged<34 years,especially in the foreign population not protected by vaccination.In our cohort of patients,liver cirrhosis was also found in young adults.展开更多
Community based organizations play a vital role in the health of communities in the United States, particularly among immigrant and minority populations. Yet the gap between the needs of the community and the health i...Community based organizations play a vital role in the health of communities in the United States, particularly among immigrant and minority populations. Yet the gap between the needs of the community and the health issues that are being addressed remains quite large. This qualitative assessment provides a brief summary of community-based organizations in the US that focus on health issues specifically addressing the needs of South Asian Americans. In addition, this assessment explores the health needs of the South Asian American community living in the Washington DC metropolitan region, the fifth largest densely populated city in the US of South Asian Americans. While the report provides an array of organizations serving this population, the question of how effective can community-based organizations be if they can not prioritize their needs based on the community’s needs still remains.展开更多
Objective:Circulating tumor DNA(ctDNA)and alpha-fetoprotein(AFP)plus ultrasound(US)have been considered to have high diagnostic accuracy for cancer detection,however,the efficacy of ctDNA methylation combined with the...Objective:Circulating tumor DNA(ctDNA)and alpha-fetoprotein(AFP)plus ultrasound(US)have been considered to have high diagnostic accuracy for cancer detection,however,the efficacy of ctDNA methylation combined with the traditional detection modality of liver cancer has not been tested in a Chinese independent cohort.Methods:The high-risk individuals aged between 35 and 70 years who were diagnosed with liver cirrhosis or had moderate and severe fatty liver were eligible for inclusion.All participants were invited to receive a traditional examination[referring to AFP plus US],and ctDNA methylation,respectively.The sensitivity and specificity of different diagnostic tools were calculated.The logistic regression model was applied to estimate the area under the curve(AUC),which was further validated by 10-fold internal cross-validation.Results:A total of 1,205 individuals were recruited in our study,and 39 participants were diagnosed with liver cancer.The sensitivity of AFP,US,US plus AFP,and the combination of US,AFP,and ctDNA methylation was33.33%,56.41%,66.67%,and 87.18%,respectively.The corresponding specificity of AFP,US,US plus AFP,and the combination of all modalities was 98.20%,99.31%,97.68%,and 97.68%,respectively.The AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 65.77%,77.86%,82.18%,and92.43%,respectively.The internally validated AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 67.57%,83.26%,86.54%,and 93.35%,respectively.Conclusions:The ctDNA methylation is a good complementary to AFP and US for the detection of liver cancer.展开更多
Objectives: As smartphones become more popular, so do their applications. However, expectations of the elderly regarding the contribution of smartphone in controlling chronic diseases remain unclear. This research aim...Objectives: As smartphones become more popular, so do their applications. However, expectations of the elderly regarding the contribution of smartphone in controlling chronic diseases remain unclear. This research aims to understand senior retirees’ smartphone acceptance, perceived contribution of smartphone application in facilitating chronic disease control and their association. Findings from the study provide insights for the development of mobile applications in chronic disease management. Methods: convenience sampling was conducted to recruit 110 senior retirees who worked as volunteers in a regional hospital in Taipei. Data was collected through a structured questionnaire. Descriptive, chi-square and logistic regression statistics were applied to analyze data. Results: A total of 108 completed questionnaires were collected with a return rate of 98.2%. Mean age was 65.34 ± 9.59 years old. Of all respondents, 40.7% reported acceptance of internet-enabled smartphones and 54.6% expected that smartphones would facilitate chronic disease management in the future. However, a statistically significant 37.3% of those expecting smartphone to play a role in disease management did not accept smartphones yet. After controlling for age and education, logistic regression analysis showed that older adults with higher smartphone acceptance were more likely to expect use of smartphone in case management (OR = 7.439, p < 0.001). Conclusions: The research presented a scope for smartphone application to control chronic disease in the future. Despite a relatively lower level of smartphone acceptance, the elderly still expected a positive role for mobile appliances to play in chronic disease management.展开更多
文摘Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use.For targeting risk factors of drug initiation in Chinese adolescents,a school-based health intervention program named "Cognition-Motivation-Emotional IntelligenceResistance Skills" (CMER) was developed to enhance cognition upon drug use,to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study.A total of 798 students from 3 senior high schools in Wuhan,a city in central China,were assigned randomly to intervention and control groups.The intervention group received the CMER program in which knowledge,development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements.The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session.Students from both groups were asked to complete a self-administered questionnaire.The questionnaire included demographic items,self-reported drug use behavior,cognition,attitude,and motivation associated with the initiation of drug use and resistance skills.Three months after the intervention,significant effects were found on "illegal substance use at least once" (P【0.05) between the intervention and control groups.Immediate effects of the intervention were also found on knowledge,motivation and peer resistance skills (P【0.05),but there was no clear evidence for any effects on attitude towards substance use (P】0.05).It was concluded that the CMER program,which significantly increased the knowledge of drugs and peer resistance skills,was effective in the drug abuse prevention in a sample of school students in Wuhan,China.
基金Supported by the Natural Science Research Project of Higher Education Institutions in Jiangsu Province,No.23KJB360013China and Jiangsu Province Traditional Chinese Medicine Science and Technology Development Program,No.MS2023001Guiding Project of Changshu Science and Technology Development Plan,No.CSWS202411.
文摘BACKGROUND Intestinal mucositis is a severe and common complication of chemotherapy,characterized by disruption of the gut microbiota,intestinal inflammation,and epithelial barrier damage.Intestinal stem cells(ISCs)are essential for epithelial renewal and barrier maintenance,yet chemotherapy impairs ISC proliferation and function,delaying mucosal repair.We hypothesized that Wumei Pills(WMP)could protect against chemotherapy-induced intestinal mucositis by modulating gut microbiota-particularly Lactobacillus reuteri(L.reuteri)-to restore ISC activity,preserve microbial balance,reduce inflammation,and promote epithelial regeneration.AIM To characterize these changes and the safety of WMP via a 5-fluorouracil(5-FU)induced intestinal mucositis mouse model.METHODS In this study,we established a 5-FU induced intestinal mucositis mouse model,to explore the protective effect of WMP regulating L.reuteri on integrity of intestinal mucosa.RESULTS We found that intestinal flora is an important mechanism causing chemotherapyinduced intestinal mucositis,but WMP and live L.reuteri were effective in protecting the morphology of intestinal mucositis and normal proliferation of epithelial.L.reuteri colonized in the intestinal mucosa and WMP ameliorated intestinal mucosa damage caused by 5-FU treatment,including improvement of body weight,pathological change,and proliferation level,reducement proinflammatory cytokine secretion(tumor necrosis factor-α,interleukin-6)and the lipopolysaccharides concentration in serum.The repair process stimulated by both L.reuteri and WMP were also accompanied with increased leucine-richrepeat-containing G-protein-coupled receptor 5(+)and proliferating cell nuclear antigen of mice intestine.Furthermore,we demonstrated that WMP and L.reuteri activated the Wingless-type/β-catenin pathway to accelerate proliferation of intestinal epithelial,thus recovering damaged intestinal mucosa.However,the relieving effect of L.reuteri on intestinal mucosa was inferior to that of WMP.CONCLUSION Our findings indicate that WMP regulating L.reuteri protects intestinal barrier and activates intestinal epithelial proliferation,which sheds light on treatment approaches for intestinal inflammation based on ISCs with traditional Chinese medicine and probiotics L.reuteri.
基金Supported by a Grant from Guangzhou Health Bureau Project, No. 2004-Z001
文摘AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province,China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province,China. Questionnaires,designed by co-working of epidemiologists and hepatologists,included demographic characteristics,current medication use,medical history and health-relevant behaviors,i.e. alcohol consumption,smoking habits,dietary habits and physical activities. Anthropometric measurements,biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects,609 (17.2%) were diagnosed having FLD (18.0% males,16.7% females,P > 0.05). Among them,the prevalence of confirmed alcoholic liver disease (ALD),suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%,1.8%,and 15.0%,respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age,gender and residency,the standardized prevalence of FLD in adults was 14.5%. Among them,confirmed ALD,suspected ALD and NAFLD were 0.5%,2.3%,and 11.7%,respectively,in adults and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%,P < 0.001). However,the opposite phenomenon was found over the age of 50 years (20.6% vs 27.6%,P < 0.05). Multivariate and logistic regression analysis indicated that male gender,urban residency,low education,high blood pressure,body mass index,waist circumference,waist to hip ratio,serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD,especially NAFLD,is prevalent in South China. There are many risk factors for FLD.
文摘Given the analysis of underground pressure, a stress calculation model of coal floor stress has been established based on a theory of elasticity. The model presents the law of stress distribution on the relatively fixed position of the mining coal floor： the extent of stress variation in a fixed floor position decreases gradually along with depth, the decreasing rate of the vertical stress is clearly larger than that of the horizontal stress at a specific depth. The direction of the maximum principal stress changes gradually from a vertical direction to a horizontal direction with the advance of the working face. The deformation and permeability of the rock mass of the coal floor are obtained by contrasting the difference of the principal stress established from theoretical calculations with curves of stress-strain and permeability-strain from tests, which is an important mechanical basis for preventing water inrush from confined aauifers.
基金supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2017-I2M-1-004 & 2019-I2M-2-003)the National Key Research and Development Program of China(2017 YFC0211703 & 2018YFE0115300 & 2018YFC1311703 & 2017YFC0908401)the National Natural Science Foundation of China(91643208)
文摘Background In China,lack of evidence remains a significant challenge for the national initiative to promote physical activity(PA).We aimed to quantify the beneficial effects of meeting or maintaining the recommended PA level[150 minutes per week(min/wk)of moderate PA or 75 min/wk of vigorous PA or an equivalent combination]on incident cardiovascular disease(CVD)among Chinese population.Methods We included 100,560 participants without history of CVD from three cohorts in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR)project.Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)for CVD events and its subtypes,including stroke,coronary heart disease,heart failure,and CVD death.Results During a median follow-up of 7.3 years(range:6–15 years),777,163 person-years and 4693 incident CVD events were observed.Compared with participants who were inactive at baseline,the multivariable adjusted HR(95%CI)of developing CVD was 0.74(0.69–0.79)for those who met recommended moderate to vigorous physical activity(MVPA)level at baseline.Furthermore,the risk of CVD incidence was reduced with increment of MVPA(Ptrend<0.001),and the HR(95%CI)of highly-active versus inactive category was 0.62(0.56–0.68).Compared with individuals who were inactive both at the baseline and follow-up,those keeping active over the period of follow-up had a substantial lower risk of incident CVD with the HR(95%CI)of 0.57(0.43–0.77).Conclusions The findings demonstrated that meeting and maintaining the recommended MVPA level could reduce the cardiovascular risk.Wider adoption of the PA recommendations would have considerable health impacts to the Chinese population.
基金Supported by Italian Ministry of Health,and Fondazione Benefica Alberto e Kathleen Casali
文摘AIM: To evaluate variation of the concentration of thiopurine metabolites after 5-aminosalicylate(5-ASA) interruption and the role of genetic polymorphisms of N-acetyl transferase(NAT) 1 and 2. METHODS: Concentrations of thioguanine nucleotides(TGN) and methymercaptopurine nucleotides(MMPN), metabolites of thiopurines, were measured by high performance liquid chromatography in 12 young patients(3 females and 9 males, median age 16 years) with inflammatory bowel disease(6 Crohn's disease and 6 ulcerative colitis) treated with thiopurines(7 mercaptopurine and 5 azathioprine) and 5-ASA. Blood samples were collected one month before and one month after the interruption of 5-ASA. DNA was extracted and genotyping of NAT1, NAT2, inosine triphosphate pyrophosphatase(ITPA) and thiopurine methyl transferase(TPMT) genes was performed using PCR assays. RESULTS: Median TGN concentration before 5-ASA interruption was 270 pmol/8 x 108 erythrocytes(range: 145-750); after the interruption of the aminosalicylate, a 35% reduction in TGN mean concentrations(absolutemean reduction 109 pmol/8 × 108 erythrocytes) was observed(median 221 pmol/8 × 108 erythrocytes, range: 96-427, P value linear mixed effects model 0.0011). Demographic and clinical covariates were not related to thiopurine metabolites concentrations. All patients were wild-type for the most relevant ITPA and TPMT variants. For NAT1 genotyping, 7 subjects presented an allele combination corresponding to fast enzymatic activity and 5 to slow activity. NAT1 genotypes corresponding to fast enzymatic activity were associated with reduced TGN concentration(P value linear mixed effects model 0.033), putatively because of increased 5-ASA inactivation and consequent reduced inhibition of thiopurine metabolism. The effect of NAT1 status on TGN seems to be persistent even after one month since the interruption of the aminosalicylate. No effect of NAT1 genotypes was shown on MMPN concentrations. NAT2 genotyping revealed that 6 patients presented a genotype corresponding to fast enzymatic activity and 6 to slow activity; NAT2 genotypes were not related to thiopurine metabolites concentration in this study. CONCLUSION: NAT1 genotype affects TGN levels in patients treated with thiopurines and aminosalicylates and could therefore influence the toxicity and efficacy of these drugs; however the number of patients evaluated is limited and this has to be considered a pilot study.
文摘Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kazaks of Xinjiang Uyghur Autonomous Region,China.Methods These loci were analyzed by PCR-restriction fragment length polymorphism （PCR-PFLP）.Two hundred and five patients with CHD and two hundred and thirty six controls were involved.Results There were significant distinctions among low-density lipoprotein cholesterol （LDL-C）,triglyceride （TG） and the ApoAI/ApoB ratio between the two groups,but no significant distinction among the polymorphism frequencies of the four sites between the two groups.The polymorphism coalition frequency of X-/Ms＋＋/M1＋-/M2＋＋ （named Coalition 11） was significantly higher in CHD compared to the control group （14.6％ vs.7.2％,P ＜ 0.05）.The level of total cholesterol （TC） in Coalition 1 1 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1～10 in CHD patients.The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1～10 in control group.The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups,respectively.The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group.The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group.The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1～10 of the two groups,respectively.The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group.The ratio of ApoAI/ApoB was negatively related to TC,LDL-C and was positively related to HDL-C,both in CHD and control groups.Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks,and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters.CHD may also be associated with Coalition 5,and,perhaps,Coalition 3 may have been confirmed as a protection factor against CHD,if more samples were enrolled.
文摘An enhanced cascade of care should include a younger population,helping to achieve the goal of the World Health Organization with a focus on elimination in the pediatric population.Furthermore,enhanced screening and awareness efforts and continued education of health care providers will improve the outcomes of chronic hepatitis C virus(HCV)infection in the pediatric population.The present work discusses and comments on the topic"cascade of care in HCV chronic pediatric patients".
基金Supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2017-I2M-1-004,2019-I2M-2-003)National Key Research&Development Program of China(2017YFC0211700)National Natural Science Foundation of China(91843302).The authors declared no conflicts of interest.
文摘Background The relationships between dietary intake of soybean products and incident hypertension were still uncertain.This study aimed to illustrate the associations between intake of soybean products with risks of incident hypertension and longitudinal changes of blood pressure in a prospective cohort study.Methods We included 67,499 general Chinese adults from the Project of Prediction for Atherosclerosis Cardiovascular Disease Risk in China(China-PAR).Information about soybean products consumption was collected by standardized questionnaires,and study participants were categorized into the ideal(≥125 g/day)or non-ideal(<125 g/day)group.Hazard ratios(HRs)and corresponding 95%confidence intervals(95%CIs)for incident hypertension were calculated using Cox proportional hazard models.Among participants with repeated measures of blood pressure,generalized linear models were used to examine the relationships between soybean products consumption and blood pressure changes.Results During a median follow-up of 7.4 years,compared with participants who consumed<125 g of soybean products per day,multivariable adjusted HR for those in the ideal group was 0.73(0.67-0.80).This inverse association remained robust across most subgroups while significant interactions were tested between soybean products intake and age,sex,urbanization and geographic region(P values for interaction<0.05).The mean systolic and diastolic blood pressure levels were 1.05(0.71-1.39)mmHg and 0.44(0.22-0.66)mmHg lower among participants in the ideal group than those in the non-ideal group.Conclusions Our study showed that intake of soybean products might reduce the long-term blood pressure levels and hypertension incidence among Chinese population,which has important public health implications for primary prevention of hypertension.
基金Dalian Science and Technology Plan Project,No 2022080102.
文摘BACKGROUND The Cariostat caries activity test(CAT)was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral health status of pregnant women.AIM To investigate whether personalized oral hygiene management enhances the oral health status of pregnant women.METHODS A total of 114 pregnant women who were examined at Dalian Women’s and Children’s Medical Center were divided into four groups:High-risk experimental group(n=29;CAT score≥2;received personalized oral hygiene management training),low-risk experimental group(n=29;CAT score≤1;received oral health education),high-risk control group(n=28;CAT score≥2),and low-risk control group(n=28;CAT score≤1).No hygiene intervention was provided to control groups.CAT scores at different times were compared using independent samples t-test and least significant difference t-test.RESULTS No significant difference in baseline CAT scores was observed between the experimental and control groups,either in the high-risk or low-risk groups.CAT scores were reduced significantly after 3(1.74±0.47 vs 2.50±0.38,P<0.0001)and 6 months(0.53±0.50 vs 2.45±0.42,P<0.0001)of personalized oral hygiene management intervention but not after oral health education alone(0.43±0.39 vs 0.46±0.33,P>0.05 and 0.45±0.36 vs 0.57±0.32,P>0.05,respectively).Within groups,the decrease in CAT scores was significant(2.43±0.44 vs 1.74±0.47 vs 0.53±0.50,P<0.0001)for only the high-risk experimental group.CONCLUSION Personalized oral hygiene management is effective in improving the oral health of pregnant women and can improve pregnancy outcomes and the oral health of the general population.
基金supported by a Chongqing Social Science Plan Project(2015YBSH142)
文摘Dementia is increasing dramatically and imposes a huge burden on society. To date, there is a lack of data on the health status of patients with dementia in China. In an attempt to investigate the comorbidity burden of dementia patients in China at the national level, we enrolled 2,938 patients with Alzheimer＇s disease（AD）, vascular dementia（Va D）, or other types of dementia, who were admitted to tertiary hospitals in seven regions of China from January2003 to December 2012. The Charlson Comorbidity Index（CCI） was used to evaluate the comorbidity burden of the patients with dementia. Among these patients, 53.4% had AD, 26.3% had Va D, and 20.3% had other types of dementia. The CCI was 3.0 ± 1.9 for all patients,3.4 ± 1.8 for those with Va D, and 3.0 ± 2.1 for those with AD. The CCI increased with age in all patients, andthe length of hospital stay and daily expenses rose with age and CCI. Males had a higher CCI and a longer stay than females. Moreover, patients admitted in the last 5 years of the study had a higher CCI than those admitted in the first 5 years. We found that the comorbidity burden of patients with dementia is heavy. These findings provide a better understanding of the overall health status of dementia patients, and help to increase the awareness of clinicians and policy-makers to improve medical care for patients.
文摘The aim of this study was to describe the intensive care unit (ICU) nurses’ knowledge, attitude, and practice of mouth care for their patients. This is a cross sectional hospital based study. A total of 154 ICU nurses were randomly selected from seven governmental hospitals in Khartoum state and were invited to take part in this study. 97.4% of ICU nurses had high knowledge of the importance of mouth care for ICU patients and similarly for the priority of mouth care. However, only 20% of nurses were found to apply good practice. 64.5% of the nurses received training in mouth care provision, and (81%) indicated that further training would be beneficial. The oral care practice of ICU nurses ranged between average among 57% and poor among 23%. The study highlighted the need for setting of ICU protocols and adoption of advanced training for ICU nurses.
文摘Objective: This study examines risk perceptions, nutrition practices, and physical activity among ever pregnant South Asian American women, and explores differences by history of GDM, a significant risk factor for the development of type 2 diabetes. Methods: The Diabetes Prevention Study (DPS) recruited a convenience sample of South Asian adults living in the metropolitan Washington DC region. Specific eligibility criteria included English proficiency;having at least one child between the ages of 5 and 15;no current diagnosis of type 2 diabetes mellitus (T2DM);and having a family history of T2DM. The present study utilizes a subset of the DPS dataset and includes 109 ever pregnant women, including 58% with a history of GDM. Results: Mean scores for perceptions of risk showed that both worry and personal control are slightly greater than “neutral” with 3.5 out 5. Therefore, women worry about T2DM yet also perceive personal control for their risk. 40.2% of all respondents use ghee (clarified butter) to cook meals and 41.7% re-use cooking oil. 35% of respondents report no physical activity in an average week. Only 39.8% of women meet the recommended guidelines for adults in the US There are no significant differences between women with or without a history of GDM for nutrition practices and physical activity. Conclusions: This study adds to the literature on GDM and missed opportunities for the prevention of future T2DM.Future research ought to explore knowledge levels on T2DM during and after pregnancy, as well as what types of intervenetions would be effective and acceptable to South Asian women.
基金supported by the National Natural Science Foundation of China(Nos.81373074 and 81402752)Science and Technology Development Foundation of Shenzhen(No.JCYJ20140418091413562)+1 种基金Natural Science Foundation of Shenzhen University(No.201404)High-level Personnel Special Support Project of Zhengzhou University(No.ZDGD13001)
文摘This cohort study was designed to evaluate the association of transcription factor 7-like 2 （TCF7L2） and proglucagon gene （GCG） variants with disordered glucose metabolism and the incidence of type 2 diabetes mellitus （T2DM） in a rural adult Chinese population. A total of 7,751 non-T2DM participants 〉18 years old genotyped at baseline were recruited. The same questionnaire interview and physical and blood biochemical examinations were performed at both baseline and follow-up. During a median 6 years of follow-up, T2DM developed in 227 participants. After adjustment for potential contributory factors, nominally significant associations were seen between 3T genotype and the recessive model of TCFTI.2 rs7903146 and increased risk of T2DM [hazard ratio （HR）=4.068, 95% confidence interval （CI）： 1.270-13.026; HR=4.051, 95% CI： 1.268-12.946, respectively]. The TT genotype of rs7903146 was also significantly associated with higher fasting plasma insulin level and the homeostasis model assessment of insulin resistance in case of new-onset diabetes. In addition, the TCF7L2 rs290487 TT genotype was associated with abdominal obesity and the GCG rs12104705 CC genotype was associated with both general obesity and abdominal obesity in case of new-onset diabetes.
文摘Objective: As the literature on conventional criteria for discriminating early-onset (EO) from late-onset (LO) Alzheimer’s disease (AD) is sparse and controversial, the aim of this study was to establish a precise age at onset (AAO) criterion, by using a specific statistical procedure, and to describe the clinical characteristics of the two sub-groups. Methods: Admixture analysis was performed to establish the AAO cut-off in a multi-center study including 2000 AD patients consecutively recruited in eight Italian Memory Clinics. None of the patients were taking acetylcholinesterase inhibitors, antipsychoticor anti-depressant drugs. At the first diagnosticvisit, they were administered the Mini Mental StateExamination, the Basic and Instrumental Activities of Daily Living and the Neuropsychiatric Inventorytoassess clinical phenomenology. Results: Using a specific statistical procedure, we established that AAO that discriminated EO-from LO-AD was 66. Compared with the LO-AD group, the EO-AD group showed longer duration of illness and a higher educational level as well as less severe functional impairment and delusions. Conclusions: Differences in sociodemographic and clinical characteristics, such as duration of illness, education and delusion severity, suggested the involvement of different pathogenic processes. Additional studies are needed to further investigate the mechanisms underlying the disorder in the two sub-groups of AD patients.
基金Supported by Scientific Research project of Hunan Provincial Health Commission,No.B202303077689Hunan Natural Science Foundation Project,No.2023JJ40397.
文摘BACKGROUND Transhepatic arterial chemoembolization(TACE),as a local treatment,has been widely used in the treatment of unresectable liver cancer.The introduction of drug carrier microspheres has brought new hope for the therapeutic effect of TACE.Microspheres can realize the slow release and directional delivery of drugs,reduce systemic toxicity and improve local curative effect.AIM To compare the effectiveness of traditional transcatheter arterial chemoembolization against microsphere-assisted transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma that is incurable.METHODS We searched the PubMed,Embase,Cochrane Library,and CNKI databases for clinical trials of drug-luting beads TACE(DEB-TACE)vs conventional TACE(cTACE)for the treatment of unresectable liver cancer.We screened references based on inclusion and exclusion criteria and then selected valid data for meta-analysis using RevMan 53 software.The complete response(CR)rate,partial response(PR)rate,postoperative stable disease(SD)rate,and 6-month and 12-month survival rates were compared.RESULTS A total of 12 articles were included,including 1177 patients,519 of whom received DEB-TACE and 658 of whom received cTACE.The CR rate in the DEB-TACE group was much greater than that in the cTACE group[relative risk(RR)=1.42,95%CI:1.18-1.72,P=0.0002].The 12-month survival rate significantly increased(RR=1.09;95%CI:1.01-1.17,P=0.03);the PR rate(RR=1.13;95%CI:0.97-1.30,P=0.12);the SD rate(RR=0.82;95%CI:0.64-1.05,P=0.12);and the 6-month survival rate(RR=1.05;95%CI:1.00-1.10,P=0.07).There was no significant difference(P<0.05).CONCLUSION Compared with those of iodized oil TACE,the drug-loaded microspheres tended to have therapeutic advantages.
文摘AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional cohort design.We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units.Information in the case report forms included main demographic data,blood chemistry data,viral hepatitis markers,instrumental evaluations,and eligibility for treatment or ongoing therapy and liver transplantation.RESULTS Of 4015 chronic viral hepatitis patients,1096(27.3%)were HBV infected.The case report form was correctly completed for only 833 patients(64%males,36%females;mean age 50.1±15.4).Of these HBV-infected patients,73%were Caucasian,21%Asian,4%Central African,1%North African and 1%American.Stratifying patients by age and nationality,we found that 21.7%of HBV-infected patients were aged<34 years(only 2.8%were Italian).The most represented routes of transmission were nosocomial/dental procedures(23%),mother-to-child(17%)and sexual transmission(12%).The most represented HBV genotypes were D(72%)and A(14%).Of the patients,24.7%of patients were HBe Ag positive,and 75.3%were HBe Ag negative.Of the HBV patients 7%were anti-HDV positive.In the whole cohort,26.9%were cirrhotic(35.8%aged<45 years),and 47%were eligible for or currently undergoing treatment,of whom 41.9%were cirrhotic.CONCLUSION Only 27.3%of chronic viral hepatitis patients were HBV infected.Our results provide evidence of HBV infection in people aged<34 years,especially in the foreign population not protected by vaccination.In our cohort of patients,liver cirrhosis was also found in young adults.
文摘Community based organizations play a vital role in the health of communities in the United States, particularly among immigrant and minority populations. Yet the gap between the needs of the community and the health issues that are being addressed remains quite large. This qualitative assessment provides a brief summary of community-based organizations in the US that focus on health issues specifically addressing the needs of South Asian Americans. In addition, this assessment explores the health needs of the South Asian American community living in the Washington DC metropolitan region, the fifth largest densely populated city in the US of South Asian Americans. While the report provides an array of organizations serving this population, the question of how effective can community-based organizations be if they can not prioritize their needs based on the community’s needs still remains.
基金the National Natural Science Foundation of China(No.81974492)。
文摘Objective:Circulating tumor DNA(ctDNA)and alpha-fetoprotein(AFP)plus ultrasound(US)have been considered to have high diagnostic accuracy for cancer detection,however,the efficacy of ctDNA methylation combined with the traditional detection modality of liver cancer has not been tested in a Chinese independent cohort.Methods:The high-risk individuals aged between 35 and 70 years who were diagnosed with liver cirrhosis or had moderate and severe fatty liver were eligible for inclusion.All participants were invited to receive a traditional examination[referring to AFP plus US],and ctDNA methylation,respectively.The sensitivity and specificity of different diagnostic tools were calculated.The logistic regression model was applied to estimate the area under the curve(AUC),which was further validated by 10-fold internal cross-validation.Results:A total of 1,205 individuals were recruited in our study,and 39 participants were diagnosed with liver cancer.The sensitivity of AFP,US,US plus AFP,and the combination of US,AFP,and ctDNA methylation was33.33%,56.41%,66.67%,and 87.18%,respectively.The corresponding specificity of AFP,US,US plus AFP,and the combination of all modalities was 98.20%,99.31%,97.68%,and 97.68%,respectively.The AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 65.77%,77.86%,82.18%,and92.43%,respectively.The internally validated AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 67.57%,83.26%,86.54%,and 93.35%,respectively.Conclusions:The ctDNA methylation is a good complementary to AFP and US for the detection of liver cancer.
文摘Objectives: As smartphones become more popular, so do their applications. However, expectations of the elderly regarding the contribution of smartphone in controlling chronic diseases remain unclear. This research aims to understand senior retirees’ smartphone acceptance, perceived contribution of smartphone application in facilitating chronic disease control and their association. Findings from the study provide insights for the development of mobile applications in chronic disease management. Methods: convenience sampling was conducted to recruit 110 senior retirees who worked as volunteers in a regional hospital in Taipei. Data was collected through a structured questionnaire. Descriptive, chi-square and logistic regression statistics were applied to analyze data. Results: A total of 108 completed questionnaires were collected with a return rate of 98.2%. Mean age was 65.34 ± 9.59 years old. Of all respondents, 40.7% reported acceptance of internet-enabled smartphones and 54.6% expected that smartphones would facilitate chronic disease management in the future. However, a statistically significant 37.3% of those expecting smartphone to play a role in disease management did not accept smartphones yet. After controlling for age and education, logistic regression analysis showed that older adults with higher smartphone acceptance were more likely to expect use of smartphone in case management (OR = 7.439, p < 0.001). Conclusions: The research presented a scope for smartphone application to control chronic disease in the future. Despite a relatively lower level of smartphone acceptance, the elderly still expected a positive role for mobile appliances to play in chronic disease management.
