A allele of SNP12 in <Emphasis Type="Italic">estrogen receptor 1</Emphasis> was a risk factor for cryptorchidism in Asians: a systematic review with meta-analysis and trial sequential analysis

Objective

Some studies have been carried out to evaluate the association between SNP12 in estrogen receptor 1 and cryptorchidism, but the results remain inconsistent. We carried out a meta-analysis to explore the association between this polymorphism and cryptorchidism risk.

Methods

All eligible studies were searched in PubMed, Web of Science, Embase and Cochrane Library. Pooled odds ratios, with 95 % confidence intervals, were assessed for the association using fixed- and random-effects models.

Results

Overall, four case–control studies (363 cases, 415 controls) were included in the meta-analysis. No significant publication bias (P _Begg = 0.308, P _Egger = 0.288) was found. A allele of SNP12 in estrogen receptor 1 was protective factor to cryptorchidism in allele model, dominant genetic model and heterozygote comparison in Caucasians, but the result was turned out to be false positive by trial sequential analysis. However, A in allele model was risk factor to cryptorchidism in Asians (odds ratio 2.02, 95 % confidence interval 1.03–3.01, p = 0.946 for heterogeneity) and the result was turned out to be true positive by trial sequential analysis, even though there were merely two original studies.

Conclusions

The results of this meta-analysis suggest that A allele of SNP12 in estrogen receptor 1 may increase the risk of cryptorchidism in Asians. Meanwhile, further well-designed studies with large sample sizes are required to confirm the present findings, especially in Caucasians.

     

Risk of Treatment Failure in Patients with Drug-susceptible Pulmonary Tuberculosis in China

正The objective of this prospective study of the risks of treatment failure in patients with drug-susceptible pulmonary tuberculosis(PTB)was to provide reference data to help develop a disease control strategy.Participants were recruited in eight provinces of China from October 2008 to December2010.A total of 1447 patients with drug-susceptible     

2006-2015年重庆市流行性乙型脑炎流行特征分析

目的 分析2006-2015年重庆市流行性乙型脑炎的流行特征,为控制乙脑流行提供有针对性和科学性的防治措施。 方法 采用描述性流行病学方法,利用SAS软件进行统计分析。 结果 2006-2015年重庆市共报告乙脑病例1 611例,发病率由2006年的0.72/10万降低到2015年的0.12/10万,发病率年均降低17.67%,年均发病率为0.49/10万;死亡31例,年均死亡率为0.009/10万,年均病死率为1.62%。男性发病率(0.57/10万)显著高于女性(0.40/10万)(P<0.05)。39个区县均有病例报告,发病呈散发,主要分布在大足区(129例,8.00%)、丰都县(123例,7.64%)、开县(114例,7.08%)、垫江县(97例,6.02%)。发病呈明显季节性,发病病例和死亡病例主要集中在7-8月(1 530例,94.97%);发病年龄以1~7岁为主,占73.43%,死亡以1~3岁为主,死亡中位年龄为2岁;职业分布以散居儿童为主,占55.62%。临床诊断病例698例(43.33%),实验室确诊病例913例(56.67%);病例以发热(89.63%),嗜睡(72.32%)等症状为主。病例中有疫苗接种史占18.37%,无疫苗接种史占26.88%,免疫史不详的占54.75%。 结论 重庆市乙脑发病逐年降低,今后应加强流行季节病例监测,在持续常规免疫的基础上,免疫重点应针对发病率相对较高地区的1~5岁散居儿童,同时提高个案调查质量和实验室诊断比例。     

2011-2016年重庆市江北区居民伤害死亡分析

目的 了解重庆市江北区2011-2016年伤害死亡变化特点,为针对性的开展伤害干预和控制提供依据。 方法 采用描述性统计方法对重庆市江北区2011-2016年居民伤害死亡资料进行流行病学分析。 结果 2011-2016年重庆市江北区居民伤害粗死亡率27.74/10万,标化死亡率为20.45/10万,伤害死亡人数占总死因的5.35%,其中男性标化死亡率26.13/10万,女性标化死亡率14.75/10万。江北区居民伤害死因排首位的为意外跌落,死亡率为8.39/10万,其中男性死亡率为10.52/10万,女性为6.18/10万。男性和女性伤害死亡排名前五位的原因相同,为意外跌落、机动车以外的运输事故、其他意外事故和有害效应、自杀、机动车辆交通事故。0~<5岁幼儿伤害首位死因为机动车辆交通事故,5~<15岁儿童伤害首位死因为其他意外事故和有害效应,15~<45岁青年伤害首位死因为机动车以外的运输事故,45~岁中老年人群伤害首位死因为意外跌落。 结论 伤害是2011-2016年重庆市江北区居民死亡的重要原因之一,应多部门协作,针对不同人群制定相应的干预措施,尤其应重点预防和控制居民意外跌落和机动车相关的事故,重点加强对老年人等重点人群的保护。     

Randomised controlled trial: effect of metformin add-on therapy on functional cure in entecavir-treated patients with chronic hepatitis B

Introduction and ObjectivesHepatitis B surface antigen (HBsAg) clearance, indicating functional cure or resolved chronic hepatitis B (CHB), remains difficult to achieve via nucleos(t)ide analogue monotherapy. We investigated whether metformin add-on therapy could help achieve this goal in entecavir-treated patients with hepatitis B e antigen (HBeAg)-negative CHB.Patients and MethodsPatients with HBeAg-negative CHB who met eligibility criteria (entecavir treatment for > 12 months, HBsAg < 1000 IU/mL) were randomly assigned (1:1) to receive 24 weeks of either metformin (1000 mg, oral, once a day) or placebo (oral, once a day) add-on therapy. The group allocation was blinded for both patients and investigators. Efficacy and safety analyses were based on the intention-to-treat set. The primary outcome, serum HBsAg level (IU/mL) at weeks 24 and 36, was analysed using mixed models.ResultsSixty eligible patients were randomly assigned to the metformin (n = 29) and placebo (n = 31) groups. There was no substantial between-group difference in the HBsAg level at week 24 (adjusted mean difference 0.05, 95% confidence interval -0.04 to 0.13, p = 0.278) or week 36 (0.06, -0.03 to 0.15, p = 0.187), and no significant effect of group-by-time interaction on the HBsAg level throughout the trial (p = 0.814). The occurrence of total adverse events between the two groups was comparable (9 [31.0%] of 29 vs. 5 [16.1%] of 31, p = 0.227) and no patient experienced serious adverse events during the study.ConclusionAlthough it was safe, metformin add-on therapy did not accelerate HBsAg clearance in entecavir-treated patients with HBeAg-negative CHB.     

Beyond direct impact: Evidence synthesis towards a better understanding of effectiveness of environmental health interventions

Systematic reviews are a cornerstone of evidence-based public health, and there is much discussion on how this method may need to be modified to do justice to complex interventions, such as environmental health interventions. This paper asserts that intervention effectiveness is influenced by variability in five distinct layers – direct (intrinsic) impact, user compliance, delivery, programming and policy measures – which are embedded in the broader geographical, socio-economic, political and cultural context. The multi-component, multi-sectoral nature of most environmental health interventions results in a complex relationship between these layers of influence, involving systemic interactions. As illustrated with examples, understanding environmental health interventions critically relies on considering all of these layers. These distinct layers of influence can serve as a framework towards the comprehensive analysis of environmental health interventions in systematic reviews, drawing on quantitative and qualitative methods and a variety of disciplines.     

A systematic review of air pollution as a risk factor for cardiovascular disease in South Asia: Limited evidence from India and Pakistan

Cardiovascular diseases (CVD) are major contributors to mortality and morbidity in South Asia. Chronic exposure to air pollution is an important risk factor for cardiovascular diseases, although the majority of studies to date have been conducted in developed countries. Both indoor and outdoor air pollution are growing problems in developing countries in South Asia yet the impact on rising rates of CVD in these regions has largely been ignored. We aimed to assess the evidence available regarding air pollution effects on CVD and CVD risk factors in lower income countries in South Asia. A literature search was conducted in PubMed and Web of Science. Our inclusion criteria included peer-reviewed, original, empirical articles published in English between the years 1990 and 2012, conducted in the World Bank South Asia region (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka). This resulted in 30 articles. Nine articles met our inclusion criteria and were assessed for this systematic review. Most of the studies were cross-sectional and examined measured particulate matter effects on CVD outcomes and indicators. We observed a bias as nearly all of the studies were from India. Hypertension and CVD deaths were positively associated with higher particulate matter levels. Biomarkers of oxidative stress such as increased levels of P-selection expressing platelets, depleted superoxide dismutase and reactive oxygen species generation as well as elevated levels of inflammatory-related C-reactive protein, interleukin-6 and interleukin-8 were also positively associated with biomass use or elevated particulate matter levels. An important outcome of this investigation was the evidence suggesting important air pollution effects regarding CVD risk in South Asia. However, too few studies have been conducted. There is as an urgent need for longer term investigations using robust measures of air pollution with different population groups that include a wider range of air pollutants and outcomes, including early indicators of CVD. These regions are facing burdens from increasing urbanization, air pollution and populations, generally weaker health infrastructure, aging populations and increased incidence of non-communicable diseases, included CVD. The extent to which the problem of air pollution and CVD will impact these countries will depend largely on the information available to inform policy and programs, which are still lacking, political will as well as social and economic development.     

重庆市不同地区人群脊髓灰质炎中和抗体水平调查

目的了解重庆市人群脊髓灰质炎（脊灰）中和抗体水平,发现脊灰免疫薄弱环节。方法根据重庆地域分布特征,随机缺陷取3个区县,每个区县7个年龄组,分别为〈1岁,1～2岁,3～4岁,5～6岁,7～14岁,15～19岁,≥20岁,每个年龄组随机抽取30名对象开展血清学检测和问卷调查。结果共调查629名对象：①Ⅰ、Ⅱ、Ⅲ型脊灰抗体几何平均值（GMT）分别为1∶77.86、1∶76.5、1∶26.41,Ⅰ、Ⅱ、Ⅲ型脊灰抗体阳性率分别为85.85%、90.78%、73.29%。②各型抗体GMT均随年龄增长呈明显下降的趋势。③男性Ⅰ、Ⅱ型脊灰抗体水平较女性高。④有疫苗免疫史人群各型抗体GMT和阳性率比无免疫史和不详的人群高。⑤Ⅰ型和Ⅲ型脊灰抗体阳性率在地域分布上差异有统计学意义（P〈0.05）。结论调查地区人群脊灰中和抗体阳性率70.00%以上、GMT总体保持在较高水平,但是各型抗体GMT均随年龄增长呈明显下降的趋势;在经济地理环境较差的地区,应加强脊灰疫苗接种的质量评价;针对大年龄儿童及成人适时开展补充免疫等措施保持人群较高的免疫水平。     

重庆市农村居民慢性病相关生活方式研究

目的了解农村居民吸烟、饮酒、膳食、身体活动等慢性病相关生活行为方式,为开展农村地区慢性病防控提供建议。方法采用整群随机抽样的方法在万州区、大足区、綦江区与奉节县抽取农村居民进行面对面的问卷调查,数据经Epidata3．02双录入后采用SPSS12．0进行统计分析,采用卡方检验比较不同性别人群吸烟、饮酒、身体活动情况。结果共计调查1528人,农村居民现在吸烟率为22．51％,42．28％的农村居民有被动吸烟史。过去12个月内饮酒率为22．84％,居民膳食以米面为主,蔬菜水果摄入达到《中国居民膳食指南》推荐标准,奶制品（21．47％）食用比例较低。44．31％的居民有高强度的劳动,68．52％的居民有中等强度的劳动,休闲时分别有2.55％与6．68％的居民有高强度与中等强度的体育活动,每天静态生活的时间为3h。结论农村居民吸烟率与饮酒率较高,存在膳食不合理与身体活动不足的情况,应针对农村地区慢性病相关危险因素开展干预。     

某新建火电厂锅炉化学清洗有害因素职业暴露评价及防护

目的针对作业人员可能接触的化学毒物进行职业暴露分析,将健康风险进行分级和定量评价,提出可采取的职业卫生控制措施,降低人员接触风险,保护劳动者健康。方法以职业卫生相关法规及风险矩阵半定量分析评估模型为基础进行计算和综合分析。结果该新建火电厂投入使用前锅炉清洗涉及到的化学药品人员接触风险水平较高,氨、联氨、硫酸、氢氧化钠的风险级别均为4级,应予以关注和防护。结论在实施有效的工程控制,提供必要的个人防护用品,制定应急救援预案,配备现场应急救援设施和用品,制定和实施安全、正确的工作程序后,可有效降低风险水平。