A case-control study of risk factors for intussusception among infants in eastern France after the introduction of the rotavirus vaccine

ObjectiveThe objective of the present study was to investigate the risk factors for intussusception (IS) among infants, including vaccination against rotavirus.MethodsCase-control study with systematic inclusion of all infants aged <1 year with suspected IS admitted to emergency departments in the eastern region of France between 1 April 2008 and 31 March 2012. All cases classed level 1 according to the Brighton classification were matched to 4 hospital controls. Two exposure windows were examined; exposure to the first dose of rotavirus vaccine in the 7 and in the 14 days prior to the occurrence of IS.ResultsA total of 115 cases were matched with 457 controls. The average vaccination coverage rate over the 4 years of study was 8.6%. Rotavirus vaccine was not found to be significantly associated with the occurrence of IS in the 7 days (odds ratio (OR) not calculated; p = 0.99) and in the 14 days after administration of one dose vaccine (OR 1.33, 95% confidence interval (CI) 0.14–12.82). Infant formula alone or combined with breastfeeding was associated with an excess risk of IS (OR 2.74, 95% CI 1.10–6.79). A history of gastroenteritis within 2 weeks prior to hospitalisation was also associated with an increased risk (OR 2.24, 95% CI 1.07–4.67).ConclusionOur study indicates that infant formula alone or combined with breastfeeding is a risk factor for IS. A small, non-significant increase in the risk of IS was observed after rotavirus vaccination, although the low vaccine coverage rate likely precluded detection of a significant increase in risk.     

The influence of environmental and health indicators on premature mortality: An empirical analysis of the City of Toronto's 140 neighborhoods

The objective of this paper was to assess the link between premature mortality and a combination of neighbourhood contextual (environmental and health) and compositional (socioeconomic and demographic) characteristics. We statistically and spatially examined six environmental variables (ultrafine particles, carcinogenic and non-carcinogenic pollutants, pollution released to air, tree cover, and walkability index), six health service indicators (number health providers, breast, colorectal and cervical cancer screening uptake rates, student nutrition program uptake rates, and healthy food index), and eight socioeconomic indicators (total income, Gini coefficient, two age categories – below and above 40 years, proportion of females to males, visible minorities, Indigenous peoples, education, less than grade 9) among 140 neighbourhoods of the City of Toronto in Ontario (Canada). We applied principal component analysis to identify patterns and to reduce the number of explanatory variables into combined component axes that represent unique variation in these confounded and overlapping factors. We then applied regression analysis to model the relationship between the indices of enviro-health and socioeconomics and their potential relationship with premature mortality. Residual spatial analysis was used to investigate any remaining spatial structure (such as neighbourhoods with higher residual premature mortality rates). Neighbourhood Equity Index was correlated with our enviro-health and socioeconomic indices. Premature mortality within neighbourhoods was predicted by poor cancer screenings, pollution, lack of tree canopy, increased uptake of student nutrition programs and high walkability index. A negative association between premature mortality and pollution was associated low walkability index and presence of visible minorities within neighbourhoods. There was some unexplained residual spatial variation in our model of premature mortality - especially along the shores of Lake Ontario and in neighbourhoods with major highways or road corridors: premature mortality in Toronto neighbourhoods was higher than expected along highway-corridor neighbourhoods and shorelines. Our analysis revealed a significant relationship between neighbourhood contextual features – both environmental and health – and premature mortality, suggesting that these contextual components of neighbourhoods can predict rates of urban premature mortality in Toronto.     

GATA6基因启动区多态性与急性心肌梗死患者易感性和临床特征的相关性分析

目的探讨GATA6基因启动区-493(rs144923558)G/A、-172(rs146748749)G/A 2个位点单核苷酸多态性(SNP)与急性心肌梗死(AMI)之间的关系及其相关的危险因素。方法采用病例-对照研究方法,收集328例AMI患者和344例正常对照;应用聚合酶链反应-限制性内切酶片段长度多态性技术结合DNA测序后的序列比对进行数据统计;运用Hardy-Weinberg平衡检验后,应用χ~2检验进行相关分析;利用Logistic回归对多种危险因素以及2个SNP位点与AMI发病进行关联性分析;利用Haplovview4.2软件和SHEsis网站进行连锁不平衡及单倍体分析。结果 2个SNP位点共检测出3种基因型为GG、GA和AA,其基因型分布均符合Hardy-Weinberg平衡(P0.05),同时在AMI组与对照组间差异无显著性(P0.05)。多因素Logistic回归分析:增龄、高血压病、吸烟、低密度脂蛋白胆固醇(LDLC)和甘油三酯(TG)升高是AMI发病的独立危险因素(P0.05),HDLC为保护因素(P0.05)。在显性、隐性和加性3种不同遗传模式下进行Logistic回归分析发现,2个SNP位点与AMI发病无关联性。进行连锁不平衡和单倍型分析提示,该2个SNP位点处于同一个连锁不平衡区域(D′=1.000,r~2=1.000),单倍型GG和AA均未增加AMI易感性(P0.05)。结论 GATA6基因启动区-493(rs144923558)G/A与-172(rs146748749)G/A两个SNP位点为完全连锁不平衡,其中GG为主要单倍型。该2个SNP位点及其单倍体型与AMI发病无相关性,但提供了GATA6基因启动区多态性的群体遗传学资料。     

Consumption of whole grain food and its determinants in a general Italian population: Results from the INHES study

Background and aimsWhole grain (WG) food consumption is associated with lower risk of cardiovascular disease, cancer and neurological diseases. The aim of this study was to assess the consumption of WG food and its major demographic, socioeconomic, psychosocial and behavioral determinants in a general Italian population.Methods and resultsData were from the Italian Nutrition & Health Survey (INHES), a telephone-based survey established in 2010–2013 including 9422 participants aged ≥5 years from all over Italy. WG food intake was assessed by the European Food Propensity Questionnaire and included bread, pasta, breakfast cereals, biscuits and WG soups. WG consumption was categorized as none, occasional (<1 time/week) and regular (≥1 time/week). Overall, 26.9% of the sample reported a regular consumption of WG food (27.2% of adults aged 20–97 y, and 21.9% of children/adolescents aged 5–19 y). In both age-groups, the major food source contributing to total WG intake was WG bread followed by WG pasta. Among adults, greater consumption of WG was associated with healthier lifestyle (e.g. sport activity), and higher educational level. Eating meals outside of the house in adults, and spending >2 h/day watching TV in children/adolescents were inversely associated with WG intake.ConclusionsThe percentage of WG consumers in Italy in 2010–2013 appears to be quite low and still below that recorded in other countries of Europe where consumption is frequently over 50 percent. WG consumption is likely to be influenced by socioeconomic status and is associated with a number of psychosocial factors, meal patterns and eating-related behaviors.     

膝关节镜术后结合活血祛瘀汤内服对膝关节炎患者骨代谢指标及炎性指标的影响

目的:研究膝关节镜术后结合活血祛瘀汤内服对膝关节炎患者骨代谢指标及炎性指标的影响。方法:选取2013年6月至2016年5月抚顺市中医院骨科住院部收治的进行关节镜清理术的膝骨关节炎患者68例进行回顾性分析,按照术后治疗方法的不同分为观察组和对照组,每组34例。观察组内服活血祛瘀汤(58膝),对照组行单纯关节镜清理术(62膝)。将2组患者术后6个月随访疗效结果进行比较。结果:6个月治疗结束后,观察组总有效率81. 02%,显著高于对照组的48. 55%,差异有统计学意义(P 0. 05),观察组治疗后夜间卧床休息时疼痛、晨僵或起床后疼痛加重、绞锁、肿胀以及跛行优于对照组,差异有统计学意义(P 0. 05)。观察组治疗后TNF-α、IL-6改善显著,与对照组比较,差异有统计学意义(P 0. 05),观察组与对照组治疗后COMP、CTX-Ⅱ、CTX-Ⅰ、MMP-3治疗后效果显著,且观察组优于对照组,差异有统计学意义(P 0. 05)。结论:活血祛瘀汤可明显降低膝关节术后患者炎性反应递质水平,患者COMP,CTX-Ⅱ,CTX-Ⅰ和MMP-3指标亦有显著改善,患者综合治疗疗效优于患者单纯使用关节镜下清理术疗效。     

Gene-Loaded Nanoparticle-Coated Sutures Provide Effective Gene Delivery to Enhance Tendon Healing

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左、右半结肠癌骨转移病理特征及预后分析

目的:比较左半结肠癌（LSCC）和右半结肠癌（RSCC）骨转移的病理特征和临床预后差异。方法:对漯河市中心医院2007年1月至2015年12月收治的103例结肠癌骨转移病例资料进行回顾性分析，据解剖位置将64例纳入LSCC组，39例纳入RSCC组，对比分析其病理学特征,绘制并分析生存曲线,筛选预后因素。结果:RSCC骨转移相对LSCC表现为:CA199 阳性率高、年龄大、分化程度更差、分期更晚、预后更差。单因素分析结果示原发肿瘤位置、TNM分期、LDH水平、ALP水平是影响结肠癌骨转移3年生存的相关因素。Logistic多因素回归分析显示原发肿瘤位置、TNM分期、ALP水平是结肠癌骨转移的独立危险因素。结论:左、右半结肠癌在病理特点、临床表现、生物学行为、生存预后等方面存在差异，本文为区分左、右半结肠癌骨转移的不同病理特征及预后评价提供了依据。     

全面两孩政策下已育育龄妇女生育意愿的影响因素及其对策研究

目的：在全面两孩政策下，通过抽样调查上海市户籍已育育龄妇女二孩生育意愿，并分析其影响因素，为生育政策的实施及相关配套的完善提供参考。方法：采用目的抽样的方法，对上海市2个区4个街道的920名夫妻一方为上海市户籍家庭中15~49岁已育一孩妇女进行问卷调查，采用卡方检验、多因素Logistic回归模型进行二孩生育意愿影响因素分析。结果：回收有效问卷904份，其中有二孩生育意愿者20.7%，无意愿者57.7%，不确定者21.6%。回归分析结果显示，育龄妇女年龄、家庭年收入、夫妇类型、生育偏好和区域差异是妇女二孩生育意愿的重要影响因素。结论：全面两孩政策的实施对已生育一孩妇女的二孩生育意愿影响有限，意愿生育子女数明显低于政策允许生育子女数，除生育政策外，还有很多因素制约着人们的二孩生育意愿。全面两孩政策之后，延长产假、哺乳假和提供经济支持是最受期待的育儿支持政策。