Controls for monitoring the deterioration of stored blood samples in the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study)

Cohort studies commonly store blood samples to measure the associations of biomarkers with disease risks for a long time after the study subjects are enrolled. To obtain valid measurements of the stored samples, monitoring their degree of deterioration is essential. The first stage of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study launched in 2005 included a project to validate the quality of stored blood samples. This project will compare the measurements of representative molecules over different storage periods (1, 4, and 8 years after sampling, and when a nested case-control study is conducted), different storage temperatures (-80 and -150 degrees C), and different separation conditions (temperature and time) before storage. For these purposes, 28 ml of peripheral blood from 10 people was sampled four times annually, using two tubes for serum and two EDTA-Na tubes for plasma. These samples were treated using the process adopted for the J-MICC study protocol, and stored in tubes containing 300 microliters of serum or plasma labeled with two-dimensional bar codes. The sampling was started in 2006, and some of the specimens will be stored until the end of the J-MICC Study in 2035. The resulting findings will produce valuable information on the stability of the molecules, not only for the J-MICC Study, but also for other cohort studies.     

Improvements in Helicobacter pylori eradication rates through clinical CYP2C19 genotyping

Lansoprazole (LPZ), amoxicillin (AMPC) and clarithromycin (CAM) are commonly used drugs (LAC regimen) for Helicobacter pylori (H. pylori) eradication, but the eradication rate with this regimen was reported to be 70% to 90%. A few studies have reported that a successful eradication was associated with the CYP2C19 genotype, which influences the metabolism of proton pump inhibitors (PPI) including LPZ. This study examined the changes in the H. pylori eradication rates between the periods before and after the commencement of a routine genetic test for CYP2C19 at the Daiko Medical Center in Nagoya, Japan, in November, 2005. Subjects were patients who visited the Center during the period from June, 2004 to August, 2010. The patients were classified into three groups according to their CYP2C19 genotype: rapid metabolizers (RM) with a *1*1 genotype, intermediate metabolizers (IM) with a *1*2 or *1*3 genotype, and poor metabolizers (PM) with a *2*2, *2*3, or *3*3 genotype. Non-rapid metabolizers (IM and PM) were basically treated with a LAC regimen, while RMs were treated with a RAM reg imen(rabeprazole, AMPC, and metronidazole). The eradication rate was 80.0% (n=90) for the period without the genetic testing and 88.7% (n=124) for the period with the genetic testing (chi2=3.11, p=0.078). The age-sex adjusted odds ratio of eradication success was 2.29 (95% confidence interval, 0.99-5.28, p=0.051) for the latter period relative to the former period among those less than 70 years of age. Those results suggested that the routine genetic test which allows a choice of the RAM regimen for R M improved the eradication rate.     

Hindu-Muslim differences in the prevalence of coronary heart disease and risk factors

Differences in coronary risk factors and coronary heart disease (CHD) prevalence between the Hindus and the Muslims have not been adequately studied. This study aims to determine the prevalence of certain socio-economic and biological coronary risk factors in urban communities and to compare the findings found in the Hindus and the Muslims. The study employed a cross-sectional survey design and stratified random sampling technique consisting of 1,415 males and 797 females. Among males there were 1,092 Hindus (77.2%) and 272 Muslims (19.2%) while in females there were 685 Hindus (85.9%) and 91 Muslims (11.4%). Prevalence of illiteracy and sedentary lifestyle were significantly more in Muslims (p<0.05). Smoking or tobacco use in males was similar but in females it was more in the Hindus. Self-reported diabetes was found in 1.4% Hindu males and in 1.2% Hindu females. No Muslim reported diabetes. Hindu males were significantly taller than Muslims (163.9 +/- 8.3 versus 160.9 +/- 8.9 cm; p < 0.001). In both males and females there was no significant difference in body mass index and obesity. In Hindu males the diastolic BP was significantly greater than in Muslims (81.2 +/- 9.2 versus 79.0 +/- 8.6 mm Hg; p < 0.001); prevalence of hypertension (30.5% versus 25.7%) was also significantly more (p = 0.048). In Hindu females the mean systolic BP was significantly more and there was also difference in hypertension prevalence (35.2% versus 25.3%). CHD prevalence was significantly greater in Hindu males as compared to the Muslims when determined by the presence of either ECG changes alone (4.3% versus 0.7%; p = 0.008) or ECG changes combined with clinical history (7.1% versus 1.8%; p = 0.002). A similar, though not significant, trend was seen in females (ECG changes: 8.9% versus 6.6%, clinical and ECG changes: 10.4% versus 6.6%). The prevalence of CHD is significantly more in Hindu males as compared to the Muslims and is associated with a greater prevalence of diabetes and hypertension.     

Past medical history and risk of death due to hepatocellular carcinoma, univariate analysis of JACC study data

The relationship between the past history of selected diseases and the risk of dying from hepatocellular carcinoma (HCC) was analyzed using 110,792 cohort members (46,465 males and 64,327 females) recruited between 1988 and 1990 by the JACC Study (the Japan Collaborative Cohort Study for Evaluation of Cancer Risk). Significantly elevated hazard ratios (HRs) were observed in both genders for the past history of kidney diseases, liver diseases, gallstones or cholecystitis, diabetes mellitus, and blood transfusion. Further, when analyzed by age group (those 40-59 years of age were "younger" and those 60-79 years of age were "older"), although the significant associations were generally maintained, the magnitude of the HRs for liver diseases and diabetes mellitus seemed to be considerably different between the younger and older age groups for male cohort members. When the analyses were limited to cohort members without the past history of liver diseases, the past histories which had significantly elevated HRs were hypertension (HR = 3.14, 95% confidence interval (CI): 1.25-7.89), diabetes mellitus (HR = 4.17, 95% CI: 1.22-14.25), and blood transfusion (HR = 7.69, 95% CI: 3.09-19.15) in the younger male age group and gallstone or cholecystitis (HR = 2.58, 95% CI: 1.11-5.98) in the older male age group. On the other hand, for females, the significantly elevated HRs were gastric or duodenal ulcer (HR = 4.33, 95% CI: 1.09-17.25) in the younger age group and diabetes mellitus (HR = 6.16, 95%CI: 2.25-16.90) and blood transfusion (HR = 3.86, 95%CI: 1.58-9.41) in the older age group. However, since the evidence from our univariate analyses might not be decisive, multivariate Cox proportional hazards models controlling for potential confounders and effect modifiers will be required to obtain more valid or unbiased hazard ratios.     

Influence of genetic polymorphisms of glutathione S-transferases T1 and M1 on serum lipid parameters

OBJECTIVE: To determine the effect of genetic polymorphisms of glutathione S-transferase theta 1 (GSTT1) and GSTM1 on serum levels of lipid parameters. METHODS: We conducted this cross-sectional study on 152 adult healthy subjects (54 females and 98 males) from June 2004 to September 2004. The participants in our study were recruited from the Research Clinic in Abarku (Yazd province, central part of Iran). There were unrelated Iranian Muslims. The genotypes of GSTT1 and GSTM1 were determined using a polymerase chain reaction based method. After an overnight fasting, serum lipid indices including triglyceride (TG), total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) were measured. RESULTS: There were significant partial correlation coefficients between levels of TG (r=-0.4833, df=48, p<0.001) and TG/HDL-C ratio (r=-0.4041, df=48, p=0.004) and numbers of active GST genotypes in females after controlling for age and body mass index (BMI). In males, the level of TG increased as a function of numbers of active GST genotypes after controlling for age and BMI (r=+0.2082, df=94, p=0.042). There were significant differences between females and males. CONCLUSION: Data show that genetic polymorphisms of GSTM1 and GSTT1 modulate levels of TG, and TG/HDL-C in females.     

新疆维吾尔族、哈萨克族外周动脉疾病患病率及危险因素分析

目的 了解新疆维吾尔族(维族)、哈萨克族(哈族)成年人外周动脉疾病(PAD)的患病率和相关危险因素.方法 2007年10月至2010年5月应用整群抽样法抽取新疆35岁以上汉族、维族、哈族人群14 618名作为研究对象.统计不同民族不同年龄、不同性别人群的PAD患病率,并对PAD的危险因素进行分析.结果 新疆维族、哈族成年人PAD总患病率6.46%(542例),标化患病率6.51%.维族PAD患病率7.05%(315例),哈族为5.79%(227例),经标化后,维族、哈族患病率分别为7.08%、5.83%,差异有统计学意义(x2=5.55,P＜0.05).男性患病率4.49%(170例),女性为8.08%(372例),经标化后,男性患病率为4.30%,女性为7.90%,差异有统计学意义(x2=44.26,P＜0.01).经多因素Logistic回归分析,年龄(OR=1.01,95%CI1.00～1.02)、女性(OR=1.75,95%CI1.45～2.14)、肥胖或超重(OR=1.04,95%CI1.01～1.06)、糖尿病(OR=1.59,95%CI 1.01～2.36)、收缩压增高(OR=1.02,95%CI1.01～1. 03)、舒张压增高(OR=1. 08,95%CI 1.01～1.11)、冠心病史(OR=1.69,95%CI1.14～2.50)与PAD患病有关.结论 新疆维、哈族成年人PAD患病率较低.女性、年龄、超重或肥胖、糖尿病、收缩压升高、舒张压升高、冠心病史为PAD危险因素.     

Pattern of cancers in adolescent and young adults.: A 15-year retrospective study at King Fahad Hospital,Al-Madinah Al-Munawwarah,Saudi Arabia

Objectives:To evaluate the incidence and pattern of cancer in adolescents and young adults (AYAs) age group in Al-Madinah Al-Munawwarah region of Saudi Arabia.Methods:This retrospective histopathology-based study was conducted at a tertiary care center in Al-Madinah Al-Munawwarah, Saudi Arabia and comprised cases of cancers for 15 years between January 2006 and December 2020.Results:During the last 15-year period, 8,769 cases of cancers were diagnosed out of which 475 (5.4%) cases were registered in AYAs. Of these cases, 232 (48.8%) were males while 243 (51.2%) were females, with a male-to-female ratio of 0.9:1. The 3 most common cancer groups in the entire cohort were carcinomas (n=165; 34.7%), lymphomas (n=135; 28.4%), and leukemias (n=91; 19.2%). The most common sites in carcinomas were thyroid (n=60; 12.6%), breast (n=35; 7.4%), and gastrointestinal (n=18; 3.8%). The leading cancers in males were the lymphomas (n=74; 15.6%), leukemias (n=57; 12%), bone (n=21; 4.4%), and central nervous system (n=20; 4.2%), while in females, the most common cancers were the lymphomas (n=61; 12.8%), thyroid (n=40; 8.4%), breast (n=34; 7.2%), and leukemias (n=34; 7.2%).Conclusion:Our findings are in concordance with studies in national and international literature and we believe that our study provides a baseline tool for future population-targeted studies.     

The prevalence of internet gaming disorder among medical students at King Saud University,Riyadh, Saudi Arabia: A cross-sectional study

Objectives:To estimate the prevalence of internet gaming disorder (IGD) among King Saud University (KSU), Riyadh, Saudi Arabia medical students and to determine the association of IGD with gender, age, academic achievement, amount of sleep, and accommodation.Methods:We conducted a cross-sectional study between October 2019 and April 2020 on KSU medical students with a sample size of 281 medical students currently studying at KSU chosen by a stratified proportionate random sampling. The questionnaire contained the IGD short scale and questions eliciting demographic data.Results:The sample comprised of 228 responses. The prevalence of IGD was 8.8% (n=20), while 19.3% (n=44) of the participants were risky gamers. There was a significant association (p=0.0040) between IGD and gender, with 10.1% (n = 15) of males having IGD compared to 6.3% (n=5) of females. Additionally, 25% (n = 37) of males were risky gamers, as compared to 8.8% (n=7) of females.Conclusion:There is a high prevalence of internet gaming disorder among KSU medical students, with higher frequency among males. However, there was no significant association between this disorder and age, sleep, academic achievement, or accommodation.     

Association between diabetes mellitus and hepatocellular carcinoma: results of a hospital- and community-based case-control study

The present study was performed to investigate the relationship between diabetes mellitus (DM) and primary hepatocellular carcinoma (HCC). Incident HCC cases were recruited in Kyushu, Japan. Ethnicity-, age-, gender-, residence-matched hospital controls and community controls were collected. Information on viral hepatitis B (HBsAg) or viral hepatitis C infection, history of blood transfusion, past histories including DM, amount of drinking or smoking, and genotypes of alcohol metabolizing enzymes was collected. Associations between these items and HCC were analyzed multivariately by conditional logistic regression analysis. Two hundred and twenty two (177 males and 45 females) case-control sets were completed between July 1995 and June 2000. Since hospital controls turned out to be a biased one or those sampled from a DM-prone population, a multivariate analysis was performed for the HCC-community controls sets, and it yielded significantly elevated odds ratio (OR)s due to past histories of DM (2.522; 95% Confidence Interval (CI) = 1.267-5.020), blood transfusion (1.747; 1.136-2.689), and unit increment of alcohol consumption (1.358; 1.096-1.684) for males. The same analyses of the HCC-community-controls sets for females, revealed an elevated but not statistically significant OR due to past histories of DM (4.195; 0.808-21.805). A multivariate analysis revealed that DM might be a risk factor for HCC.     

Dentinal sensitivity among a selected group of young adults in Nigeria

Background:

There is paucity of data on the prevalence of dentinal sensitivity outside the hospital setting and impact of dentinal sensitivity among young adults in Africa. This study aimed to determine the prevalence and impact of dentinal sensitivity among young adults in Nigeria.

Materials and Methods:

A cross-sectional survey was conducted among the undergraduates of University of Benin in August, 2010. Self-administered questionnaire elicited information on demography, self-reported dentinal sensitivity, the trigger factor, action taken, functional, and psychological impact.

Results:

The prevalence of dentinal sensitivity was 211 (52.8%) among the participants and it was significantly higher in females than males (P=0.027). Participants experienced shocking sensation more on the left-side of the mouth. The most common trigger factor for the dentinal sensitivity was due to cold drink [169 (80.1%)]. Among the participants with dentinal sensitivity, majority [139 (65.9%)] have not taken any action and only 24 (11.4%) have visited the dentist because of the problem. Dentinal sensitivity exhibited psychological impact among the participants as 64 (30.3) reported unhappiness due to the shocking sensation. Eating and talking were disturbed, respectively, in 59 (28.0%) and 12 (5.7%) of the participants.

Conclusion:

The prevalence of dentinal sensitivity was high which was significantly higher in females than males. Despite the negative functional and psychological impact among the participants, only a few sought dental professional care. Screening for dentinal sensitivity at community level is required to proffer early treatment and ameliorate its impact on the populace.     

Relationship between A-3826G polymorphism in the promoter of the uncoupling protein-1 gene and high-density lipoprotein cholesterol in Japanese individuals: a cross-sectional study

BACKGROUND: A-3826G polymorphism within the promoter region of the uncoupling protein-1 (UCP-1) gene is possibly involved in the pathophysiology of obesity and metabolic disorders. However, the effects of UCP-1 A-3826G polymorphism on high-density lipoprotein cholesterol (HDL-C), a major contributor to atherosclerotic disease, still have not been established. METHODS: A total of 298 healthy Japanese subjects (144 males and 154 females, mean age: 45.2 years) with a body mass index (BMI) of 20.0-30.0 kg/m(2), regular lifestyles, and receiving no medication were enrolled in the cross-sectional study to estimate the relationship of serum HDL-C levels with UCP-1 A-3826G polymorphism by genomic PCR and Bcl1-restriction fragment length polymorphism analysis. We used 1.04 mmol/L of HDL-C in Japanese males and 1.29 mmol/L in Japanese females as cut-off values of low HDL-cholesterolemia. RESULTS: The genotype and allele frequencies of UCP-1 A-3826G polymorphism were similar to those previously reported in the Japanese population. In males, HDL-C levels of the GG genotype (1.75+/-0.49 mmol/L) were significantly higher than those found in the AA genotype (1.45+/-0.34 mmol/L, p=0.015). In females, the occurrence rate of low HDL-cholesterolemia was significantly different by genotype: a low prevalence in the GG genotype (15.4% in the AA, 4.8% in the AG, 15.4% in the GG genotype, p=0.022). Logistic regression analysis was used to identify risk factors for low HDL-cholesterolemia, with adjustments for age, gender, smoking, alcohol intake, BMI, hypertriglyceridemia, and genotype. The GG genotype was detected as being a significant associated factor (odds ratio =0.11 [95% confidence interval =0.01-0.90], p=0.01), in addition to BMI and the presence of hypertriglyceridemia. CONCLUSIONS: These results suggest that the GG genotype may be an independent protective factor associated with low HDL-cholesterolemia in this population, although the role of the UCP-1 A-3826G polymorphism in HDL-C is complex and remains controversial. This hypothesis needs further investigation.     

The effect of sugar-free green tea chew candies on the degree of inflammation of the gingiva

The components of green tea extracts such as catechins and polyphenols gain increasing significance in tumor research and immunology. - The clinical double blind study presented here was aimed at the investigation on how green tea catechins and polyphenols in the form of green tea dragées may influence the inflammatory behaviour of the gingiva. A total of 47 test persons with a mean age of 25.76 years (23 males, 24 females) were randomly divided into two groups: one group (n = 22: 11 males, 11 females) received chew candies containing green tea extracts, the other group (n = 25: 12 males, 13 females) received placebos with the same flavour but without active substances. At the beginning of the four week investigation period, a professional dental cleaning was carried out on all test persons. Then the persons were instructed to do their usual dental cleaning and chew eight candies distributed over the day. The API (approximal plaque index) and the SBI (sulcus bleeding index) were determined after seven days (API-1, SBI-1) and after another 21 days (API-2, SBI-2). Within the verum group, a mean value of 33.2% +/- 18.3% was determined for API-1, and 29.6% +/- 17.5% for API-2. The mean SBI-1 was 5.9% +/- 7.6%, and 3.6% +/- 5.8% for SBI-2. The clinical data within the placebo group were different: The plaque index values changed from API-1 30.3% +/- 16.3% after one week to API-2 31.8% +/- 17.2% after another three weeks. The values for the inflammatory degree of the gingiva had also changed to the negative: from SBI-1 3.4% +/- 4.1% after seven days to SBI-2 4.7% +/- 6.4% after another 21 days. Whereas in the verum group a distinct improvement in both API and SBI values could be stated, slight worsening of the values were determined for the placebo group. The results indicate that the oral application of green tea catechins and polyphenols might have a positive influence on the inflammatory reaction of periodontal structures.     

Metabolic syndrome defined by new criteria in Japanese is associated with increased liver enzymes and C-reactive protein

Metabolic syndrome (MetS) is characterized by the presence of atherogenic risk factors, and is associated with a marked increase in the risk of cardiovascular disease. Recently, the criteria of MetS were newly defined in Japan. We examined the relationship between MetS and the various metabolic parameters in Japanese subjects. This study included 458 Japanese subjects undergoing medical checkups at Nagoya University Hospital. New criteria developed by the joint committee of eight Japanese medical societies for the clinical recognition of MetS were adopted. We examined the association between MetS and various metabolic parameters, including liver enzymes (alanine aminotransferase, ALT; gamma glutamyltransferase, GGT) and highly sensitive C-reactive protein (hsCRP). The mean overall prevalence of MetS was 8.7% (male: 12.9%; female: 2.2%, p = 0.0001). MetS was significantly associated with elevated ALT (> 45 IU/L) (OR: 3.37, 95% CI: 1.19-9.52, p < 0.05) and GGT (> 64 IU/L in males, > 45 IU/L in females) (OR: 4.96, 95% CI: 2.31-10.66, p = 0.0001), respectively. MetS was also significantly associated with elevated hsCRP (> or = 0.1 ng/mL) (OR: 2.77, 95% CI: 1.20-6.41, p < 0.05). Thus, MetS was associated with elevated liver enzymes (especially, GGT), and inflammation (hsCRP).     

高血压患者的初发病年龄研究

目的:研究高血压患者的初发病年龄。方法:1500例确诊为原发性高血压的患者进行问卷调查,男820例,女680例。研究初次确诊为高血压的年龄、家族遗传史、工作性质、食盐程度。结果:1 500名研究对象初次确诊为高血压的平均年龄为(41.57±9.28)岁,集中在36～65岁之间。0～25岁的高血压初发病年龄段男性多于女性(χ~2=7.627;P<0.01)。26～35岁之间的高血压发病人数为100人,占100/1 500=6.7%。随着年龄的增长,男女发病率由36～45岁具有统计学差异(χ~2=2.472;P<0.05)到逐渐趋于相等(χ~2=1.76;P>0.05)。遗传所占比重为58.4%。遗传与高血压的相关系数r=3.14,P为0.008。从工作性质与高血压的初次发病年龄无关(P>0.05)。食盐多的易患高血压,相关系数r=2.34,P=0.017。结论:对于有家族遗传史者,从5岁左右就应该对高血压进行预防。对于无家族遗传史者,应该从35岁左右开始警惕高血压的发生。     

Renin-angiotensin system polymorphisms and renal graft function in renal transplant recipients

OBJECTIVE: To analyze the role of 3 polymorphisms of the renin-angiotensin system (RAS) in renal transplant recipients (RTRs) and correlate them with graft function. METHODS: The present study was performed in the Drug Applied Research Center, Tabriz Medical University, Tabriz, Iran from September 2003 to December 2005 on 108 RTRs (66 males and 42 females, with a mean age of 37.34 +/- 4.97 years) with stable allograft function (creatinine < or =2.2 mg/dl). Following the DNA extraction from the blood leukocytes, the genotypes of the angiotensin converting enzyme (ACE I/D), angiotensinogen (ANG M235T), and angiotensin II type 1 receptor (ATR1 A1166C) were determined by polymerase chain reaction. The magnitude of clearance of creatinine (ClCr) in the setting of each of the above RAS polymorphisms was determined. The ClCr was measured by modification of diet in renal disease formula. Values were expressed as mean +/- SD; p< or =0.05 was considered to indicate statistical significance. RESULTS: There was no association of each genotype of the RAS alone with ClCr, serum urea, cyclosporine through level and the degree of urinary protein excretion rate. However, patients with the DD genotype of angiotensin converting enzyme + CC genotype of angiotensin II type I receptor polymorphisms had lower ClCr (p=0.05) and a higher urinary protein excretion rate (p=0.03). Other combination genotypes of RAS had no effect on allograft function. Interestingly, the percent of hypertensive patients in the C allele (70%) was more than the A allele (30%) of ATR1 polymorphism (p=0.04). CONCLUSION: Although none of the single gene polymorphisms of the RAS affected renal allograft function, combinations of these genotypes were associated with the outcome of allograft function.     

Gender-related differences of risk factors among patients undergoing coronary artery bypass graft in Ahwaz, Iran

OBJECTIVE: To evaluate the major risk factors among male and female patients with severe coronary artery diseases undergoing coronary artery bypass graft (CABG). METHODS: This randomized clinical trial was performed on 897 (655 male and 242 female) patients from March 2001 to March 2006 in the Department of Cardiovascular Surgery, Golestan Hospital, Ahwaz, Iran, with male to female ratio approximately 2.7. The mean age was 54.37+/-0.3 years. The major risk factors were diabetes mellitus, smoking, hyperlipidemia, hypertension, obesity, familial history of coronary artery disease, past medical history of myocardial infarction and heart failure before surgery. RESULTS: The results show that the rate of risk factors among the males and females was age (male=54.01, female=55.35 years), smoking (p=0.00001), previous myocardial infarction (p=0.00004), heart failure (p=0.05), diabetes mellitus (p=0.0001), hyperlipidemia (p=0.00001), obesity (p=0.03), historical familial background (p=0.01) and hypertension (p=0.000001). The risk factors were revealed significantly higher in females than males (p<0.05). CONCLUSION: The incidence of the risk factors among the females showed higher than males patients.     

Obesity, albuminuria and hypertension among Hong Kong Chinese with non-insulin-dependent diabetes mellitus (NIDDM).

A total of 412 Hong Kong Chinese diabetic patients were studied on at least two occasions 8-16 weeks apart. Although 28% were insulin-treated, only 3.6% had insulin-dependent diabetes (IDDM). In the remaining 397 patients with non-insulin-dependent diabetes (NIDDM), the mean (s.d.) body mass index (BMI) was 24.4 +/- 3.2 kg/m2 in females and 24.2 +/- 3.2 kg/m2 in males. Obesity was present in 17% of males (BMI > 27 kg/m2) and 40% of females (BMI > 25 kg/m2). Established hypertension was present in 49%. Abnormal albuminuria, defined as a mean urinary albumin/creatinine (UA/Cr) ratio greater than 5.4 mg/mmol based on two random spot urine samples, was present in 47%. On stepwise multiple regression analysis, UA/Cr ratio (R2 = 0.34, F = 65.4, P < 0.001) showed significant associations with systolic blood pressure (standardized regression coefficient beta = 0.40, P < 0.001), plasma creatinine concentration (beta = 0.27, P < 0.001) and glycosylated haemoglobin (beta = 0.20, P < 0.001). While the prevalence of hypertension increased with increasing severity of proteinuria, 40% of normoalbuminuric patients had hypertension. Among patients diagnosed before the age of 35 (n = 67), 52% were insulin-treated although only 10% were insulin-dependent. Among these NIDDM patients of young onset (n = 59), obesity was present in 25% of males and 56% of females. Overall, 18% of these patients had a blood pressure greater than 140/90 mmHg and 27% had abnormal albuminuria. In Hong Kong Chinese, diabetes mellitus is predominantly non-insulin-dependent even in the young. Obesity is more prevalent among females. Abnormal albuminuria is relatively common and is closely associated with hypertension and glycaemic control. In the light of increasing prevalence of diabetes among overseas Chinese, our findings may have important implications in the management of Chinese diabetic patients.     

冠状动脉心肌桥的临床和预后分析

目的　分析心肌桥的临床表现和预后的关系。方法　对 35例心肌桥病例 (其中 2 4例为孤立性心肌桥 )的临床和冠脉造影资料 ,分析心肌桥与冠状动脉粥样硬化、心肌缺血、预后及心肌肥厚的关系。结果　心肌桥在冠状动脉造影上的检出率为 1 2 2 %。心肌桥前段血管粥样硬化组的肌桥收缩期狭窄程度 (6 8%± 15 % )与无粥样硬化组 (5 4 %± 14 % )差异有非常显著意义 (P <0 0 1) ,心电图异常组的肌桥收缩期狭窄程度 (6 3%± 13% )重于心电图正常组 (4 9%± 13% ,P <0 0 5 ) ,但与心绞痛的典型 (5 8%± 15 % )与否 (5 4 %± 15 % )关系不大 ,左室肥厚者的肌桥收缩期狭窄程度 (6 9%±9% )重于非肥厚者 (5 8%± 16 % ,P =0 0 9)。 3～ 5 0 (2 6 6± 17 7)个月的随访期内无恶性临床事件发生。结论　 (1)心肌桥的狭窄程度越重 ,造成的心肌缺血越严重 ,即出现心电图异常的可能性就越大 ;(2 )心肌桥有促发或加速其前段冠状动脉血管发生粥样硬化病变的倾向 ,且与心肌桥的狭窄程度有关 ;(3)左室肥厚可能促进本不严重的心肌桥的发生 ;(4 )心肌桥的预后良好。     

Smoking rates and attitudes to smoking among medical students: a 2009 survey at the Nagoya University School of Medicine

Since smoking is implicated in many diseases, medical professionals are expected to contribute to the reduction of smoking rates in their practice. Medical students are also expected to learn the importance of practical measures against smoking. This study surveyed the smoking rates and attitudes to smoking among medical students of the Nagoya University School of Medicine. Out of 612 students in their 1st to 6th year in 2009, 31 students answered "yes" to the question "Did you smoke one or more cigarettes this past month?" and eight students did not respond. The maximum smoking rate was 6.4% (39/612). The respective rates of students to accept smoking by doctors, co-medical personnel, patients in general, and terminally ill patients were 50.8% in males and 38.9% in females, 51.3% in males and 41.6% in females, 41.4% in males and 23.0% in females, 80.5% in males and 84.1% in females. This survey demonstrated that though smoking rates among medical students were relatively low, many accepted smoking, especially for terminally ill patients.     

Association of UGT1A1 Gly71Arg with urine urobilinogen

Bilirubin is glucoronized by uridine diphosphate-glucuronosyl transferase 1A1 (UGT1A1) mainly in the liver, and excreted into bile. The conjugated form is metabolized into the unconjugated form, and then into urobilinogen by bacteria in the intestine. Unconjugated bilirubin and urobilinogen are absorbed into the blood stream. The kidney filtrates conjugated bilurubin and urobilinogen into urine. Accordingly, the reduced enzyme activity of UGTIAI may decrease serum conjugated bilirubin levels, resulting in a lower frequency of positive results of urine bilirubin and urobilinogen. This study examined the associations of UGTIAI Gly71Arg (UGTIAI *6) with urine bilirubin and urobilinogen, as well as serum AST, ALT and GGT. Subjects were 5,172 inhabitants 35 to 69 years old who participated in a cohort study in Nagoya from June 2008 to May 2010. Among them, data from 5,151 participants (1,465 males and 3,686 females) were available for analysis. The age-sex-adjusted odds ratio (OR) of ArgArg relative to GlyGly was 1.37 (95% confidence interval (95% CI), 0.55-1.23) for bilirubin, and 1.67 (95% CI, 0.86-3.26) for urobilinogen. Those of ArgArg+ArgGly were 0.87 (95% CI, 0.59-1.27) and 1.50 (95% CI, 1.17-1.94), respectively. AST, ALT and GGT levels had no associations with the genotype. Although the significant association for urobilinogen was contrary to the biological expectation, this study indicated that UGTIA1 Gly71Arg may be a genetic factor of urine urobilinogen.