慢性萎缩性胃炎的现代观点

慢性萎缩性胃炎是临床常见消化系疾病。根据胃镜及病理检查所见，慢性胃炎主要分为非萎缩性胃炎和萎缩性胃炎。前者具有粘膜充血、水肿等炎症的组织学特点，后者可见正常腺体的萎缩及消失，通常伴有肠上皮化生。将胃炎分为萎缩性和非萎缩性具有重要意义，因为只有进行性的萎缩和肠上皮化生、异型增生与胃癌尤其是肠型胃癌的发生密切相关。     

慢性萎缩性胃炎的现代观点

慢性萎缩性胃炎是临床常见消化系疾病.根据胃镜及病理检查所见,慢性胃炎主要分为非萎缩性胃炎和萎缩性胃炎.前者具有粘膜充血、水肿等炎症的组织学特点,后者可见正常腺体的萎缩及消失,通常伴有肠上皮化生.将胃炎分为萎缩性和非萎缩性具有重要意义,因为只有进行性的萎缩和肠上皮化生、异型增生与胃癌尤其是肠型胃癌的发生密切相关.     

Salt and obesity: a systematic review and meta-analysis of observational studies

Background: Existing research has investigated the association between sodium intake and obesity. We aim to conduct a systematic review and meta-analysis of reported evidence regarding the association between sodium intake and obesity.

Methods: Multiple electronic databases (PubMed, Scopus, and Google Scholar) were searched for observational studies published until August 2016. A systematic literature review identified 11 cohort and 21 cross-sectional studies.

Result: Among the 32 studies identified in the systematic literature search, only 18 cross-sectional reports had sufficient data to be included in the meta-analysis. Higher sodium consumption was associated with greater BMI (weighed mean difference (WMD)?=?1.24?kg/m², 95%CI: 0.80, 1.67; I^2?=^?98.4%; p?p?<.0001) greater waist circumference (WC).

Conclusion: The present meta-analysis suggests that sodium consumption was associated with greater BMI and WC.     

胃镜下慢性萎缩性胃炎诊断准确性分析

目的合理评估胃镜下慢性萎缩性胃炎诊断的临床参考价值。方法回顾性分析自2012年9月—2013年9月于我院接受胃镜检查的32例患者的临床资料,对照病理诊断结果,分析胃镜检测的符合率。结果 32例患者在胃镜直视下诊断为慢性萎缩性胃炎患者共26例,诊断为慢性浅层胃炎者6例,胃镜检查与病理诊断符合率为81.25%。结论为提高胃镜下慢性萎缩性胃炎的检出率,在提高胃镜分辨率的同时,强化医师对肠胃黏膜形态的精确认识,多角度、多方位观察患者肠胃黏膜形态,必要情况下还需结合病理诊断反复验证。     

102例慢性萎缩性胃炎并HP感染10年随访研究

目的 探讨慢性萎缩性胃炎(CAG)并HP感染的转归,尤其是CAG合并HP感染与胃癌的关系.方法 对102例经胃镜、病理及HP监测诊断为CAG并HP感染的患者进行10年随访.结果 5例逆转为慢性浅表性胃炎,36例有不同程度的减轻,23例萎缩范围与程度及肠上皮化生有不同程度的扩大与加重,35例病情稳定,3例癌变.结论 对慢性萎缩性胃炎特别是CAG伴肠上皮化生、不典型增生与HP感染者,应进行包括根除幽门螺杆菌在内的防治干预和定期随访,提高早期胃癌的诊断率.     

睡眠时间能否预测心血管疾病风险相关前瞻性研究的系统综述与Meta分析

为探讨睡眠时间与冠心病、卒中和心血管疾病发病风险间的关系,英国学者对文献做了Meta分析.研究的入选标准为:随访时间＞3年的成年人前瞻性研究;基线时调查了睡眠时间;结局事件包括冠心病、卒中或心血管疾病.最后共纳入了15项研究(24个队列)的474 684名研究对象(随访时间6.9～25.0年).使用随机效应模型合并了入选研究的相对危险度(RR)及其95％置信区间(CI),作者对效应结果进行了评估.     

慢性萎缩性胃炎患者临床流行病学分析

目的 了解慢性萎缩性胃炎（CAG）的临床特征。方法 随机抽取2011年6月-2016年6月在黑龙江省大庆油田总医院行胃镜和胃粘膜检查的2 532例患者的临床资料,分析CAG的流行病学特点。结果 2 532例患者中,CAG患者523例,占20.66%,25例CAG患者因个人原因未能完成调查,最终纳入研究者498例。498例CAG患者中男性302例（60.64%）,女性196例（39.35%）,男女比例为1.54：1;CAG在30岁之前患者中的构成比为7.83%,在30岁以后呈直线上升,并在51~60岁达到发病高峰,60岁后逐渐下降。CAG患者中有幽门螺旋菌感染、吸烟、饮酒、饮食不规律以及水果摄入量低、腌制食品摄入量高和新鲜蔬菜摄入量低的患者所占比例明显高于无幽门螺旋菌感染、不吸烟饮酒、饮食规律以及水果摄入量高、腌制食品摄入量低和新鲜蔬菜摄入量高者（P<0.05）。结论 黑龙江地区CAG的发病率较高,且多与该地区生活饮食习惯有关,应引起重视并采取相应预防对策减少CAG的发生。     

去甲二氢愈创木酸对大鼠慢性萎缩性胃炎的影响

目的 去甲二氢愈创木酸（nordihydroguaiaretic acid,NDGA）对多种肿瘤细胞具有抑制增殖和诱导凋亡作用,本文主要研究去甲二氢愈创木酸对大鼠慢性萎缩性胃炎（CAG）的预防作用,初步探讨其作用机制.方法 建立Wistar大鼠慢性萎缩性胃炎模型,将72只Wistar大鼠采用随机分组法平分为6组：正常组、模型组、三种不同剂量去甲二氢愈创木酸干预组和对照组.喂养24周后,处死大鼠,观察大鼠大体标本、胃黏膜HE染色后病理组织学改变,并采用免疫组化检测各组大鼠胃黏膜组织的5-脂氧合酶（5-LOX）、多肿瘤抑制基因（P16）蛋白的表达情况.结果 模型组萎缩性胃炎发生率较正常组明显高（77.8%vs 0%,P＜0.05）,说明造模成功.模型组较去甲二氢愈创木酸各剂量组慢性萎缩性胃炎发生率升高（77.8%vs 25%、27.3%、25%,P＜0.05）,阳性对照组与去甲二氢愈创木酸各组比较差异无统计学意义（30%vs 25%、27.3%、25%,P＞0.05）.5-LOX蛋白在模型组表达率与去甲二氢愈创木酸各组相比升高（44%vs25%、27%、25%,P＜0.05）.P16蛋白在模型组表达率与去甲二氢愈创木酸各组相比下降（66.7%vs 83.3%、81.8%、83.3%,P＜0.05）,而去甲二氢愈创木酸各组与阳性对照组差异无统计学意义（83.3%、81.8%、83.3%vs 80%,P＞0.05）.结论 去甲二氢愈创木酸能有效降低甲基硝基亚硝基胍（MNNG）诱导的大鼠萎缩性胃炎的发生,有逆转慢性萎缩性胃炎的预防作用.去甲二氢愈创木酸降低MNNG诱导的大鼠萎缩性胃炎的发生机制可能与下调5-脂氧合酶表达及上调多肿瘤抑制基因P16蛋白表达有关.     

慢性萎缩性胃炎危险因素病例对照研究

目的探讨慢性萎缩性胃炎危险因素,为疾病防治提供科学依据。方法以1∶1配对病例对照研究方法,对148例慢性萎缩性胃炎病例和148例健康对照者进行问卷调查。用卡方检验、单因素和多因素条件logistic回归法进行分析。结果烧烤(OR=7.00)、吸烟(OR=3.18)、口味偏咸(OR=2.38)、家族慢性胃病史(OR=2.22)和饮酒(OR=2.14)是慢性萎缩性胃炎的危险因素,而经常吃水果(OR=0.33)、新鲜蔬菜(OR=0.35)、奶制品(OR=0.42)和个性温和(OR=0.49)是保护因素。结论家族慢性胃病史、饮食生活习惯及精神心理因素等对慢性萎缩性胃炎发病有影响。     

Prevalence of chronic obstructive pulmonary disease and chronic bronchitis in eight countries: a systematic review and meta-analysis

ObjectiveTo estimate the prevalence of chronic obstructive pulmonary disease (COPD) and chronic bronchitis in eight countries in South Asia through a systematic review and meta-analysis.MethodsWe searched MEDLINE® Complete, Web of Science, Embase®, Scopus, CINAHL and reference lists of screened studies for research on the prevalence of COPD and chronic bronchitis in South Asian countries published between January 1990 and February 2021. We used standardized diagnostic criteria for definitions of COPD and chronic bronchitis. Two reviewers undertook study screening, full-text review, quality appraisal and data extraction.FindingsOf 1529 studies retrieved, 43 met the inclusion criteria: 32 provided data from India; four from Bangladesh; three from Nepal; two from Pakistan; and two from both India and Sri Lanka. Twenty-six studies used standardized diagnostic definitions and 19 were included in the meta-analysis. The estimated pooled prevalence of COPD was 11.1% (95% confidence interval, CI: 7.4–14.8%), using the Global Initiative for Chronic Obstructive Lung Disease fixed criteria and 8.0% (95% CI: 5.6–10.4%) using the lower limit of normal criteria. The prevalence of COPD was highest in north India (19.4%) and Bangladesh (13.5%) and in men. The estimated pooled prevalence of chronic bronchitis was 5.0% (95% CI: 4.1–6.0%) in India and 3.6% (95% CI: 3.1–4.0%) in Pakistan.ConclusionIncluded countries have a high prevalence of COPD although it varied by geographical area and study characteristics. Future research in South Asia should use standardized diagnostic criteria to examine the contribution of setting-specific risk factors to inform prevention and control strategies.     

2016年12月全国艾滋病性病疫情

  目的  了解中国大陆地区大学生性行为发生情况,为学校开展大学生性教育提供参考依据。  方法  检索中国期刊全文数据库（CNKI）、万方数据资源系统和PubMed数据库,并辅以手工检索和文献追溯法收集2010年1月1日 — 2016年11月29日公开发表的关于中国大陆地区大学生性行为发生情况的相关文献,应用Stata 12.0软件对纳入的文献进行meta分析。  结果  最终纳入66篇文献（中文文献61篇和英文文献5篇）,累计研究对象476 262人。meta分析结果显示,中国大陆地区大学生性行为发生率为15.1 %（9 5 % CI=13.9 % ～16.4 %）。亚组分析结果显示,男大学生性行为发生率为21.1 %,高于女大学生的10.6 %,差异有统计学意义（χ² = 6 167.307,P < 0.001）;东部地区大学生性行为发生率为16.4 %,均高于中部地区大学生的14.8 % 和西部地区大学生的14.8 %,差异均有统计学意义（均P < 0.001）;大一、大二、大三和大四年级大学生性行为发生率分别为9.5 %、12.8 %、 18.2 % 和23.9 %,年级越高的大学生性行为发生率越高（χ_趋势² = 271.355,P < 0.001）;研究时间在2005 — 2009年大学生的性行为发生率为14.6 %,低于研究时间在2010 — 2015年的17.4 %,差异有统计学意义（χ² = 739.486,P < 0.001）。Begg秩相关结果显示本次纳入meta分析的文献不存在发表偏倚（Z = 0.26,P = 0.799）。  结论  中国大陆地区大学生性行为发生率较高,应根据大学生性行为的流行病学特征来制定干预措施,帮助学生形成正确的性观念,正确引导大学生的安全性行为,提高大学生的身心健康水平。     

Fruit and vegetables consumption and gastric cancer: a systematic review and meta-analysis of cohort studies

Fruit and vegetable intake is widely recognized as protective for gastric cancer occurrence but prospective research challenged this belief. To evaluate the influence of design options in such results we did a meta-analysis of relevant published cohort studies identified from inception to 2004 in PubMed, EMBASE, and LILACS. Random-effects meta-analysis, stratification, and meta-regression were used to pool effects and to analyze the association with type of outcome event and length of follow-up independent of other study characteristics. An inverse association was observed between fruit intake and gastric cancer incidence (relative risk, RR = 0.82; 95% confidence interval, CI = 0.73-0.93) and stronger for follow-up periods of > or = 10 yr (RR = 0.66; 95% CI = 0.52-0.83) but not when the study outcome was death (RR = 1.08; 95% CI = 0.86-1.35). For vegetables, the RR was 0.88 (95% CI = 0.69-1.13) using all incidence studies and 0.71 (95% CI = 0.53-0.94) when considering only those with the longer follow-up. The association observed between vegetable intake and gastric cancer mortality was 1.05 (95% CI = 0.89-1.25). Other study characteristics assessed added no significant contribution to explain heterogeneity. This meta-analysis showed that design options might play a key role in the observed magnitude or the direction of the association between fruit and vegetable intake and gastric cancer.     

Physical activity and risk of venous thromboembolism: systematic review and meta-analysis of prospective cohort studies

European Journal of Epidemiology - The inverse association between physical activity and arterial thrombotic disease is well established. Evidence on the association between physical activity and...     

Associations of working conditions and chronic low-grade inflammation among employees: a systematic review and meta-analysis

Objectives:Chronic low-grade inflammation has been identified as a key pathway linking stress experience to human health. However, systematic evaluations on the relationship of work stress and immune function are scarce and predominantly based on cross-sectional studies. We performed a systematic review and meta-analysis of prospective studies on associations of working conditions and inflammatory biomarkers.Methods:In line with our previously established study protocol and the PRISMA-guidelines, we systematically searched electronic databases for prospective studies on working conditions as well as workplace interventions and inflammatory markers in employees. We classified studies (by design, type of exposure/intervention, outcome) and performed rigorous risk-of-bias assessments. Studies were summarized qualitatively, and a meta-analysis was conducted.Results:We identified 23 eligible studies (N=16 432) with a broad scope of working conditions and inflammatory markers. For interventional designs, we differentiated between individual-directed/behavioral (including physical and mental) and organization-directed/structural interventions. Workplace physical exercise interventions were associated with a decrease in C-reactive protein (k=5; d=-0.61; P<0.001). For other workplace interventions, ie, mental and organizational/structural, results were inconclusive. Concerning observational studies, dimensions of the job demand–control(–support) model were most frequently investigated, and results showed weak – if any – associations with inflammatory markers.Conclusions:The research base was heterogeneous and high-level evidence was limited. More prospective studies are needed with broader consideration of work stressors and inflammatory markers. For practical occupational health management, exercise interventions are effective measures to reduce chronic low-grade inflammation.     

Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies

Objectives

We conducted a systematic review and meta-analysis to evaluate potential associations between firefighting and police occupations, and prostate cancer incidence and mortality.

Methods

Original epidemiological studies published from 1980 to 2017 were identified through PubMed and Web of Science. Studies were included if they contained specific job titles for ever/never firefighting and police work and associated prostate cancer risk estimates with 95% confidence intervals (CI). Study quality was assessed using a 20-point checklist. Prostate cancer meta-risk estimates (mRE) and corresponding 95% CIs were calculated for firefighting and police work separately and by various study characteristics using random effects models. Between-study heterogeneity was evaluated using the I² score. Publication bias was assessed using Begg’s and Egger’s tests.

Results

A total of 26 firefighter and 12 police studies were included in the meta-analysis, with quality assessment scores ranging from 7 to 19 points. For firefighter studies, the prostate cancer incidence mRE was 1.17 (95% CI = 1.08–1.28, I² = 72%) and the mortality mRE was 1.12 (95% CI = 0.92–1.36, I² = 50%). The mRE for police incidence studies was 1.14 (95% CI = 1.02–1.28; I² = 33%); for mortality studies, the mRE was 1.08 (95% CI = 0.80–1.45; I² = 0%). By study design, mREs for both firefighter and police studies were similar to estimates of incidence and mortality.

Conclusion

Small excess risks of prostate cancer were observed from firefighter studies with moderate to substantial heterogeneity and a relatively small number of police studies, respectively. There is a need for further studies to examine police occupations and to assess unique and shared exposures in firefighting and police work.

     

基于密切接触者队列的新型冠状病毒肺炎病程和相关流行病学参数研究

  目的   评价新冠肺炎暴发疫情中对密切接触者的密切接触者（次密接）进行集中隔离管控的效果。  方法  对2021年12月绍兴市上虞区一起由Delta变异株引起的新冠肺炎本土疫情的次密接管理信息数据库进行分析。如随访的次密接成为感染者,则进一步查阅分析其关联病例、关联密切接触者（密接）及次密接本人的流行病学调查报告。根据密接和次密接随访结局（感染新冠病毒与否）,建立有效、无效、负效和无法评价4类管控效果评价结果。采用描述流行病学方法对次密接管控效果进行评价。  结果  该起疫情共报告感染者387例,符合纳入标准的次密接共8192人,平均每个病例排查次密接21人。99.8 %的次密接经多轮新冠病毒核酸检测均为阴性,属无效管控。随访过程中18例（0.2 %）次密接检出核酸阳性,均为其关联密接同住的家庭成员,其中9例关联密接核酸检测结果全程阴性,提示次密接可能在转运或集中隔离过程中感染。对核酸检出阳性的18例次密接管控效果作进一步评价,结果判为有效的0例,判为无效、负效和无法评价的分别为3例（16.7 %）、9例（50.0 %）和6例（33.3 %）。  结论  该起新冠肺炎暴发疫情对次密接进行集中隔离管控未能取得正面的防控效果,少数次密接反而可能在转运或隔离过程中感染。建议取消暴发疫情中常规对次密接采取集中隔离措施,可代之以居家隔离管理,同时及时对一些涉及面广的防控措施开展效果评价。     

Body mass index and biliary tract disease: A systematic review and meta-analysis of prospective studies

ObjectiveTo evaluate the association between body mass index (BMI, kg/m²) and incidence of biliary tract disease.MethodsWe performed a systematic review and a meta-analysis of prospective studies by searching the database of PubMed and EMBASE published up to December 31, 2013. Outcome of interest was disease of biliary tract system (gallbladder, extrahepatic bile duct and Ampullar of Vater). We used a random-effects model to combine the study-specific relative risks (RRs) and 95% confidence intervals (95% CIs) from 22 prospective studies. We examined whether BMI was associated with a higher risk of biliary tract disease in a combined analysis.ResultsThe positive association was stronger for non-cancer biliary tract disease than biliary tract cancer; combined RRs (95% CIs) comparing the top with bottom categories were 1.40 (1.15–1.65) for biliary tract cancer and 2.75 (2.35–3.15) for non-cancer biliary tract disease (P for difference < 0.001). For non-cancer biliary tract disease, combined RRs (95% CIs) comparing the top with bottom categories were 3.21 (2.48–3.93) for women and 2.01 (1.66–2.37) for men (P for difference = 0.04).ConclusionObesity is associated with higher risks of biliary tract cancer and, to a greater extent, non-cancer biliary tract disease.