Interaction of Polymorphisms of Resistin Gene Promoter -420C/G,Glutathione Peroxidase -1 Gene Pro198Leu and Cigarette Smoking in Nonalcoholic Fatty Liver Disease

Background:

Many studies have suggested that cigarette smoking and polymorphisms of resistin and glutathione peroxidase-1 (GPx-1) genes are closely correlated with the pathogenesis of nonalcoholic fatty liver disease (NAFLD). However, few reports have investigated these associations with respect to NAFLD susceptibility. We, therefore, examined the distribution of polymorphisms in GPx-1 and resistin genes in NAFLD patients and healthy controls and analyzed the relationship between these polymorphisms and smoking status.

Methods:

Nine hundred NAFLD patients and 900 healthy controls were selected, and the genetic polymorphisms of resistin gene promoter-420C/G and GPx-1 gene Pro198Leu were analyzed by polymorphism-polymerase chain reaction (PCR) in DNA extracted from peripheral blood leukocytes. Interactions between the two mutants and the gene–environment interaction with cigarette smoking were also analyzed.

Results:

Genotype frequencies of −420C/G (GG) and Pro198Leu (LL) were significantly higher in NAFLD cases (49.56% and 50.11%, respectively) compared with healthy controls (23.67% and 24.22%, respectively) (P = 0.0069; P = 0.0072). Moreover, the risk of NAFLD with −420C/G (GG) was significantly higher than in controls (odds ratio [OR] =3.1685, 95% confidence interval (CI) =1.9366–5.2073). Individuals carrying Pro198Leu (LL) had a high risk of NAFLD (OR = 3.1424, 95% CI = 1.7951–5.2367). Combined analysis of the polymorphisms showed that the −420C/G (GG)/Pro198Leu (LL) genotype was significantly more common in the NAFLD group than in the control group (39.44% vs. 12.78%, respectively, P = 0.0054), while individuals with −420C/G (GG)/Pro198Leu (LL) had a high risk of NAFLD (OR = 5.0357, 95% CI = 3.1852–7.8106). Moreover, the cigarette smoking rate in the NAFLD group was significantly higher than in the control group (OR = 1.8990, P = 0.0083 in the smoking index (SI) ≤400 subgroup; OR = 5.0937, P = 0.0051 in the SI >400 subgroup), and statistical analysis suggested a positive interaction between cigarette smoking and −420C/G (GG) (γ = 5.6018 in the SI ≤400 subgroup; γ = 4.4770 in the SI >400 subgroup) and Pro198Leu (LL) (γ = 5.7715 in the SI ≤400 subgroup; γ = 4.5985 in the SI >400 subgroup) in increasing the risk of NAFLD.

Conclusion:

NAFLD risk factors include -420C/G (GG), Pro198Leu (LL) and cigarette smoking, and these three factors have a significant additive effect on NAFLD risk.     

Prevalence and Associated Factors of Diabetes Mellitus in a Very Elderly Chinese Population: A Cross-sectional Study

Objectives This paper aimed to investigate the prevalence of diabetes mellitus(DM) and explore the associated risk factors in a very elderly southwest Chinese population.Methods From September 2015 to June 2016, a cross-sectional survey was conducted to obtain a representative sample of 1,326 participants over 80 years old living in Chengdu. The presence of DM was based on fasting plasma glucose(FPG) and 2-h plasma glucose(2-h PG) levels during an oral glucose tolerance test(OGTT). A logistic regression model was used to calculate the odds ratios(ORs) and 95%confidence intervals(CIs) of the potential associated factors.Results The participants' mean age was 83.5 ± 3.1 years. The overall prevalence of DM was 27.4%. The prevalence was higher in males(30.2%) than females(24.7%)(P = 0.02). The prevalence of DM increased with body mass index(BMI) and decreased with aging. The multivariate analysis suggested that male sex(OR = 1.433; 95% CI, 1.116–1.843), hypertension(OR = 1.439; 95% CI, 1.079–1.936), overweight or obesity(OR = 1.371; 95% CI, 1.023–1.834), high heart rate(≥ 75 beats/min; OR = 1.362; 95% CI,1.063–1.746), and abdominal obesity(OR = 1.615; 95% CI, 1.216–2.149) were all significantly positively correlated with DM. However, age was negatively correlated with DM(OR = 0.952; 95% CI,0.916–0.989).Conclusions The prevalence of DM and newly diagnosed DM in a very elderly southwest Chinese population was high. OGTT screening should be performed regularly in people aged ≥ 80 years to ensure timely diagnosis of DM.     

ApaI,BsmI, FokI,and TaqI Polymorphisms in the Vitamin D Receptor Gene and Parkinson's Disease

Background:

The vitamin D receptor (VDR) gene has been identified as a candidate gene for susceptibility to Parkinson''s disease (PD), but results from genetic association studies to date are inconsistent. Here, we conducted a meta-analysis of published case-control studies to evaluate the association of the extensively studied VDR ApaI (G/T), BsmI (G/A), FokI (C/T), and TaqI (T/C) gene polymorphisms with risk of PD.

Methods:

Electronic search at PubMed, EMBASE, EBSCO, China National Knowledge Infrastructure, Weipu database, and Wanfang database was conducted to identify all relevant studies. Odds ratio (OR) with 95% confidence interval (CI) values was applied to evaluate the strength of the association.

Results:

A total of seven studies with 2034 PD cases and 2432 controls were included in the meta-analysis following the inclusion and exclusion criteria. Overall, no significant association between ApaI, BsmI, and TaqI gene polymorphisms and PD susceptibility in all four genetic models was found (T vs. G: OR = 1.00, 95% CI: 0.89–1.12, P = 0.97; A vs. G: OR = 0.94, 95% CI: 0.77–1.15, P = 0.53; C vs. T: OR = 1.03, 95% CI: 0.85–1.25, P = 0.77) while a significant association between FokI (C/T) and PD risk was observed (C vs. T: OR = 1.41, 95% CI: 1.14–1.75, P = 0.001; CC vs. TT: OR = 2.45, 95% CI: 1.52–3.93, P = 0.0002; CT vs. TT: OR = 2.21, 95% CI: 1.38–3.52, P = 0.0009, CC vs. CT+TT: OR = 2.32, 95% CI: 1.49–3.61, P = 0.0002).

Conclusions:

Polymorphisms of ApaI, BsmI, and TaqI may not be associated with the susceptibility to PD while the FokI (C/T) polymorphism is possibly associated with increased PD risk. However, conclusions should be cautiously interpreted due to the relatively small number of studies included.     

Penehyclidine Hydrochloride Premedication Is Not Associated with Increased Incidence of Post-Operative Cognitive Dysfunction or Delirium: A Systemic Review and Meta-Analysis

ObjectivePost-operative cognitive dysfunction (POCD) and post-operative delirium (POD) are two common post-operative cerebral complications. The current meta-analysis was to systematically review the effects of penehyclidine hydrochloride (PHC) on POCD and POD in surgical patients.MethodsElectronic databases were searched to identify all randomized controlled trials comparing PHC with atropine/scopolamine/placebo on POCD and POD in surgical patients. Primary outcomes of interest included the incidences of POCD and POD; the secondary outcomes of interest included peri-operative mini-mental state examination (MMSE) scores. Two authors independently extracted peri-operative data, including patients’ baseline characteristics, surgical variables, and outcome data. For dichotomous data (POCD and POD occurrence), treatment effects were calculated as odds ratio (OR) and 95% confidential interval (CI). Each outcome was tested for heterogeneity, and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity. For continuous variables (MMSE scores), treatment effects were calculated as weighted mean difference (WMD) and 95% CI. Statistical significance was defined as P<0.05.ResultsOur search yielded 33 studies including 4017 patients. Meta-analysis showed that, the incidence of POCD in PHC group was comparable to that in saline group (OR = 0.97; 95% CI: 0.58-1.64; P = 0.92), scopolamine group (011 = 0.78; 95% CI: 0.48-1.27; P= 0.32) and atropine group (OR = 1.20; 95% CI: 0.86-1.67; P = 0.29). The incidence of POD in PHC group was comparable to that in saline group (OR = 1.53; 95% CI: 0.81-2.90; P = 0.19) and scopolamine group (OR = 0.53; 95% CI: 0.06-4.56; P = 0.56), but higher than that in atropine group (OR = 4.49; 95% CI: 1.34-15.01; P = 0.01).ConclusionsPHC premedication was not associated with increased incidences of POCD or POD as compared to either scopolamine or placebo.     

Effect of Body Mass Index on the Associations between Parity and Metabolic Syndrome and its Components among Northern Chinese Women

Objectives The aims of this study were to assess the associations between parity and metabolic syndrome(Met S) and its components and to evaluate the effects of body mass index(BMI) on these associations.Methods A total of 5,674 women were enrolled from Jidong and Kailuan communities(Tangshan,Hebei) in Northern China. All participants completed standardized questionnaires, physical examination,and biochemical measurements. Logistic regression analysis was used to test the associations.Results Compared with women with parity of one, nulliparous women had decreased odds ratios(ORs); those with parity of two had odds of abdominal obesity [OR = 1.45, 95% confidence interval(CI)1.17–1.81, P 0.001], high blood pressure(OR = 1.26, 95% CI: 1.03–1.54, P = 0.025), elevated fasting glucose levels(OR = 1.36, 95% CI: 1.03–1.79, P = 0.029), and Met S(OR = 1.39, 95% CI: 1.13–1.73, P =0.002); and those with parity of three or more had increased odds of elevated triglyceride levels(OR =1.42, 95% CI: 1.04–1.94, P = 0.027) and Met S(OR = 1.50, 95% CI: 1.10–2.05, P = 0.011) after complete adjustment for confounders. Furthermore, BMI and age subgroups partially modified the associations between parity and Met S and its components.Conclusions Parity is positively associated with Met S and select components in women. BMI is an important modifier involved in the associations between parity and MetS.     

Mediation Effects of Placental Inflammatory Transcriptional Biomarkers on the Sex-Dependent Associations between Maternal Phthalate Exposure and Infant Allergic Rhinitis: A Population-Based Cohort Study

ObjectivePrenatal phthalate exposure has been associated with placental inflammatory factors and infant allergic rhinitis (AR). However, the results are inconclusive. We designed a population-based cohort study to examine the effects of placental inflammatory biomarkers on the sex-dependent associations between maternal phthalate exposure and infant AR.MethodsA total of 2,348 pregnant women from Ma'anshan, Anhui Province, China, who were screened before antenatal visits and met the inclusion criteria, were included in the present study. We assessed AR in their offspring aged 36 months with a questionnaire. Quantitative PCR was performed to measure placental inflammatory factor mRNAs. The independent samples t-test and multivariable logistic regression were used to determine the associations between infant AR and maternal phthalates.ResultsChildhood AR may be related to education and family monthly income (P = 0.01). The phthalate metabolites, mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-hydroxyl) phthalate (MEHHP), in pregnant women were associated with a significantly increased risk for infant AR in males [P < 0.05; odds ratio (OR): 1.285; 95% confidence interval (CI): 1.037–1.591, and OR: 1.232, 95% CI: 1.008–1.507, respectively], but not females. Additionally, irritably-increased expression levels of HO-1 and IL-4 were associated with AR in male infants (OR: 1.175; 95% CI: 1.038–1.329 and OR: 1.181; 95% CI: 1.056–1.322, respectively). The association between maternal urinary MEHHP and placental HO-1 was marginally significant according to mediation analysis.ConclusionThe associations of maternal MEHHP and MEOHP levels with fetal AR in males were significant. Placental HO-1 was a fractional mediator in the associations between MEHHP and AR. Thus, the placenta should be further investigated as a potential mediator of maternal exposure-induced disease risk in children.     

不同严重程度急性缺血性卒中患者静脉溶栓预后的影响因素分析

目的观察不同严重程度急性缺血性卒中(AIS)患者静脉溶栓远期预后和出血转化的影响因素。方法回顾性分析2009年6月至2013年12月在浙江大学医学院附属第二医院神经内科因AIS接受静脉溶栓治疗患者的资料, 根据美国国立卫生研究院卒中量表(NIHSS)将患者分为轻度(≤8分)、中度(9~15分)、重度(≥16分)三组, 分别观察影响患者溶栓后的预后(3月时改良Rankin评分≤2分定义为预后良好)及发生出血转化的因素。结果共365例患者纳入分析:轻度134例、中度121例、重度110例。轻度AIS患者中, 年龄[ OR=0.937, 95%可信区间( CI): 0.898~0.978; P=0.003]、基线NIHSS( OR=0.732, 95% CI: 0.564~0.950; P=0.019)、发病至治疗时间在270 min内( OR=4.109, 95% CI: 1.441~11.719; P=0.008) 是预后良好的独立影响因素; 而基线血糖( OR=1.326, 95% CI: 1.009~1.743; P=0.043) 是发生脑实质出血型出血转化的独立影响因素。中度AIS患者中, 年龄( OR=0.954, 95% CI: 0.924~0.984; P=0.003)、基线NIHSS( OR=0.760, 95% CI: 0.619~0.933; P=0.009) 是预后良好的独立影响因素; 而心房颤动( OR=3.307, 95% CI: 1.140~9.596; P=0.028)、收缩压( OR=0.967, 95% CI: 0.943~0.991; P=0.008) 是发生出血性梗死型出血转化的独立影响因素, 心房颤动( OR=36.972, 95% CI: 1.770~772.462; P=0.02) 是发生脑实质出血型出血转化的独立影响因素。重度AIS患者中, 基线NIHSS( OR=0.808, 95% CI: 0.677~0.963; P=0.018) 是预后良好的独立影响因素, 未发现发生溶栓后出血转化的独立影响因素。 结论对于不同严重程度的AIS患者, 影响静脉溶栓后远期预后及发生出血转化的影响因素不尽相同; 发病至治疗时间在270 min内是轻度AIS患者静脉溶栓后3个月预后良好的独立影响因素; 心房颤动是中度AIS患者静脉溶栓后发生出血转化的独立影响因素。     

亚甲基四氢叶酸还原酶基因rs1801133位点多态性与肺癌发生风险的关联分析

目的 探讨亚甲基四氢叶酸还原酶（MTHFR）基因rs1801133位点多态性与肺癌发生风险的相关性。方法 采用病例-对照研究设计,纳入上海市及江苏省泰州地区肺癌患者974例和健康对照1 005例作为研究对象,采集研究对象外周血液后提取全血基因组DNA进行MTHFR基因rs1801133位点基因分型,用非条件logistic回归分析评估该位点单核苷酸多态性与肺癌发生风险的相关性。结果 总人群中MTHFR基因rs1801133位点CT基因型与TT基因型个体肺癌的发生风险均低于CC基因型个体[比值比（OR）=0.801,95%置信区间（CI）：0.651~0.985,P=0.035;OR=0.754,95%CI：0.582~0.975,P=0.032],但经年龄、性别、吸烟状况和恶性肿瘤家族史校正后差异无统计学意义（校正后OR=0.841,95%CI：0.677~1.045,P=0.118;OR=0.799,95%CI：0.609~1.047,P=0.104）。校正后分层分析结果显示,在显性模型中CT+TT基因型男性和恶性肿瘤家族史阳性者肺癌发生风险均较CC基因型对应人群降低（OR=0.764,95%CI：0.597~0.977,P=0.032;OR=0.600,95%CI：0.385~0.925,P=0.022）,CT+TT基因型人群发生肺鳞状细胞癌的风险较CC基因型人群降低（OR=0.727,95%CI：0.542~0.976,P=0.033）。结论 MTHFR基因rs1801133位点C>T突变降低了男性和恶性肿瘤家族史阳性者肺癌的发生风险,尤其是鳞状细胞癌的患病风险。     

Association between Serum Alkaline Phosphatase and Carotid Atherosclerosis in a Chinese Population: A Community-based Cross-sectional Study

Objective This study aimed to investigate the relationship between alkaline phosphatase(ALP) and common carotid intima media thickness(IMT), carotid plaque, and extracranial carotid artery stenosis(ECAS). Methods A total of 3,237 participants aged ≥ 40 years were recruited from Jidong community in 2013-2014. Participants were divided into five quintile groups based on their serum ALP levels. Carotid atherosclerosis was assessed using ultrasound. Abnormal IMT, carotid plaque, and ECAS were defined as IMT > 0.9 mm, IMT > 1.5 mm, and ≥ 50% stenosis in at least one extracranial carotid artery, respectively. Results Common carotid IMT values and the prevalence of carotid plaque increased across serum ALP quintiles. Higher ALP quintiles were correlated with an increased risk of abnormal IMT [fourth quintile: odds ratio(OR) 1.78, 95% confidence interval(CI) 1.13-2.82, P = 0.0135;fifth quintile: OR = 1.82, 95% CI: 1.15-2.87, P = 0.0110] and ECAS compared to the lowest quintile(fifth quintile: OR = 1.47, 95% CI: 1.09-1.97, P = 0.0106). The association between ALP and prevalence of carotid plaque became insignificant after adjustment for confounders. Conclusion Serum ALP levels were independently associated with abnormal common carotid IMT and ECAS. These conclusions need to be further corroborated in future prospective cohort studies.     

Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents

Objective To assess the subjective perception of residents on the built environment in hygienic cities and its relation to the self-rated health(SRH) status of residents, providing a basis for a better promotion on construction of health-supportive environments.Methods The online survey was adopted with the respondents recruited from residents living in Chaoyang District of Beijing in January 2021. With SRH level as the dependent variable, two-category logistic regression analysis was conducted ...     

A Nested Case-Control Study to Explore the Association between Immunoglobulin G N-glycans and Ischemic Stroke

ObjectiveThis study prospectively investigates the association between immunoglobulin G (IgG) N-glycan traits and ischemic stroke (IS) risk.MethodsA nested case-control study was conducted in the China suboptimal health cohort study, which recruited 4,313 individuals in 2013–2014. Cases were identified as patients diagnosed with IS, and controls were 1:1 matched by age and sex with cases. IgG N-glycans in baseline plasma samples were analyzed.ResultsA total of 99 IS cases and 99 controls were included, and 24 directly measured glycan peaks (GPs) were separated from IgG N-glycans. In directly measured GPs, GP4, GP9, GP21, GP22, GP23, and GP24 were associated with the risk of IS in men after adjusting for age, waist and hip circumference, obesity, diabetes, hypertension, and dyslipidemia. Derived glycan traits representing decreased galactosylation and sialylation were associated with IS in men (FBG2S2/(FBG2 + FBG2S1 + FBG2S2): odds ratio (OR) = 0.92, 95% confidence interval (CI): 0.87–0.97; G1ⁿ: OR = 0.74, 95% CI: 0.63–0.87; G0ⁿ: OR = 1.12, 95% CI: 1.03–1.22). However, these associations were not found among women.ConclusionThis study validated that altered IgG N-glycan traits were associated with incident IS in men, suggesting that sex discrepancies might exist in these associations.     

Association between Mean Ocular Perfusion Pressure and Diabetic Retinopathy in a Northeastern Chinese Population

Objective To evaluate the association between diabetic retinopathy(DR) and mean ocular perfusion pressure(MOPP) in patients with type 2 diabetes mellitus(T2 DM).Methods Patients from the Fushun Diabetic Retinopathy Cohort Study(FS-DIRECT), a communitybased prospective cohort study conducted in northeast China, were included in this study. The presence and severity of DR were determined by grading fundus photographs according to the Early Treatment Diabetic Retinopathy Study(ETDRS) retinopathy scale. Systolic and diastolic blood pressure(SBP and DBP) were recorded using an electronic sphygmomanometer. Intraocular pressure(IOP) was measured using an iCare rebound tonometer. MOPP was calculated using the formula MOPP = 2/3 [DBP + 1/3(SBP-DBP)]-IOP.Results In total, 1,857 patients who had gradable fundus photography and MOPP data were enrolled in this study. Male patients had a higher MOPP than female patients(52.25 ± 8.75 vs. 50.96 ± 8.74 mmHg, P = 0.002). Overall, both male and female patients with any type of DR, non-proliferative DR(NPDR), or non-sight-threatening DR(non-STDR) had significantly higher MOPP relative to patients without DR. Increased MOPP(per 1 mmHg) was in turn associated with the presence of any type of DR[odds ratio(OR) = 1.03, 95% confidence interval(CI) : 1.02–1.04], NPDR(OR = 1.03 95% CI: 1.02–1.04),and non-STDR(OR = 1.03, 95% CI: 1.01–1.04) after adjusting for confounders. Increased MOPP(per 1 mmHg) was also associated with an increased likelihood of macular edema(OR = 1.02, 95% CI:1.01–1.04).Conclusions The results suggest that increased MOPP was associated with DR and macular edema in northeastern Chinese patients with T2 DM.     

急性缺血性卒中患者静脉溶栓后24小时血压变异与血流再灌注的相关性研究

目的明确急性缺血性卒中患者静脉溶栓后24 h血压变异对脑组织再灌注以及3个月后神经功能结局的影响。方法连续收集2009年6月至2014年9月期间在浙江大学医学院附属第二医院行多模式MRI检查或CT灌注扫描, 接受静脉溶栓治疗的急性缺血性卒中患者的临床、影像、溶栓后24 h内动态血压监测资料, 评估溶栓后24 h再灌注情况及3个月改良Rankin评分。记录血压均值和变异指标, 后者包括标准差(sd)、连续变异度(sv)、上升变异(sv-rise)和下降变异(sv-drop)。采用二元logistic回归分析血压变异指标对再灌注及神经功能结局的影响。结果最终纳入188例患者, 其中114例(60.6%)达到再灌注, 74例(39.4%)未达到再灌注。二元logistic回归分析提示, 静脉溶栓后24 h内收缩压连续变异(SBPsv), 尤其是上升变异(SBPsv-rise)较大者不易达到再灌注(sv: OR=0.421, 95% CI:0.187~0.950, P=0.037;sv-rise: OR=0.311, 95% CI:0.137~0.704, P=0.005)。同时, 静脉溶栓后24 h SBPsv-rise高者不易达到早期神经功能恢复( OR=0.372, 95% CI:0.166~0.832, P=0.016);SBPsv、SBPsv-rise和SBPsv-drop是溶栓治疗3个月后患者神经功能不良结局的独立危险因素(sv: OR=6.381, 95% CI:2.132~19.096, P=0.001;sv-rise: OR=5.615, 95% CI:2.152~14.654, P < 0.001;sv-drop: OR=3.009, 95% CI: 1.263~7.169, P=0.013)。 结论急性缺血性卒中患者早期收缩压变异越大越不利于脑组织再灌注和早期神经功能恢复, 并与静脉溶栓治疗后3个月患者神经功能不良结局有关。     

Possible Risk Factors for Severe Complications Occurring after Primary Total Knee Arthroplasty

ObjectiveTotal knee arthroplasty is one of the most common orthopedic surgeries. Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons. In this study, we evaluated the risk factors for severe complications after primary total knee arthroplasty.MethodsWe retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital. Postoperative complication > grade IE was defined as severe complication according to Clavien-Dindo classification system. Binary logistic regression was used to identify the predictive risk factors for severe complications.ResultsThe complication rate after primary total knee arthroplasty was 6.8% and severe complication rate was 2.5%. Male (OR = 2.178, 95%CI: 1.324-3.585, P = 0.002), individuals above 75 years old (OR = 1.936, 95%CI: 1.155-3.244, P = 0.012), arrhythmia (OR = 2.913, 95%CI: 1.350-6.285, P = 0.006) and cerebrovascular disease (OR = 2.804, 95%CI: 1.432-5.489, P = 0.003) were predictive risk factors for severe complications after primary total knee arthroplasty.ConclusionAdvanced age, male, arrhythmia, and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty. Special attention should be paid to patients with risk factors.     

Association between Serum Uric Acid to HDL-Cholesterol Ratio and Nonalcoholic Fatty Liver Disease Risk among Chinese Adults

Objective The aim of this case-control study was to explore the association between serum uric acid to high density lipoprotein cholesterol ratio(UHR) and the risk of nonalcoholic fatty liver disease(NAFLD) in Chinese adults.Methods A total of 636 patients with NAFLD and 754 controls were enrolled from the Affiliated Hospital of Qingdao University, China, between January and December 2016. All patients completed a comprehensive questionnaire survey and underwent abdominal ultrasound examination ...     

Clustering of Risk Behaviors and their Social Determinants among Primary School Learners in Beijing,China: A Cross-sectional Study

Background:

Studies in developed countries reveal that poor lifestyle choices triggering diseases typically cluster among children. However, there is insufficient evidence on the clustering of risk behaviors among children in developing countries. This study aimed to determine the clustering of risk behaviors and their social determinants among 4^th-and 5^th -grade learners in Beijing, China.

Methods:

The sample comprised of 967 learners from six primary schools enrolled migrant and resident learners by two-stage stratified cluster sampling. Prevalence denoted the risk behaviors and their clustering. A log-linear model was used to explore the clustering patterns. Ordinal logistic regression determined the influence of demographic characteristics, school environment, and family context on behavioral clustering.

Results:

The prevalence of none, one, two, and three or more risk factors was 61.2%, 20.0%, 10.8%, and 8.1% for infectious diseases and 46.0%, 30.6%, 15.4%, and 8.0% for chronic diseases, respectively. Some behaviors appeared dependent and were more likely to be observed together. The three most influential factors for infectious diseases were school type (odds ratio [OR] =4.47, 95% confidence interval [CI] 3.00–6.66), school located in an inner suburb (OR = 0.27, 95% CI 0.18–0.38), and gender (OR = 0.56, 95% CI 0.42–0.74). Regarding risk behaviors for chronic diseases, clustering was not associated with household registration status and number of appliances, but was significantly associated with school type (OR = 5.36, 95% CI 3.72–7.73), school located in an inner suburb (OR = 0.59, 95% CI 0.43–0.81), and gender (OR = 0.61, 95% CI 0.47–0.78). School environment variables were the most significant contributor to the number of risk behaviors.

Conclusions:

The characteristics of schools enrolling migrants and residents influenced the number of risk behaviors. Therefore, improved school conditions and integrated behavioral interventions are particularly recommended for health promotion.     

Association between ApoE Polymorphism and Type 2 Diabetes: A Meta-Analysis of 59 Studies

Objective To identify the important risk factors for type 2 Diabetes Mellitus(T2 DM) and develop effective strategies to address the problem of T2 DM. Our study aimed to evaluate the association between apolipoprotein E(Apo E) genetic polymorphism and type 2 diabetes, and to provide clues for the etiology of T2 DM.Methods Based on the criteria of inclusion and exclusion, we extracted, pooled, analyzed and assessed the case-control studies of Apo E polymorphism and T2 DM published in Pub Med, Web of Science,Medline, Wan Fang, VIP, and CNKI databases by R soft-ware(version 3.4.3). We used Random-effect models when heterogeneity was present in between-study, and fixed-effect models otherwise.Results We had 59 studies covering 6,872 cases with T2 DM and 8,250 controls, and compared the alleles and genotypes of Apo E between cases and controls. When we conducted a comparison between Apo E ε4 and ε3 alleles, we produced a pooled OR of 1.18(95% CI: 1.09-1.28; P 0.001). Apo E ε2/ε2 genotype displayed a possible association with T2 DM(OR = 1.46; 95% CI: 1.11-1.93; P = 0.007), ε3/ε4 genotype showed a 1.11-fold risk(OR = 1.11; 95% CI: 1.01-1.22; P = 0.039) and ε4/ε4 genotype had a1.71-fold risk of developing T2 DM(OR = 1.71; 95% CI: 1.33-2.19; P 0.001) when they were compared with ε3/ε3 genotype.Conclusions There is an association between Apo E polymorphism and T2 DM: allele ε4 and genotypes(ε2/ε2, ε3/ε4, and ε4/ε4) are associated with the increased risk for the development of T2 DM, and they may be risk factors for T2 DM.     

显微镜下多血管炎患者继发弥漫性肺泡出血和肺间质病的临床特征及预后分析（英文）

目的 评估继发于显微镜下多血管炎（microscopic polyangiitis,MPA）的弥漫性肺泡出血和/或肺间质病患者的临床特征以及预后相关因素。方法 回顾性分析2002年至2012年于北京协和医院内科住院的MPA患者,根据肺受累类型不同分为单纯肺间质病组、单纯弥漫性肺泡出血组、弥漫肺泡出血合并肺间质病组和无肺受累组。比较各组患者人口学资料、全身症状、脏器受累情况、实验室检查、治疗与预后。采用Logistic回归和Cox分析患者早期与晚期死亡的危险因素。结果 共181例MPA患者纳入研究,其中单纯肺间质病组96例、单纯弥漫性肺泡出血组19例、弥漫肺泡出血合并肺间质病组18例、无肺受累组48例。随访时间的中位数为67个月（范围：1～199个月）。单纯弥漫性肺泡出血组肾脏受累最严重（血肌酐中位值：449μmol/L,显著高于单纯肺间质病组（123μmol/L,Nemenyi=-35.215,P=0.045）和弥漫肺泡出血合并肺间质病组（359μmol/L,Nemenyi=-43.609,P=0.007）。单纯肺间质病组患者年龄大于单纯弥漫性肺泡出血组（中位年龄：69比57岁;Nem...     

Study of Clinical and Genetic Risk Factors for Aspirin-induced Gastric Mucosal Injury

Background:

Current knowledge about clinical and genetic risk factors for aspirin-induced gastric mucosal injury is not sufficient to prevent these gastric mucosal lesions.

Methods:

We recruited aspirin takers as the exposed group and healthy volunteers as the control group. The exposed group was categorized into two subgroups such as subgroup A as gastric mucosal injury diagnosed by gastroscopy, including erosion, ulcer or bleeding of the esophagus, stomach, or duodenum; subgroup B as no injury of the gastric mucosa was detected by gastroscopy. Clinical information was collected, and 53 single nucleotide polymorphisms were evaluated.

Results:

Among 385 participants, 234 were in the aspirin-exposed group. According to gastroscopy, 82 belonged to subgroup A, 91 belonged to subgroup B, and gastroscopic results of 61 participants were not available. Using the Chi-square test and logistic regression, we found that peptic ulcer history (odds ratio [OR] = 5.924, 95% confidence intervals [CI]: 2.115–16.592), dual anti-platelet medication (OR = 3.443, 95% CI: 1.154–10.271), current Helicobacter pylori infection (OR = 2.242, 95% CI: 1.032–4.870), male gender (OR = 2.211, 95% CI: 1.027–4.760), GG genotype of rs2243086 (OR = 4.516, 95% CI: 1.180–17.278), and AA genotype of rs1330344 (OR = 2.178, 95% CI: 1.016–4.669) were more frequent in subgroup A than subgroup B. In aspirin users who suffered from upper gastrointestinal bleeding, the frequency of the TT genotype of rs2238631 and TT genotype of rs2243100 was higher than in those without upper gastrointestinal bleeding.

Conclusions:

Peptic ulcer history, dual anti-platelet medication, H. pylori current infection, and male gender were possible clinical risk factors for aspirin-induced gastric mucosal injury. GG genotype of rs2243086 and AA genotype of rs1330344 were possible genetic risk factors. TT genotype of rs2238631 and TT genotype of rs2243100 may be risk factors for upper gastrointestinal bleeding in aspirin users.     

上海地区高出生体质量与儿童肥胖关系的横断面研究

目的 探讨高出生体质量与儿童肥胖之间的关系,为预防和减少儿童肥胖的发生提供科学依据。方法 采用多阶段分层整群随机抽样调查方法,选取70 284名3~12岁上海儿童作为研究对象,通过问卷调查收集所有研究对象年龄、性别、体质量、身高、新生儿时期数据（包括出生孕周、出生体质量和喂养方式）等信息,分析高出生体质量与儿童肥胖之间的关系。结果 男孩高出生体质量组和正常出生体质量组超重、肥胖及重度肥胖构成比差异均有统计学意义（P均<0.05）,女孩高出生体质量组和正常出生体质量组超重、肥胖及重度肥胖构成比差异有统计学意义（P均<0.05）。经多变量logistic回归模型调整年龄及性别因素后,高出生体质量是引起儿童超重（OR=1.41,95%CI 1.33~1.51,P<0.05）、肥胖（OR=1.45,95%CI 1.31~1.62,P<0.05）、重度肥胖（OR=1.51,95%CI 1.35~1.68,P<0.05）的独立危险因素;调整年龄、性别及新生儿特征因素（包括孕周、喂养模式）后,高出生体质量是引起儿童超重（OR=1.40,95%CI 1.31~1.50,P<0.05）、肥胖（OR=1.44,95%CI 1.28~1.61,P<0.05）、重度肥胖（OR=1.42,95%CI 1.25~1.60,P<0.05）的独立危险因素。结论 高出生体质量是儿童超重、肥胖和重度肥胖的重要危险因素。