A prospective study of cigarette smoking and risk of cataract in men.

OBJECTIVE--To examine the association between cigarette smoking and the incidence of cataract. DESIGN, SETTING, AND PARTICIPANTS--The design was a prospective cohort study using data from the Physicians' Health Study, a randomized trial of aspirin and beta carotene among 22,071 US male physicians aged 40 to 84 years that began in 1982. This analysis includes the 17,824 physicians who did not report cataract at baseline and did provide complete risk factor information. Based on information reported at baseline, 10% were current smokers, 39% were past smokers, and 51% were never smokers. MAIN OUTCOME MEASURE--An incident cataract was defined as a self-report confirmed by medical record review to have been first diagnosed after randomization, age-related in origin, and responsible for a decrease in best corrected visual acuity to 20/30 or worse. MAIN RESULTS--During 60 months of follow-up, 557 incident cataracts among 371 participants were confirmed. Compared with never smokers, current smokers of 20 or more cigarettes per day had a statistically significant increase in the risk of cataract (relative risk [RR], 2.16; 95% confidence interval [Cl], 1.46 to 3.20; P less than .001). Similar results were obtained after simultaneously controlling for other potential cataract risk factors in a logistic regression model (RR, 2.05; 95% Cl, 1.38 to 3.05; P less than .001). Among the 557 eyes with cataract, nuclear sclerotic changes were present in 442 while posterior subcapsular changes were present in 204. After controlling for other potential cataract risk factors, current smokers of 20 or more cigarettes per day had statistically significant increases in nuclear sclerosis (RR, 2.24; 95% Cl, 1.47 to 3.41; P less than .001) and posterior subcapsular (RR, 3.17; 95% Cl, 1.81 to 5.53; P less than .001) cataract. Past smokers had an elevated risk of posterior subcapsular (RR, 1.44; 95% Cl, 0.97 to 2.13; P = .07) but not nuclear sclerosis cataract. For current smokers of fewer than 20 cigarettes per day, no increased risks were observed of total, nuclear sclerosis, or posterior subcapsular cataract. CONCLUSIONS--These data provide support for the hypothesis that cigarette smoking increases the risk of developing both nuclear sclerosis and posterior subcapsular cataract.     

A prospective study of cigarette smoking and risk of cataract surgery in women.

OBJECTIVE--To examine prospectively the association between cigarette smoking and the risk of cataract extraction in women. DESIGN--Prospective cohort study beginning in 1980 with 8 years of follow-up. SETTING--United States, multistate. PARTICIPANTS--Registered nurses 45 to 67 years of age and free of diagnosed cancer. There were 50,828 women included in 1980 and others were added as they became 45 years of age. MAIN OUTCOME MEASURE--Incidence of senile cataract extraction. RESULTS--We documented 493 incident senile cataracts diagnosed and extracted during 470,302 person-years of follow-up. The age-adjusted relative risk (RR) among women who smoked at least 65 pack-years was 1.63 (95% confidence interval [Cl], 1.18 to 2.26; P for trend, .02). A similar increase in RR was noted when smoking was assessed in terms of number of cigarettes currently smoked or number of cigarettes smoked by past smokers. Results were also similar after adjusting for other potential risk factors for cataract. Smoking was also strongly associated with posterior subcapsular cataract specifically (RR, 2.59; 95% Cl, 1.49 to 4.50 for greater than or equal to 65-pack-year smokers relative to nonsmokers. CONCLUSION--Smoking appears to increase the risk of cataract extraction.     

Parkinson＇s Disease and Smoking： An Integral Part of PD＇s Etiological Study

OBJECTIVE: To explore the association of Parkinson's disease (PD) with cigarette smoking. METHODS: One hundred of fourteen PD patients were compared with 205 control subjects who were matched by gender, race and residency. A previously validated questionnaire including smoking, alcohol/tea consumption as well as some other environmental exposure data was administered. RESULTS: With never-smokers as the reference category, we observed reduced risk for PD among ever smokers (OR=0.49, 95% CI: 0.30 to 0.79) current smokers (OR=0.44, 95% CI: 0.23 to 0.86) and ex-smokers (OR=0.54, 95% CI: 0.30 to 0.96). When ever smokers were stratified by years of smoking, there was an inverse correlation between those whose smoking history was longer than 20 years (OR=0.40 95% CI: 0.21 to 0.81) and an even mild protective correlation between those who smoked less than 20 years (OR=0.57, 95% CI: 0.33 to 0.99). Those who had quitted smoking for more than 20 years were less likely to have the disease than never smokers, and those who had quitted for less than 20 years were least likely to have PD, while those who were current smokers were still least likely to have the disease. We found significant inverse gradient with pack-day smoking (trend P<0.05), and the inverse correlation between cigarette smoking and PD was not confounded by alcohol/tea consumption and other confounding bias. CONCLUSIONS: The inverse correlation between Parkinson's disease risk and smoking as well as the trend of gradient dose response is again observed in our study. More future researches are needed to confirm these correlations and to explore further biochemical evidence.     

吸烟与口腔鳞癌发病相关性的病例对照研究

目的：探讨吸烟与口腔鳞癌发病之间的关系。方法：对病例组74例口腔鳞癌患者和对照组131例腮腺多形性腺瘤患者的吸烟史进行调查分析,对所得数据进行X^2检验,并计算优势比（OR）及其95％可信限,为排除性别和年龄这两个可能的混杂因素的影响,也对男性患者和45岁以上患者吸烟史进行对比分析。结果：对照组吸烟率为22．1％,病例组吸烟率为58．1％,明显高于对照组（P＜0．005）,OR为4．9,其95％可信限为2．7－8．9;在男性患者和45岁以上患者中,病例组吸烟率均显著大于对照组（P＜0．005）。结论：吸烟是口腔鳞癌发病的危险因素之一。     

Effects of SalB on the antioxidases

Background Dual anti-platelet treatment with aspirin and clopidogrel is established foundation for patients undergoing percutaneous coronary intervention （PCI） to prevent thrombotic events. The present study was conducted to examine whether the CYP2C19 681G〉A polymorphism and cigarette smoking had independent or interactive effect on response to clopidogrel. Methods Among 722 Chinese Han patients undergoing elective coronary stent placement due to stable angina pectoris, a loading dose of 300 mg clopidogrel was given to all patients and a daily maintenance dose of 75 mg for a minimum of 12 months. CYP2C19 681G〉A polymorphism was genotyped. The platelet reactivity was measured by light transmittance aggregometry （LTA） with 5 lumol/L adenosine diphosphate （ADP） induced. The poor response was defined as 10% or less absolute difference between aggregation at baseline and 24 hours after loading dose of clopidogrel. Results The results showed that the poor-response to clopidogrel was presented in 105 patients （14.5%）. Overall, the genotype GA/AA carriers were likely to be poor-responsive cases （19.6% vs. 11.0%, P=-0.001） with odds ratio （OF/） of 1.971 （95% CI： 1.296-2.998, P=0.002）, compared with the GG homozygotes. Meanwhile, compared with nonsmokers, the smokers showed lower rate of poor-response （10.9% vs. 17.3%, P=0.015） with OR of 0.582 （95% C/： 0.374-0.904, P=-0.016）. The smokers with GG genotype had the lowest risk with OR of 0.487 （95% CI： 0.246-0.961, P=-0.038） while nonsmokers with GA/AA genotype had the highest risk of poor-response with OR of 1.823 （95% C/： 1.083-3.068, P=0.024）, compared with nonsmokers with GG genotype. However, there was no significant interaction between genotype and smoking. Conclusion Our study indicated that both CYP2C19 polymorphism and smoking independently affected response to clopidogrel.     

Cigarette smoking associated with delayed conception

We conducted an epidemiologic study to test the hypothesis that women who smoke have reduced fertility. Data on smoking history and number of noncontracepting cycles until conception were collected from 678 pregnant women. Thirty-eight percent of nonsmokers conceived in their first cycle compared with 28% of smokers. Smokers were 3.4 times more likely to have taken greater than a year to conceive compared with nonsmokers. After adjusting for potential confounding variables by Cox proportional hazards regression, fertility of smokers was estimated to be 72% of the fertility of nonsmokers. Heavy smokers experienced lower fertility than did light smokers (57% and 75% of the pregnancy rate of nonsmokers, respectively). Fertility was not affected by the husband's smoking. These data provide evidence that reduced fertility should be added to the growing list of reproductive hazards of cigarette smoking.     

新疆维吾尔族和哈萨克族男性吸烟与代谢综合征的相关性

目的 探讨新疆维吾尔族和哈萨克族男性吸烟与代谢综合征(MS)的相关性.方法 2007年10月至2010年3月应用四阶段整群随机抽样法,在新疆抽取乌鲁木齐市、克拉玛依市、阜康市、吐鲁番地区、和田地区、伊犁哈萨克自治州等6个地区年龄在35岁以上的维吾尔族和哈萨克族男性人群作为样本.探讨两个民族男性人群吸烟与MS及各组分的相关性.结果 共调查维吾尔族和哈萨克族人群4019人,维吾尔族吸烟869人,哈萨克族1114人,两民族吸烟组MS患病率分别为24.74%和29.62%,非吸烟组MS患病率分别为16.75%,24.72%,差异有统计学意义(P＜0.05);进行同民族间基线资料比较发现在维吾尔族吸烟组中,收缩压、舒张压、腰围、血糖和甘油三酯均高于非吸烟组,而高密度脂蛋白小于非吸烟组,其中舒张压、腰围、甘油三酯在两组中比较差异有统计学意义(P＜0.05);在哈萨克族中吸烟组腰围、甘油三酯、收缩压和舒张压水平高于非吸烟组,但血糖和高密度脂蛋白在吸烟组中的水平均低于非吸烟组,其中收缩压、舒张压和腰围在两组间的比较差异有统计学意义(P＜0.01).通过Logistic多因素回归分析发现,在维吾尔族和哈萨克族MS中,吸烟OR值分别为1.698(95%CI 1.129～2.553)和1.845(95%CI 1.544～2.206),且P＜0.05.结论 新疆维吾尔族和哈萨克族男性吸烟人群中MS患病率较高,吸烟可能为维吾尔族及哈萨克族MS患病的危险因素之一.

Abstract：

Objective To investigate the prevalence and risk factors of smoking and metabolic syndrome (MS) among male Uygur and Kazakh adults residing in Xinjiang.Methods Four-stage selected random sampling was used to analyze the prevalence and the relationship between the risk factors of smoking and metabolic syndrome.The sampled adult populations over 35 years old were collected 6 localities (Urumqi,Kelamayi,Fukang,Turfan Basin locality,Hetian locality & Yili Kazakh Autonomous Prefecture) in Xinjiang,China.The subjects were 4019 males of Uygur and Kazakh.Each individual answered a questionnaire,received physical examinations and a biochemical indicator survey.The smoking patients were divided into two groups: one complicated with metabolic syndrome and the other not.A logistic regression analysis was also made to identify the possible risk factors and their powers on the prevalence of metabolic syndrome with smoking.Results With regards to the habit of smoking,the smokers of Uygur and Kazakh were 869 and 1114 respectively.The prevalence of MS was 24.74% and 29.62% for Uygur and Kazakh smokers respectively.And 16.75% and 24.72% for Uygur and Kazakh non-smokers respectively.The comparison of baseline information showed that,in Uygur males,the mean values of diastolic blood pressure,waist circumference and triglyceride were higher in smoker group than those in non-smoker group ( P ＜ 0.05 ); in Kazakh males,the mean values of systolic blood pressure,diastolic blood pressure and waist circumference were higher than nonsmoker group ( P ＜ 0.05 ).Logistic regression analysis showed that the OR value of smoking was 1.698 (95% CI 1.129 -2.553) in Uygur and 1.845(95% CI 1.544 -2.206)in Kazakh of MS patients.Conclusion The prevalence of MS is higher in male smokers than that in nonsmokers in Uygur and Kazakh.Perhaps smoking is one of the risk factors for MS.     

hOGG1 Ser326Cys and XRCC1 Arg399Gln polymorphisms associated with chronic obstructive pulmonary disease

Background Cigarette-smoke induced DNA damage can cause airway cell apoptosis and death, which may be associated with the development of chronic obstructive pulmonary disease （COPD）. However, only 20%-30% of smokers develop COPD, suggesting that different degrees of DNA repair produce different outcomes in smokers, i.e., part of them develop COPD. We investigated the association between polymorphisms in DNA repair genes hOGG1 （Ser326Cys） and XRCC1 （Arg399GIn）, alone or in combination, and susceptibility of COPD. Methods Altogether 201 COPD patients and 309 controls were recruited and frequency-matched on age and sex. hOGG1 and XRCC1 genotypes were determined by PCR-restriction fragment length polymorphism analysis. Results The risk of COPD was not significantly different among individuals with Ser/Cys and Cys/Cys genotypes compared with those with hOGG1 Ser/Ser genotype. The risk of COPD was not significantly different among individuals with Gin/Gin genotype compared with those with XRCC1 Arg/Arg genotype, but it was significantly elevated among individuals with Arg/GIn genotype （adjusted odds ratios （OR）=1.55, 95% confidence intervals （CI） 1.05-2.29, P=0.029）. Assessment of smoking status in current smokers compared with those with hOGG1 Ser/Ser genotype revealed that the risk of COPD was significantly elevated among individuals with Cys/Cys genotype （adjusted OR=5.07, 95% CI 1.84-13.95, P=0.002）. Compared with those with XRCC1 Arg/Arg genotype, the risk of COPD was significantly elevated among individuals with Arg/GIn genotype （adjusted OR=2.77, 95% CI 1.52-5.07, P=-0.001）. Assessment of smoking exposure in light smokers compared with those with hOGG1 Ser/Ser genotype showed that the risk of COPD was significantly elevated among individuals with Cys/Cys genotype （adjusted OR=4.02, 95% CI 1.05-16.80, P=0.042）. Compared with those with XRCC1 Arg/Arg genotype, the risk of COPD was significantly elevated among individuals with Gin/Gin genotype （adjusted OR=4.48, 95% CI 1.35-14.90, P=0.014）. In heavy smokers compared with those with XRCC1 Arg/Arg genotype, the risk of COPD was significantly elevated among individuals with Arg/GIn genotype （adjusted OR= 2.55, 95% CI 1.42-4.58, P=0.002）. When hOGG1 Ser326Cys and XRCC1 Arg399GIn polymorphisms were evaluated together, compared with those with 0-1 of hOGG1 326Cys and XRCC1 399Gin alleles, the risk of COPD was significantly elevated among individuals with 3-4 of hOGG1 326Cys and XRCC1 399Gin alleles （adjusted OR=3.18, 95% CI 1.86-5.43, P=0.000）. Assessment of smoking status and smoking exposure in current/light/heavy smokers showed that the risk of COPD was significantly elevated among individuals with 3-4 of hOGG1 326Cys and XRCC1 399Gin alleles （adjusted OR=8.32, 95% CI 3.59-19.27, P=0.000; OR=5.46, 95% CI 2.06-14.42, P=0.001; OR=2.93, 95% CI 1.43-6.02, P=0.003; respectively）. Conclusions hOGG1 Ser326Cys and XRCC1 Arg399GIn polymorphisms are associated with the susceptibility to COPD. The risk of COPD is significantly elevated among current/light smokers with hOGG1 326Cys and XRCC1 399Gin.     

不同性别人群吸烟与代谢综合征危险因素相关性分析

目的 探讨北京社区成人吸烟与代谢综合征危险因素的关系.方法 2007年4至8月期间接受代谢综合征危险因素调查的社区居民10 054名(18～92岁),使用卡方检验、Logistic回归分析对吸烟状况与代谢综合征的关系进行评估.结果 男性人群平均血压、甘油三酯(TG)、腰围水平高于女性,而高密度脂蛋白胆固醇(HDL-C)、体质指数(BMI)水平低于女性(P＜0.05).男性BMI、腰围分别为24.99 kg/m2、89.13 cm,女性分别为25.49 kg/m2、85.49 cm.两组人群年龄、血糖水平差异无统计学意义.男性吸烟人群的代谢综合征患病率显著高于不吸烟人群(23.0%比21.2%,P＜0.05).男性戒烟后腹围有升高的趋势,但吸烟者的高甘油三酯血症和低HDL-C血症发生风险显著升高.校正年龄、饮酒、运动后,从不吸烟、过去吸烟和现在吸烟的男性人群高甘油三酯血症相对风险[OR(95%CI)]分别为1.00、1.19(0.92～1.47)和1.36(1.02～1.69)(P＜0.05),低HDL-C血症分别为1.00、1.08(0.79～1.32)和1.59(1.13～1.89)(P＜0.05).患代谢综合征分别为1.00、1.10(0.76～1.43)和1.49(1.06～1.89)(P＜0.05).已戒烟男性随着戒烟时间的延长,代谢综合征的发生风险呈下降趋势.女性人群中吸烟仅与低HDL-C血症显著相关.结论 吸烟不显著增加女性代谢综合征发生风险.而在男性人群,尽管戒烟可能增加中心型肥胖的风险,但仍是男性人群发生代谢综合征的重要危险因素.

Abstract：

Objective Cigarette smoking is a risk factor for the development of insulin resistance.However,whether a smoker has a lesser waist circumference (WC) and whether the potential changes in WC may reduce the benefits of smoking cessation remains in dispute. The aims of this study are to re-examines the relationships between smoking and metabolic risk factors by the data from Beijing adults. Methods A total of 3710 men and 6344 women,aged 18 -92 years old,were sampled from community centers in Beijing for this cross-sectional clinical study between April and August 2007. Their concentrations of total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C) and plasma glucose (PG) were measured. And the anthropometric parameters (WC,body weight and height) and blood pressure (BP) were record according to a standard protocol. Their social,demographic,personal medical history and behavioral characteristics were collected by the welltrained staff. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. The relationships between smoking and metabolic syndrome were analyzed by x2 test and logistic regression. Results The mean age and glucose concentration were similar in both genders. Males tended to have a higher mean BP ( systolic and diastolic ),a higher level of TG and a lower HDL-C. Among the obesity indices,the mean WC was higher in males than that in females whereas the mean BMI higher in females. The means of BMI and WC were 24. 99 kg/m2 and 89. 13cm for males and 25.49 kg/m2 and 85.49 cm for females respectively. Smoking was an independent risk factor of metabolic syndrome in male subjects.It was mainly due to a higher prevalence of dyslipidemia,i.e. a higher level of TG and a lower level of HDL-C in smokers. And the trough prevalence of central obesity was higher in former smokers than current smokers. With adjustment for age,alcohol intake,and regular physical activity,the odds ratios[OR( 95%CI)] of never smokers,ex-smokers,and current smokers were 1.00,1.10(0. 92 - 1.47),and 1.36( 1.02- 1.69) for hypertriglyceridemia ( P ＜ 0. 05 ) and 1. 00,1.08 (0. 79 - 1.32),and 1.59 ( 1.13 - 1.89 ) for low H DL-C respectively (P ＜ 0. 05 ). The odds ratios of the MS were 1.00 (referent),1.10 (0. 76 -1.43 ),and 1.49 ( 1.06 - 1.89 ) for never smokers,ex-smokers,and current smokers respectively ( P ＜ 0. 05 ).Cessation of smoking had a general trend of lowering the risk of metabolic syndrome in a year-dependent manner in males. In females,the prevalence of metabolic syndrome and obesity was similar between smokers and nonsmokers. Among the features of metabolic syndrome,only a low HDL-C was associated with chronic smoking in females. Conclusion Although smokers tend to have a lower waist circumference than nonsmokers,the males have higher risk factors for metabolic disorders. There is no significant relationship between smoking and metabolic syndrome in female subjects.     

Prevalence of risk factors associated with human papillomavirus infection in women living with HIV

BACKGROUND: Concurrent infection with HIV and human papillomavirus (HPV) in women is associated with increased rates of cervical dysplasia and shorter survival following the development of cervical cancer. The authors examined risk factors for HPV infection at study entry in HIV-positive women enrolled in the Canadian Women's HIV Study, a prospective open cohort study. METHODS: Subjects eligible for this analysis included the 375 HIV-positive women in the Canadian Women's HIV Study for whom HPV test results were available. Questionnaires on behavioural and clinical information, Pap smears, cervicovaginal lavage specimens and vaginal tampon specimens for HPV detection and typing by polymerase chain reaction were obtained at study entry. RESULTS: Overall, 67.2% (252/375) of the women were HPV-positive; the global prevalence of intermediate- and high-risk oncogenic HPV types was 49.1% (184/375). Women with squamous cell dysplasia (32/294) were more likely to have HPV infection than those without dysplasia (90.6% v. 62.6%; p = 0.002). Multivariate logistic regression analysis, with adjustment for number of lifetime partners and history of STD, revealed that the following risk factors were independently associated with HPV infection: CD4 count of less than 0.20 x 10(9)/L (adjusted odds ratio [OR] 1.99 [95% confidence interval (Cl) 1.17-3.37 (p = 0.011)]), non-white race (adjusted OR 2.00 [95% Cl 1.17-3.42 (p = 0.011)]), inconsistent condom use in the 6 months before study entry (adjusted OR 2.02 [95% Cl 1.16-3.50 (p = 0.013)]), and lower age, with women age 30-39 years (adjusted OR 0.51 [95% Cl 0.30-0.87 (p = 0.013)]) and age 40 years or older (adjusted OR 0.52 [95% Cl 0.26-1.01 (p = 0.052)]) compared with women less than 30 years of age. INTERPRETATION: Close monitoring for HPV-related effects is warranted in all HIV-positive women, particularly younger, non-white women who do not always use condoms. Counselling for women living with HIV, particularly younger women, should emphasize the importance of regular cytological screening, with increasing frequency as the CD4 count falls.     

Effects of disease stage and zidovudine therapy on the detection of human immunodeficiency virus type 1 in semen.

OBJECTIVE--To determine the prevalence and temporal expression of infectious human immunodeficiency virus type 1 (HIV-1) in the semen of HIV-1 seropositive men and to determine whether the detection of HIV-1 in semen is associated with disease stage, zidovudine treatment status, or other clinical factors. DESIGN--A microculture technique was used to detect infectious HIV-1 in semen from a cohort of 95 seropositive men. In addition, semen cultures were performed monthly for at least 6 months for 14 of the men. Information was obtained by interview and extracted from medical records to identify clinical variables associated with HIV-1 in semen. PATIENTS--Sixty HIV-1 seropositive homosexual men participating in clinical studies at the Fenway Community Health Center, Boston, Mass, and 35 HIV seropositive bisexual or heterosexual men participating in the California Partner Study of the University of California, San Francisco. MAIN OUTCOME MEASURES--Semen HIV-1 culture results, seminal leukocyte counts, Centers for Disease Control (CDC) disease stage, peripheral CD4+ cell counts, zidovudine therapy, HIV risk category. RESULTS--In the cross-sectional study, HIV-1 was cultured from the semen of nine (9%) of 95 men. Factors associated with detection of HIV-1 in semen were peripheral CD4+ cell counts of 0.20 x 10(9)/L (200/microL) or less (adjusted odds ratio [OR], 23.33; 95% confidence interval [Cl], 2.89 to 175.63); symptomatic (CDC class IV) disease (adjusted OR, 6.56; 95% Cl, 1.02 to 66.76); and seminal leukocytosis (greater than 1 x 10(9) white blood cells per liter of semen) (adjusted OR, 7.02; 95% Cl, 1.28 to 39.29). Zidovudine therapy was associated with decreased detection of HIV-1 in semen (adjusted OR, 0.04; 95% Cl, 0.00 to 0.63). In the longitudinal study of 14 men who had neither peripheral CD4+ cells counts of 0.20 x 10(9)/L or less nor seminal leukocytosis, seminal HIV-1 was detected in at least one sample from six men (43%). CONCLUSION--HIV-1 is more commonly found in semen from men with advanced HIV-1 infection and seminal leukocytosis but can also be cultured from semen of men with neither of these conditions. Zidovudine therapy may decrease the prevalence and/or titer of seminal HIV-1. However, all HIV-1-infected persons should continue to assume that they are potentially infectious through sexual contact.     

Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease.

OBJECTIVE--To evaluate the association between prior infection with Chlamydia pneumoniae, as measured by IgG antibody, and coronary artery disease. DESIGN--A population-based, case-control study. SETTING--Group Health Cooperative of Puget Sound, a Seattle-based health maintenance organization. PARTICIPANTS--Men 55 years of age and younger and women 65 years of age and younger. Cases (n = 171) were members of Group Health Cooperative undergoing diagnostic coronary angiography who had at least one coronary artery lesion occupying 50% or more of the luminal diameter. The population controls (n = 120) were Group Health Cooperative members without known coronary heart disease. MAIN OUTCOME MEASURE--The adjusted odds ratio (OR) for coronary artery disease associated with prior C pneumoniae infection as measured by the presence of IgG antibody. RESULTS--After adjusting for age, gender, and calendar quarter of blood drawing, the OR for coronary artery disease associated with the presence of antibody was 2.6 (95% confidence interval, 1.4 to 4.8). The association was limited to cigarette smokers, in whom the OR was 3.5 (95% confidence interval, 1.7 to 7.0). Among never-smokers, the OR was 0.8 (95% confidence interval, 0.3 to 1.9). When cases and controls were restricted to those assayed concurrently, the adjusted OR (smokers and nonsmokers combined) was 4.2 (95% confidence interval, 1.8 to 10.0). Adjustment for serum cholesterol, hypertension, alcohol use, diabetes, and socioeconomic status did not change these results. Only a week association was found when cases were compared with 63 subjects whose angiographic results were normal (OR, 1.2; 95% confidence interval, 0.6 to 2.2). CONCLUSIONS--These results generally support the previously reported association between C pneumoniae infection and coronary heart disease. However, caution should be used in interpreting the basis for this association.     

HIV infection seroprevalence and risk factor study among pregnant women attending the Antenatal Clinic at the University Hospital of the West Indies,Kingston, Jamaica

The objectives of this study were to determine the seroprevalence and risk factors for Human Immunodeficiency Virus (HIV) infection among the antenatal clinic population at the University Hospital of the West Indies (UHWI). Pregnant mothers (4186) attending antenatal clinic at the UHWI were screened for HIV infection between September, 1998, and October, 2000. Tests were performed with the use of Abbott enzyme immunoassay (EIA) kits for the detection of antibodies to HIV 1 and 2. Demographic characteristics and risk factor assessments were performed using a questionnaire for all positive cases and four randomly selected negative controls matched by age to each positive case. Twenty-one women were found to be HIV positive. Nineteen of these women were not previously aware that they were HIV-positive. The seroprevalence of HIV infection among antenatal mothers was 0.5%. The mean age of cases was 29.3 +/- 4.6 years. There was no significant difference between cases and controls with regards to parity, socio-economic status and educational achievement. Women residing in urban Kingston and St Andrew (Odds ratio (OR) 5, 95% confidence interval (CI) 1.4, 18), as well as those with a higher number of lifetime sexual partners (OR 1.42, 95% CI 1.13, 1.79) and those with previous sexually transmitted diseases (OR 3.4, 95% CI 1.1, 10.6) were at greater risk for HIV infection. In contrast, women who commenced coitus at a later age were at less risk of becoming infected (OR 0.79, 95% CI 0.6, 0.97). This study demonstrates a low seroprevalence of HIV in the UHWI antenatal population compared to the reported seroprevalence of 2%-8% in pregnant women in Latin America and the Caribbean. The results from this study emphasize the continuing need for voluntary HIV testing and HIV/AIDS educational campaign for this vulnerable group.     

Acute effects of passive smoking on the coronary circulation in healthy young adults

CONTEXT: Recent studies have shown that passive smoking is a risk factor for ischemic heart disease and may be associated with vascular endothelial dysfunction. The acute effects of passive smoking on coronary circulation in nonsmokers are not known. OBJECTIVE: To determine the acute effects of passive smoking on coronary circulation using coronary flow velocity reserve (CFVR), assessed by noninvasive transthoracic Doppler echocardiography. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study conducted from September 2000 to November 2000 among 30 Japanese men (mean age, 27 years; 15 healthy nonsmokers and 15 asymptomatic active smokers) without history of hypertension, diabetes mellitus, or hyperlipidemia. MAIN OUTCOME MEASURES: Coronary flow velocity reserve, calculated as the ratio of hyperemic to basal coronary flow velocity induced by intravenous infusion of adenosine triphosphate and measured in each participant before and after a 30-minute exposure to environmental tobacco smoke. RESULTS: Heart rate and blood pressure responses to adenosine triphosphate infusion were not affected by passive smoking exposure in either group. Passive smoking exposure had no effect on basal coronary flow velocity in either group. Mean (SD) CFVR in nonsmokers was significantly higher than that in active smokers before passive smoking exposure (4.4 [0.91] vs 3.6 [0.88], respectively; P =.02), while CFVR after passive smoking exposure did not differ between groups (P =.83). Passive smoking exposure significantly reduced mean (SD) CFVR in nonsmokers (4.4 [0.91] vs 3.4 [0.73], respectively; P<.001). CONCLUSIONS: Passive smoking substantially reduced CFVR in healthy nonsmokers. This finding provides direct evidence that passive smoking may cause endothelial dysfunction of the coronary circulation in nonsmokers.     

Effect of age and cigarette smoking on carcinoembryonic antigen levels.

Serum carcinoembryonic antigen (CEA) levels were determined by the Hansen-Z-gel technique in 276 healthy volunteers, of whom 154 were smokers and 122 nonsmokers. The mean CEA level was significantly higher in smokers (2.7 ng/ml) than in nonsmokers (1.9 ng/ml) (P less than .001), and a significantly higher percentage of smokers had elevated CEA levels (P less than .05). In both groups, CEA levels were directly related to age. Seventy-six of the 154 smokers who entered the study ceased smoking. Their CEA levels were determined at one, three, and six months after cessation of smoking. Within three months after cessation, elevated CEA levels declined to within the range of nonsmokers and did not appear to be influenced by previous smoking habits. Both age and smoking history must be considered for accurate evaluation of CEA levels. A reappraisal of the diseases associated with elevated CEA levels that considers the influence of age and smoking may invalidate some of the correlations previously reported.     

Smoking-induced leukocytosis can persist after cessation of smoking

BACKGROUND: Associations between smoking and leukocytosis or elevated hemoglobin concentrations in the blood need to be validated using multivariate analysis. METHODS: A total of 2,511 male subjects aged 25-62 years participated in an annual health examination held at their workplace. The relationship between white blood cells (WBC) and hemoglobin (Hb) levels in blood and smoking status was then evaluated using a cross-sectional survey and multiple logistic regression analysis. Age, body mass index (BMI), smoking and drinking status, diastolic blood pressure, and physical activity were used as covariate factors. RESULTS: Odds ratios (ORs) and 95% confidence intervals (95% CIs) of WBC of >9,000 counts/mm3 of total blood for current smokers and ex-smokers with a period of 5-9.9 years since smoking cessation vs. that of nonsmokers were 12.1 (7.0-21.0) and 3.8 (1.2-12.0), respectively. OR (95% CI) of Hb level >16 g/dL of total blood for current smokers vs. nonsmokers was 1.6 (1.1-2.3). Significant ORs for elevated Hb level in total blood were also observed for age (OR, 1.0; 95% CI, 0.9-1.0), BMI >25 (OR, 2.2; 95% CI, 1.6-3.1), and diastolic blood pressure of >90 mmHg (OR, 2.2; 95% CI, 1.5-3.2). CONCLUSIONS: Current smoking is associated with increase in WBC count and Hb levels in total blood, the former relationship recognized in subjects who have stopped smoking for 5-9.9 years. Obesity and aging are inversely related with Hb level in blood.     

A case-control study of association between life-style, alcohol dehydrogenase 2 and aldehyde dehydrogenase 2 genotype and idiopathic osteonecrosis of the femoral head

A case-control study of idiopathic osteonecrosis of femoral head (ION) was carried out to investigate the association between workload intensity, smoking, drinking, ADH2 and ALDH2 genotype and other factors and development of ION by comparing 43 cases (34 males and 9 females) without history of systemic corticosteroid use with 86 matched controls (68 males and 18 females). Univariate analysis by conditional logistic regression for males showed statistically significant odds ratios (OR) for heavier workload (OR = 4.661), cumulative alcohol consumption (OR trend per drink-years = 1.015), ALDH2(1/1) (OR = 3.310), consumption of green tea less than 3 or 4 times/week (OR = 2.705), body weight over 60 kg at examination (OR = 0.413), or body mass index of over 25 at examination (OR = 0.208). Multivariate analysis based on a hierarchically well-formulated model strategy for males revealed that heavier workload (OR = 5.785, 95% confidence interval (CI): 1.211, 27.635) and cumulative alcohol consumption (OR = 1.016, 95% CI: 1.005, 1.026) remained as the significantly associated risk factors for ION after adjusting the remaining confounders. The reason for the insignificant multivariate OR of ALDH2(1/1) may be due to the strong confounding of alcohol consumption on the association between ALDH2 genotype and ION. For females, the small sample size made it impossible to produce any meaningful univariate analysis.     

竞争风险模型在吸烟与缺血性脑卒中复发关系研究中的应用

目的 探讨吸烟与缺血性脑卒中患者复发的关系。方法 对首发卒中患者进行随访观察,采用竞争风险模型,分性别建模,探讨男性吸烟、女性被动吸烟与脑卒中复发的关系。结果 本研究最终共纳入初发缺血性脑卒中患者594例进行分析,男性361例（复发59例,竞争事件13例）,女性233例（均为非吸烟者,复发49例,竞争事件11例）。校正混杂因素后,相对于既无主动又无被动吸烟的男性而言,除无主动仅有被动吸烟的男性相对危险度对应 P值为0.050外(SHR=3.040),吸烟指数第二分组（100~200 支年）相对危险度为0.947外,虽然其余各对比组SHR均大于1,但差异均无统计学意义。本研究也未发现吸烟指数等级和累积吸烟量与缺血性脑卒中复发有关。相对于无被动吸烟的女性而言,基线有而随访时无被动吸烟组危险比为1.4,其余各对比组相对危险度均小于1,无统计学意义。结论 本次研究尚未发现吸烟与缺血性脑卒中复发有关系,尚需更大样本的研究进行验证。     

Impact of HIV/sexually transmitted infection testing on risky sexual behaviors among men who have sex with men in Langfang, China

Background Men who have sex with men (MSM) in China remain at high risk for HIV infection,the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011.HIV testing an...     

Seroprevalence of and risk factors for HIV-1 infection in injection drug users in Montreal and Toronto: a collaborative study.

OBJECTIVE: To determine the prevalence of antibodies to HIV-1 and risk factors for HIV-1 infection among injection drug users. DESIGN: Questionnaire survey. A venous blood sample was taken for HIV-1 antibody testing. SETTING: Montreal and Toronto. PARTICIPANTS: A total of 810 subjects who had used injection drugs in the previous 6 months recruited mainly from treatment centres and from the street in Montreal (425 subjects) and from treatment centres in Toronto (385 subjects) between September 1988 and September 1990. The overall participation rate was 82%. OUTCOME MEASURES: HIV-1 seropositivity, sociodemographic and behavioural risk factors for HIV-1 infection. RESULTS: The overall seroprevalence rate of HIV-1 infection was 4.8% (95% confidence limits [CL] 3.5 and 6.5). In Montreal the rate was 8.2% (95% CL 6.0 and 11.2), and in Toronto 1.0% (95% CL 0.4 and 2.6) (p < 0.001). Seropositive subjects were significantly older (p = 0.041) and were more likely to have a history of imprisonment (p = 0.006) than seronegative subjects. In univariate analysis seropositivity was associated with the following behaviours: more frequent cocaine use (p < 0.001), injecting drugs in "shooting galleries" (p = 0.002), sharing equipment with a person known to be HIV-1 seropositive (p = 0.006), "booting" fresh blood (p = 0.004), homosexual or bisexual orientation (p = 0.006), engaging in prostitution (p < 0.001) and, for men, number of male sexual partners in the previous 6 months (p = 0.007). In multivariate analysis the determinants of HIV-1 seropositivity were Montreal as the city of recruitment (odds ratio [OR] 6.7, 95% CL 2.32 and 19.42), engaging in prostitution (OR 2.13, 95% CL 1.01 and 4.75), a history of imprisonment (OR 3.51, 95% CL 1.33 and 9.29) and sharing equipment with a person known to be HIV-1 seropositive (OR 4.43, 95% CL 1.43 and 13.74). CONCLUSIONS: Our findings show that HIV-1 is circulating among injection drug users in Montreal and Toronto and that both drug use and sexual behaviours are implicated in the transmission of infection in the populations studied. Adapted preventive programs should be developed to prevent further spread of HIV-1 infection in this population.