非酒精性脂肪性肝病与结直肠腺瘤发病相关性的Meta分析

[目的]系统评价非酒精性脂肪性肝病(NAFLD)与结直肠腺瘤之间的关系。[方法]计算机检索中国知网、万方数据库、中国生物医学文献数据库、中国维普数据库、PubMed、Web of science、Embase、Cochrane图书馆等数据库，纳入涉及NAFLD与结直肠腺瘤关系的研究。根据文献纳入及排除标准筛选文献并评价质量，采用RevMan5.3对纳入文献进行Meta分析，stata15.0对文献进行发表偏移检验。[结果]最终纳入15篇研究，包括6401例结直肠腺瘤患者。Meta分析结果显示：NAFLD与结直肠腺瘤的关系密切(OR=1.58,95%CI:1.37～1.82,P<0.000 01)。各研究组分析显示：在国内组与国外组、超声检查组与CT检查组以及病例对照研究组、队列研究组与横断面研究组中病例者与对照者相比均差异有统计学意义(P<0.05)。[结论]NAFLD与结直肠腺瘤发病具有一定相关性。     

他汀类药物预防结直肠肿瘤的Meta分析

目的系统评价他汀类药物对结直肠癌的发病率及病死率的影响。方法使用Medline等数据库收集他汀类药物与结直肠肿瘤相关的文献,筛选高质量文献,分别计算RR或OR值以及95%CI等,分析他汀类药物预防结直肠癌及结直肠腺瘤的作用,运用漏斗图评价发表偏倚。结果共纳入30项研究,研究对象2 417 713例。他汀类药物预防结直肠癌的森林图提示存在统计学差异(RR=0.87,95%CI:0.77-0.99,P=0.03),他汀类药物预防结直肠腺瘤的森林图不存在统计学差异(OR=0.61,95%CI:0.31-1.22,P=0.16),漏斗图分析各项研究未发现发表偏倚。结论他汀类药物对结直肠癌可能起到一定的化学预防作用,而对结直肠腺瘤的作用有待进一步研究。     

2型糖尿病患者结直肠腺瘤临床病理特征和进展期腺瘤危险因素分析

背景:结直肠腺瘤为结直肠癌的癌前病变,糖尿病可增加结直肠癌发生风险。目的:探讨2型糖尿病患者结直肠腺瘤的临床病理特征以及进展期腺瘤的危险因素。方法:回顾性连续收集2018年1月—2020年12月在浙江中医药大学附属第二医院初次行全结肠镜检查者,227例2型糖尿病结直肠腺瘤患者、553例2型糖尿病无息肉患者和与2型糖尿病腺瘤组1∶1匹配[匹配因素包括性别、年龄、体质指数(BMI)和吸烟史]的227例非糖尿病结直肠腺瘤患者纳入研究。总结2型糖尿病结直肠腺瘤患者的临床和病理特点,采用单因素和多因素分析筛选进展期腺瘤的危险因素。结果:与2型糖尿病无息肉组相比,2型糖尿病腺瘤组年龄更大,男性、吸烟者和有胆囊结石/胆囊切除史者比例更高(P均0.05)。与非糖尿病腺瘤组相比,2型糖尿病腺瘤组多发腺瘤和进展期腺瘤比例更高(16.7%对10.1%,21.6%对14.1%,P均0.05)。多因素Logistic回归分析显示,男性(OR=1.299,95%CI:1.041～1.831,P=0.008)、年龄(OR=1.129,95%CI:1.001～1.421,P=0.025)、BMI(OR=1.118,95%CI:1.022～1.715,P=0.038)和2型糖尿病(OR=1.408,95%CI:1.141～1.721,P=0.010)是进展期腺瘤的独立危险因素。结论:2型糖尿病患者有更高的结直肠多发腺瘤和进展期腺瘤检出率,男性、年龄、BMI和2型糖尿病与进展期腺瘤显著相关。     

内镜下黏膜切除术治疗结直肠进展期腺瘤

目的探讨内镜下黏膜切除术(endoscopic mucosal resection,EMR)治疗直径≥1.5 cm结直肠亚蒂及广基进展期腺瘤的安全性及有效性,为EMR治疗较大结直肠进展期腺瘤提供依据。方法回顾性分析2014年1月-2015年1月陆军总医院消化内镜中心结直肠息肉治疗病例,收集符合纳入标准的结直肠亚蒂及广基进展期腺瘤,以腺瘤大小、位置、病理组织学和形态学为变量,分析腺瘤整块切除和术中出血的影响因素。结果共收集76例患者106枚腺瘤,男47例,女29例,平均年龄(60.9±10.8)岁;整块切除89枚(84.0%),术中少量出血23枚(21.7%),无穿孔及迟发性出血;术后随访观察52枚(49.1%),平均随访时间(6.4±3.9)个月,仅1枚(2.0%)腺瘤发现可疑残留,术后病理为炎性改变。多因素回归分析发现,组织学分化(OR=3.4,95%CI:1.2~13.2)和腺瘤位于弯曲部位(OR=3.1,95%CI:1.0~12.6)是影响术中出血的主要因素;组织学分化(OR=5.1,95%CI:1.1~23.2)和腺瘤直径≥3.0 cm(OR=28.7,95%CI:1.1~749.8)是整块切除的危险因素。结论 EMR治疗直径≥1.5 cm结直肠亚蒂及广基进展期腺瘤整块切除率高,无迟发性出血、穿孔等严重并发症,是一种安全有效的治疗方法。     

内蒙古地区生活、饮食因素对结直肠息肉的影响

背景:结直肠息肉尤其是腺瘤性息肉被认为是结直肠癌的癌前病变,其发生与生活方式、饮食习惯、遗传因素等有关。目的:探讨内蒙古地区生活、饮食因素对结直肠息肉发生的影响。方法:采用以结肠镜检查为基础的病例对照研究。选择2012-2013年在包头医学院第二附属医院检出结直肠息肉者100例作为病例组,同期200例性别、年龄、民族匹配且未检出息肉者作为对照组,进行包括人口统计学资料、生活方式、饮食习惯等内容的问卷调查,对可能与结直肠息肉有关的变量行单因素分析,有统计学意义者进一步行多因素条件Logistic回归分析。结果:Logistic回归分析显示,经调整年龄、性别、民族、婚姻状况、文化程度等因素,生活因素中,吸烟(OR=1.3,95%CI:1.0~1.8)、饮酒(OR=1.5,95%CI:1.1~2.0)为结直肠息肉的危险因素,体育锻炼≥4次/周为保护因素(OR=0.6,95%CI:0.4~0.8);饮食因素中,常食细粮(OR=1.7,95%CI:1.2~2.8)、喜食肥肉(OR=1.4,95%CI:1.2~1.9)、常食盐浸/腌制(OR=1.4,95%CI:1.1~1.8)、烧烤/油炸食品(OR=1.6,95%CI:1.1~2.3)为危险因素,常食蔬菜(OR=0.6,95%CI:0.4~0.9)、水果(OR=0.5,95%CI:0.4~0.7)为保护因素。结论:内蒙古地区结直肠息肉的发生与不良生活、饮食习惯有关,戒除烟酒、加强体育锻炼、常食蔬菜、水果、少食动物脂肪和加工食品可能降低结直肠息肉的发生风险。     

勃起功能障碍与糖尿病患者冠心病风险相关性的Meta分析

目的系统评价糖尿患者群中勃起功能障碍(ED)与冠状动脉粥样硬化性心脏病(CHD,冠心病)发病风险关系。方法检索Pub Med、Embase、中国知网、中国生物医学文献数据库及万方数据库中公开发表的探讨ED与CHD发病风险关系的观察性研究,对符合纳入标准的文献提取数据,采用CMA v2软件进行Meta分析。结果最终纳入3个队列研究、1个病例-对照研究和9个横断面研究。Meta分析结果显示,与单纯糖尿病相比,同时患有ED的人群罹患CHD的风险显著增加(队列研究:RR=1.72,95%CI:1.50~1.98,P0.01;病例对照和横断面研究:OR=3.07,95%CI=2.05~4.59,P0.01),敏感性分析显示结果稳健性好。结论糖尿病合并ED患者CHD风险显著增加,但ED是糖尿病患者群的危险因素还是仅为标记物仍待进一步研究。     

PDE4D基因SNP83多态性与中国人群缺血性脑卒中相关性的Meta分析

目的通过Meta分析的方法综合评价磷酸二酯酶4D(PDE4D)基因SNP83多态性与中国人群缺血性脑卒中(IS)的相关性。方法计算机检索Pub Med、EMbase、CNKI、CBM、Wanfang Data和VIP,搜集关于探讨PDE4D基因SNP83多态性与中国人群IS相关性的病例-对照研究,检索时限均为建库至2017年1月。由两人独立对符合纳入标准的研究进行数据提取,并对纳入研究按照NOS量表进行质量评价,然后采用Stata 12.0软件进行Meta分析。结果共纳入14项病例-对照研究,中文文献9篇,英文文献5篇,包括4119例IS和4286例对照。总体Meta分析结果显示,对于中国汉族人群,PDE4D基因SNP83多态性与IS发病风险无相关性(C vs.T:OR=1.13,95%CI:0.95~1.33,P=0.17;CC vs.TT:OR=1.12,95%CI:0.80~1.57,P=0.52;CT vs.TT:OR=1.22,95%CI:0.91~1.63,P=0.23;CC vs.CT+TT:OR=1.10,95%CI:0.81~1.49,P=0.56;CC+CT vs.TT:OR=1.14,95%CI:0.93~1.41,P=0.21)。结论当前研究证据显示,PDE4D基因SNP83多态性与中国汉族人群IS发病风险无相关性。由于纳入研究数量的限制,该结论尚需进一步开展相关研究进行验证。     

非甾体抗炎药与结直肠息肉的关系:系统回顾与Meta分析

目的:对已发表的文献进行系统回顾,评价服用非甾体抗炎药(non-steroidal antiinflammatory drugs,NSAIDs)与结肠息肉危险性的关系.方法:检索1966/2007-12数据库PubMed,EMBASE,Cantcrlit,ISI以及Cochrane Collaboration controlled trials register收录的文献.若研究的临床和方法学合理,则以随机效应模型统计OR值和95%CI.对研究设计方法、研究人群、药物种类、服用NSAIDs的频率和疗程进行亚组分析.结果:共纳入39篇文献.其中17篇为随机对照临床试验,12篇为病例对照研究,10篇队列研究.NSAIDs显著降低散发性结直肠息肉的发生或复发.随机对照临床试验OR为0.63(95%CI:0.53-0.75,P=0.37),病例对照研究OR值为0.70(95% CI:0.61-0.80,P=0.02),队列研究OR值为0.86(95% CI:0.77-0.96,P=0.02).NSAIDs减少家族性腺瘤型息肉病(FAP)患者息肉的数量和大小.分层分析显示,阿司匹林和其他NSAIDs降低结肠息肉危险性的作用相似,并存在剂量依赖性.结论:NSAIDs减少结直肠息肉的危险性,还需临床研究进一步确定在特殊人群中预防性使用NSMDs的最佳剂量和疗程.     

口袋法和传统方法在内镜黏膜下剥离术治疗结直肠肿瘤中临床疗效的Meta分析

目的系统性评价口袋法和传统方法在内镜黏膜下剥离术(ESD)治疗结直肠肿瘤中的有效性及安全性。方法通过计算机检索PubMed、The Cochrane Library、EMbase、中国知网、CBM和万方数据库,查找所有比较口袋法ESD和传统方法ESD治疗结直肠肿瘤疗效的病例对照试验,检索时间为1979年1月至2020年3月。同时手工检索纳入文献的参考文献,按照纳入及排除标准筛选文献、提取资料,采用RevMan 5.3软件进行Meta分析。结果共纳入5篇相关研究,共979例病例。Meta分析结果显示:(1)有效性:口袋法组整块切除率高(RR=1.06,95%CI:1.03～1.09,Z=4.51,P0.00001),治愈性切除率高(RR=1.08,95%CI:1.03～1.13,Z=3.14,P=0.002),解剖速度快(MD=3.07,95%CI:0.79～5.35,Z=2.64,P=0.008),手术时间差异无统计学意义(MD=-13.89,95%CI:-30.63～2.86,Z=1.63,P=0.10)。(2)安全性:口袋法组穿孔率低(RR=0.32,95%CI:0.14～0.76,Z=2.59,P=0.01),出血率差异无统计学意义(RR=1.24,95%CI:0.58～2.69,Z=0.56,P=0.58)。结论现有证据显示,口袋法较传统方法在ESD治疗结直肠肿瘤中有更高的有效性、解剖速度和更低的穿孔率。今后仍需要开展更多大样本、双盲、随机对照及多中心的临床研究,从而明确口袋法与传统方法对比的优越性,以便临床医师在工作中更好地判断口袋法的优势及其推广应用的价值。     

男男性行为者队列保持率及影响因素的Meta分析

目的采用Meta分析评价中国男男性行为者(MSM)队列保持状况及影响因素,为开展MSM队列研究提供依据。方法通过检索Pubmed、CNKI、万方数据库和维普数据库,收集2010-2016年10月发表的关于MSM队列保持的研究文献,并对纳入文献进行质量评价,应用Stata 12.0软件进行异质性检验及合并队列保持率,计算发表偏倚和进行敏感性分析。结果共16篇文献入选。Meta分析表明,合并之后中国MSM队列保持率为61.3%。当地居住时间[比值比(OR)=2.072,95%可信区间(CI):1.765~2.432]、既往HIV检测(OR=1.803,95%CI:1.568~2.073)、年龄(OR=1.806,95%CI:1.361~2.395)、文化程度(OR=1.962,95%CI:1.453~2.649)、本地户口(OR=2.714,95%CI:1.980~3.721)、参加6个月随访(OR=17.668,95%CI:8.050~38.779),是MSM队列保持的相关因素。结论中国MSM队列保持率为61.3%,当地居住时间长、既往做过HIV检测、年龄大、文化程度高、本地户口、参加6个月随访的MSM更容易完成队列随访。     

Fish consumption and colorectal cancer risk in humans: a systematic review and meta-analysis

BackgroundFish consumption may protect against colorectal cancer, but results from observational studies are inconsistent; therefore, a systematic review with a meta-analysis was conducted.MethodsRelevant studies were identified by a search of MEDLINE and EMBASE databases to May 2011, with no restrictions. Reference lists from retrieved articles also were reviewed. Studies that reported odds ratio (OR) or relative risk estimates with 95% confidence intervals (CIs) for the association between the consumption of fish and the risk of colorectal, colon, or rectal cancer were included. Two authors independently extracted data and assessed study quality. The risk estimate (hazard ratio, relative risk, or OR) of the highest and lowest reported categories of fish intake were extracted from each study and analyzed using a random-effects model.ResultsTwenty-two prospective cohort and 19 case-control studies on fish consumption and colorectal cancer risk met the inclusion criteria and were included in the meta-analysis. Our analysis found that fish consumption decreased the risk of colorectal cancer by 12% (summary OR, 0.88; 95% CI, 0.80-0.95). The pooled ORs of colorectal cancer for the highest versus lowest fish consumption in case-control studies and cohort studies were 0.83 (95% CI, 0.72-0.95) and 0.93 (95% CI, 0.86-1.01), respectively. There was heterogeneity among case-control studies (P < .001) but not among cohort studies. A significant inverse association was found between fish intake and rectal cancer (summary OR, 0.79; 95% CI, 0.65-0.97), and there was a modest trend seen between fish consumption and colon cancer (summary OR, 0.96; 95% CI, 0.81-1.14). This study had no publication bias.ConclusionOur findings from this meta-analysis suggest that fish consumption is inversely associated with colorectal cancer.     

Bisphosphonate use and gastrointestinal tract cancer risk: Meta-analysis of observational studies

AIM: To perform a meta-analysis of observational studies to further elucidate the relationship between oral bisphosphonate use and gastrointestinal cancer risk.METHODS: Systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane Library to identify studies through January 2011. Search terms were “bisphosphonates” or trade names of the drugs, and “observational studies” or “cohort studies” or “case-control studies”. Two evaluators reviewed and selected articles on the basis of predetermined selection criteria as followed: (1) observational studies (case-control or cohort studies) on bisphosphonate use; (2) with at least 2 years of follow-up; and (3) reported data on the incidence of cancer diagnosis. The DerSimonian and Laird random effects model were used to calculate the pooled relative risk (RR) with 95% confidence interval (CI). Two-by-two contingency table was used to calculate the outcomes not suitable for meta-analysis. Subgroup meta-analyses were conducted for the type of cancer (esophageal, gastric and colorectal cancers). Sensitivity analyses were performed to examine the effect sizes when only studies with long-term follow-up (mean 5 years; subgroup 3 years) were included.RESULTS: Of 740 screened articles, 3 cohort studies and 3 case-control studies were included in the analyses. At first, 4 cohort studies and 3 case-control studies were selected for the analyses but one cohort study was excluded because the cancer outcomes were not categorized by type of gastrointestinal cancer. More than 124 686 subjects participated in the 3 cohort studies. The mean follow-up time in all of the cohort studies combined was approximately 3.88 years. The 3 case-control studies reported 3070 esophageal cancer cases and 15 417 controls, 2018 gastric cancer cases and 10 007 controls, and 11 574 colorectal cancer cases and 53 955 controls. The percentage of study participants who used bisphosphonate was 2.8% among the cases and 2.9% among the controls. The meta-analysis of all the studies found no significant association between bisphosphonate use and gastrointestinal cancer. Also no statistically significant association was found in a meta-analysis of long-term follow-up studies. There was no negative association between bisphosphonate use and the incidence of esophageal cancer in the overall analysis (RR 0.96, 95% CI: 0.65-1.42, I² = 52.8%, P = 0.076) and no statistically significant association with long-term follow-up (RR 1.74, 95% CI: 0.97-3.10, I² = 58.8%, P = 0.119). No negative association was found in the studies reporting the risk of gastric cancer (RR 0.89, 95% CI: 0.71-1.13, I² = 0.0%, P = 0.472). In case of colorectal cancer, there was no association between colorectal cancer and bisphosphonate use (RR 0.62, 95% CI: 0.30-1.29, I² = 88.0%, P = 0.004) and also in the analysis with long-term follow-up (RR 0.61, 95% CI: 0.28-1.35, I² = 84.6%, P = 0.011).CONCLUSION: Oral bisphosphonate use had no significant effect on gastrointestinal cancer risk. However, this finding should be validated in randomized controlled trials with long-term follow-up.     

EGF 61A/G基因多态性与结肠癌易感性的Meta分析

目的探讨表皮细胞生长因子(epidermal growth factor,EGF)基因61A/G多态性与结肠癌风险的相关性。方法计算机检索Pubmed、EMABSE、CJFD、CBM、CNKI、VIP及WanFang Data,检索时间截止至2013年2月28日,收集关于EGF 61A/G基因多态性与结肠癌易感性的病例-对照研究。由2位评价者按照纳入标准和排除标准独立选择文献、提取资料、评价质量,采用RevMan5.1和Stata 12.0软件进行Meta分析。结果共纳入5个病例-对照研究,839例患者和844例对照者。Meta分析结果显示,3个遗传模型中EGF基因61A/G多态性与结肠癌风险的相关性差异均有统计学意义[GG+AG vs AA:OR=1.43,95%CI:1.10~1.84;GG vs AG+AA:OR=1.67,67%CI:1.10~2.53;GG vs AA:OR=2.17,95%CI:1.54~3.06],而在AG vs AA遗传模型中,两者差异无统计学意义(OR=1.16,95%CI:0.89~1.53)。结论 EGF 61A/G基因多态性与结肠癌易感性相关,基因型GG和AG+GG可增加罹患结肠癌的风险。     

Cholecystectomy and the Risk of Colorectal Adenomas

Cholecystectomy has been identified as a risk factor for colorectal cancer, yet little attention has been given to the relationship between cholecystectomy and colorectal adenomas. Utilizing data collected in two large cross-sectional studies of colorectal adenoma risk factors, we examined the association between cholecystectomy and colorectal adenomas. In the adjusted logistic regression model, both men and women showed no effect of cholecystectomy on risk of colorectal adenomas (men: OR 0.67 [95% CI 0.30–1.47]; women: OR 1.46 [95% CI 0.92–2.29]). No effect was seen when examining the time since cholecystectomy for men. There was a slight association found for women who had a cholecystectomy less than 10 years prior (OR 2.02 [95% CI 1.06–3.87]) but no association was seen in women with cholecystectomy at least 10 years prior (OR 1.14 [95% CI 0.62–2.09]). Thus, we conclude that, although cholecystectomy is a risk factor for colorectal cancer, cholecystectomy is not a risk factor for colorectal adenomas.     

Diabetes mellitus and risk of prostate cancer: a meta-analysis

Aims/hypothesis The association of diabetes mellitus with prostate cancer has been controversial. This study examines the strength of this association by conducting a detailed meta-analysis of the studies published in peer-reviewed literature on the subject.Methods A comprehensive search for articles published up to 2003 was performed, reviews of each study were conducted and data were abstracted. Prior to meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) was calculated using the random- and the fixed-effects models. Subgroup and sensitivity analyses were also performed.Results We included 14 studies, published between 1971 and 2002, in the meta-analysis (five case-control studies, nine cohort studies). We found no evidence of publication bias (p=0.89) or heterogeneity among the studies (p=0.38). The association of diabetes with prostate cancer was statistically significant, both on the basis of a random-effects model (RR=0.91, 95% CI: 0.86 to 0.96), and on the basis of a fixed-effects model (RR=0.91, 95% CI: 0.88 to 0.94). When the analysis was stratified into subgroups according to study design, the association was inverse in both cohort and case-control studies, but only in the former was it statistically significant. The sensitivity analysis strengthened our confidence in the validity of this association.Conclusions/interpretation Our meta-analysis findings provide strong evidence that people with diabetes have a significant decrease in risk of developing prostate cancer. There is biological evidence to support this association.Abbreviations RR relative risk     

Diabetes mellitus and risk of endometrial cancer: a meta-analysis

Aims/hypothesis Diabetes has been associated with a statistically significantly increased risk of endometrial cancer in most, but not all studies. To provide a quantitative assessment of the association between diabetes and risk of endometrial cancer, we conducted a meta-analysis of case-control studies and cohort studies. Subjects and methods We identified studies by a literature search of PubMed and Embase through to January 2007 and by searching the reference lists of relevant articles. Summary relative risks (RRs) with 95% CIs were calculated using random-effects model. Results The analysis of diabetes (largely type 2) and endometrial cancer is based on 16 studies (three cohort and 13 case-control studies), including 96,003 participants and 7,596 cases of endometrial cancer. Twelve of the studies showed a statistically significantly increased risk and four a non-significant increased risk of endometrial cancer. In our meta-analysis we found that diabetes was statistically significantly associated with an increased risk of endometrial cancer (summary RR 2.10, 95% CI 1.75–2.53). The risk estimates were somewhat stronger among case-control (RR 2.22, 95% CI 1.80–2.74) than among cohort studies (RR 1.62, 95% CI 1.21–2.16), stronger among studies adjusting only for age (RR 2.74, 95% CI 1.87–4.00) compared with multivariate adjustment (RR 1.92, 95% CI 1.58–2.33) and slightly lower in studies performed in the USA than in those performed Europe. The analysis of type 1 diabetes and endometrial cancer was based on three studies and found a statistically significant positive association (summary RR 3.15, 95%CI 1.07–9.29). Conclusions/interpretation Results from the meta-analysis support a relationship between diabetes and increased risk of endometrial cancer.     

白细胞介素-1β基因多态性与慢性阻塞性肺疾病易感性的系统评价

目的通过Meta分析探讨IL-1β基因多态性与慢性阻塞性肺疾病（COPD）易感性的关系。方法计算机及手工检索1980年1月至2013年1月发表的关于IL-1β基因多态性和COPD易感性关系的文献资料。根据纳入及排除标准筛选文献并提取数据。Meta分析采用RevMan5．0．25和Stata11．0软件进行。合并效应采用比值比（OR）和95％可信区间（95％CI）进行评价。发表偏倚通过漏斗图直观判断和Egger回归法、Begg秩相关法定量检测。敏感性分析为剔除不符合H—W平衡的文献后重新进行Meta分析。5篇文献（6项研究）被纳入Meta分析,共有749例COPD患者及923例对照纳入研究。结果Meta分析结果表明,IL-1β-511C／T基因多态性与COPD易感性无关联（TvsC：OR=0．97,95％CI=0．76～1．24：TTvsCC：OR：0．93,95％CI=0．55—1．59;CT＋TYvsCC：OR=1．25,95％CI=0．98～1．58;TTvsCT＋CC：OR=0．82,95％CI：0．64—1．05）,IL-1β-31T／C基因多态性与COPD易感性亦无明显联系（CUST：OR=0．99,95％CI=0．86～1．15;CCvsTF：OR=0．99,95％CI=0．72～1．35;CT＋TTvsCC：OR=1．21．95％CI=0．94—1．55;TTvsCT＋CC：OR=0．80,95％CI=0．63～1．03）。结论IL-1β-511C／T、-31T／C基因多态性与COPD易感性无关。     

5-脂氧合酶激活蛋白（ALOX5AP）基因单倍体型与心肌梗死易感性相关：人类基因组流行病学研究的荟萃分析

目的既往研究提示ALOX5AP基因变异与心肌梗死（Myocardial infarction,MI）相关,但这些研究大多样本较小,结论亦不一致。本文拟系统评价ALOX5AP基因变异与MI易感性的关系。对象与方法系统检索PubMed（1967．1—2009．5）、Embase（1967．1-2009．5）数据库及维普（1989．2009）、CNKI（1979—2009）中文期刊数据库,并通过阅读相关综述及文章的参考文献进一步获取信息。对目前已发表的评估ALOX5AP基因变异与MI关系的候选基因关联研究进行荟萃分析。应用固定效应模型（Fixed—effect models）计算比值比（Oddsratio,OR）及其95％可信限（CI）,用以描述ALOX5AP基因变异与MI的关系。结果共有5项探讨ALOX5AP基因HapA单倍体型（SG13S25G—SG13S114T．SG13S89G—SG13S32A）与MI关系的研究（合计MI病例2778人,对照2484人）及4项评估ALOX5AP基因HapB单倍体型（SG13S377A—SG13S114A—SG13S41A—SG13S35G）与MI关系的研究（合计MI病例1999人,对照1860人）纳入荟萃分析。5项关于HapA单倍体型的研究间无明显异质性（P=0．111,I^2=46．8％）。与非携带者相比,ALOX5AP基因HapA单倍体型携带者使MI的易感性增加24％（OR：1．24,95％可信限1．06—1．45,P=0．006）。4项关于HapB的研究亦无明显异质性（P=0．148,I^2=43．9％）;与非携带者相比,ALOX5AP基因HapB单倍体型携带者使MI的易感性增加31％（OR：1．31,95％可信限1．01—1．70,P=0．04）。结论本研究提示ALOX5AP基因HapA、HapB单倍体型与MI的易感性增加有关。     

肿瘤坏死因子α-308基因多态性与肝癌易感性的Meta分析

目的 探讨肿瘤坏死因子α-308（TNFα-308）基因多态性与肝癌风险的相关性.方法 计算机检索PubMed、Web of Science、中国知网（CNKI）、万方数据库、维普数据库,检索时间为建库～ 2013年7月,收集关于肿瘤坏死因子α-308基因多态性与肝癌易感性的病例对照研究.应用RevMan 5.1和Stata 12.0软件进行Meta分析.运用Begg秩相关和Egger回归法检测文献发表偏倚.结果 最终纳入19个病例-对照研究,其中包括18篇英文文献和1篇中文文献,共有3002例肝癌患者和3561例对照者.合并统计结果显示,TNFα-308基因多态性可增加肝癌患病风险[AA＋ GAvsGG,OR=1.73,CI：1.30～2.32,P＜0.05].亚组分析中,东方人群患病率高于西方人群（P＜0.05）.经begg漏斗图和egger检验,文献稳定性较好,不存在发表偏倚.结论 TNFα-308基因多态性与肝癌易感性存在显著相关,且东方人群患病率较高.