尿石症危险因素人群病例对照研究

目的 探索尿石症发病的危险因素，为人群预防提供依据。方法 选取深圳市尿石症现况调查发现的334例患者为病例组，721名健康者为对照组，进行尿石症危险因素人群病例对照研究；采用非条件logistic回归对34个变量进行分析，采用Falconer回归法估算遗传变。结果 尿石症病例组和对照组配比条件均衡可比，单因素logistic回归分析共有17个变量有统计学意义，但最终进入模型的因素有10个，其中4个变量为尿石症发病危险因素，OR值大小依次为既往泌尿系慢性炎症史（OR＝4.09,95%CI:1.38-12.14)，一级亲属尿石症史（OR＝2.61,95%CI:1.70-4.01)和多食动物蛋白质（OR＝2．14，95％CI：1．71－2．69），暴露日照时间长（OR＝1．39，95％CI：1．16－1．66）；而较高文化程度（OR＝0．46，95％CI：0．29－0．73），日引水量多（OR＝0．59，95％CI：0．48－0．72），饮果汁（OR＝0．41，95％CI：0．18－0．94），多食奶及奶制品（OR＝0．82，95％CI：0．68－0．99），多食蔬菜（OR＝0．70，95％CI：0．55－0．91）和多食水果（OR＝0．78，95％CI：0．64－0．94）6个变量为尿石症发病的保护因素。一级亲属尿石症患病率病例组高于对照组，尿石症分离比为0．0109，95％CI：0．0050－0．0168，一级亲属尿石症的遗传度为28．48％，男，女分别为32．06％和24．60％。结论 尿石症主要受饮食习惯影响，尿石症家族史和社会经济状况也与发病有关。     

贲门癌危险因素病例对照研究

目的：探讨贲门癌发生的危险因素，为深入进行病因学研究提供线索。方法：对福州市6所医院2000年和2001年4月至7月的住院病人603例进行多组病例对照研究。贲门癌组为病理、手术和胃镜确诊的贲门癌191例，非贲门部胃癌190例，健康对照组为与肿瘤病例同期住院的骨科、泌尿外科的非肿瘤病人222例。采用统一调查表进行床边询问，对资料进行单因素及多因素Logistic分析。结果：贲门癌的主要危险因素有一一级亲属患肿瘤（OR＝4．286 95％CI：2．431－7．554）、进食速度快（OR＝2．028 95％ CI：1．142－2．912）、三餐不按时吃（OR＝1．909 95％ CI：1．396－2．610）、饮用井水（OR＝1．741 95％CI：1．042－2．910）每日吸烟量多（OR＝1．347 95％CI：0．989－1．835）。主要保护 因素有：常吃新鲜水果（OR＝0．645 95％CI：0．439－0．945）、使用冰箱年数长（OR＝0．731 95％CI：0．536－0．997）、化程度高（OR＝0．468 95％CI：0．276－0．74）。结论： 贲门癌与非贲门部胃癌可能有不同的危险因素，值得进一步研究。     

中国农村人群高血压危险因素的meta分析北大核心CSCD

目的探讨中国农村人群高血压发病的主要危险因素,为今后防治提供依据。方法以高血压、农村、危险因素等为主题词或关键词,检索1998—2013年发表的有关中国农村人群高血压发病危险因素的病例对照研究,按照文献纳入与排除标准选择文献、评价质量,提取数据,采用RevMan5．1软件进行meta分析。结果共17篇文献符合条件纳入研究,meta分析结果表明各危险因素的合并OR值及95％a分别为：年龄（OR=1．07,95％CI：1．06—1．08）、BMI（OR=1．36,95％CI=1,27～1．45）、高血压家族史（OR=1．79,95％CI=1．34—2．39）、吸烟（OR=1．20,95％CI=1．07～1．34）、饮酒（OR=1．20,95％CI=1．14—1．27）、嗜盐（OR：1．28,95％CI=1．17—1．41）、高脂肪摄入（OR=1．17,95％CI=1．05—1．31）、文化程度高（OR：0．78,95％CI=0．71～0．87）、经济收入高（OR=0．90,95％CI=0．86—0．94）、锻炼（OR=0．81．95％CI=0．69～0．94）、腰臀比（OR=1．51,95％CI=1．2—1．89）、性别（OR：1．28,95％Cl=1．15-1．42）。结论高血压家族史、腰臀比、BMI、嗜盐、性别、吸烟、饮酒、高脂肪摄入、年龄为中国农村人群高血压发病的危险因素,文化程度高、锻炼、经济收入高则为保护性因素。     

北京和南京两地代谢综合征危险因素分析

目的分析北京和南京两地人群代谢综合征的危险因素。方法采用整群抽样对北京和南京的6123人进行流行病学调查,应用IDF（2005）定义。采用多因素Logistic回归分析可能存在的危险因素。结果男性和女性的年龄标化患病率分别为19．5％和33．6％。多因素条件Logis—tic回归结果,女性（OR=1．49;95％CI（1．40,1．59））、年龄增长（OR=1．23;95％CI（1．16,1．31））、低体力活动（OR=1．76;95％a（1．13,2．76））、糖尿病家族史（OR：1．33;95％CI（1．11,1．60））、高血压家族史（OR=1．46;95％CI（1．29,1．65））、年龄性别交互作用（OR=1．29;95％a（1．21,1．40））、居住在城市（OR=1．09;95％CI（1．02,1．18））均是代谢综合征的危险因素。居住在南京（OR=0．76;95％CI（0．71,0．81））是代谢综合征的保护因素。结论代谢综合征是多重危险因素共同作用的结果,其中女性、慢病家族史、低体力活动是其重要的危险因素。     

2000-2003年住院病人胃癌相关危险因素研究

目的了解住院胃癌病人饮食习惯、疾病史、不良嗜好等因素与胃癌危险性的关系。方法收集黑龙江省肿瘤医院2000--2003年经病理诊断的胃癌病人，共209例，进行病例对照研究。应用非条件logistic回归分析。结果吸烟、饮酒增加胃癌危险性。胃慢性疾病史、不良饮食习惯、嗜成与胃癌关系密切。情绪较差、性情急躁胃癌危险增加250％（OR=3．50，95％CI=1．95-6．24）。近年精神压抑可增加胃癌危险466％（OR=5．66，95％CI=3．68-8．94）。多食用葱、蒜类食品可降低胃癌危险性48．9％。结论胃慢性疾病史、不良饮食习惯及某些精神神经因素，肿瘤家族史等与胃癌有明显关系。多食用葱蒜类食品对胃癌的发生有保护作用。     

儿童腹股沟疝发病危险因素的配对病例-对照研究

目的探讨儿童腹股沟疝发生的主要危险因素。方法采用l：1配对病例一对照研究方法，对201例0-6岁腹股沟疝患儿与对照儿童的父母进行问卷调查，采用条件Logistic回归对所收集资料进行单因素及多因素分析．计算OR值及0R值的95％CI。结果多因素分析结果表明，儿童便秘史（OR=3．520，95％CI：1．238。10．015）、啼哭不安史（OR：6．532．95％CI：2．651～16．091）、母亲孕前1个月和孕期前3个月腌制品摄入史（彻=2．529，95％CI：1．271．5．031）及贫血史（DR：6．809，95％CI：2．530~18．322）、儿童腹股沟疝家族史（OR=11．250，95％CI：4．766～26．553）与儿童腹股沟疝的发病存在显著联系。结论儿童便秘史、儿童啼哭不安史、腹股沟疝家族史、母亲孕前1个月和孕期前3个月贫血史及腌制品摄人史是儿童腹股沟疝发生的危险因素。     

庄河胃癌危险因素的1:4配比病例对照研究

[目的]探讨庄河胃癌高危人群的危险因素,为社区人群开展防治工作提供科学依据.[方法]在辽宁省庄河县胃癌高发现场普查的基础上,采用1:4配比的病例对照研究,对32例普查发现的胃癌及对照进行胃癌危险因素研究,包括一般情况,胃病史、家族史、生活方式、饮食活动及胃黏膜病理的检查等指标.采用Mantel-Haenszel法计算各个因素的比值比(OR)及95%的可信限(95%CI).[结果]萎缩性胃炎和肠上皮化生为胃癌的危险因素,其OR值及95%CI分别为3.55(1.29～8.01)和3.15(1.24～7.17).对既往胃病史、家族史、吸烟、饮酒、饮食习惯,血清胃蛋白酶原,幽门螺旋杆菌感染等各因素分析均无统计学意义.[结论]胃癌发病与慢性萎缩性胃炎和肠上皮化生等危险因素有关.     

胃癌发病危险因素的病例对照研究

目的 探讨胃癌发病的危险因素。方法 以本院确诊的70例胃癌病例作为病例组，按性别、年龄、民族、居住地作为配比条件选取70名健康人群进行1：1配对的病例配对研究。并将研究因素进行条件的Logistic回归分析。结果 多因素条件Logistic回归分析显示胃癌发病与保护因素新鲜蔬菜水果(OR=0．232，95％CI=0．067—0．797)、危险因素盐腌食物(OR=7．215，95％CI=1．149—45．307)、慢性胃病史(OR=3．015，95％CI=1．021-8．904)和家族肿瘤史(OR=5．354，95％CI=1．506-19．036)关系密切。结论 多吃新鲜蔬菜水果，少吃盐腌食物，积极治疗慢性胃病可减少胃癌的发病。     

胃癌病例对照研究

目的了解胃癌与其危险因素的关系。方法对洛阳市2003～2004年新发胃癌病人153例，按性别、年龄、民族、居住地为配比条件选取该市健康人153名进行1：1配对的病例对照研究，资料处理采用条件Logistic回归分析。结果吸烟OR 3.85，OR 95％CI2.73～6．98，饮酒OR 2．14，OR 95％CI 1．42～3．21，烟熏食品OR 4．92．OR95％CI 2．63～7．32，父母患瘤OR7.59，OR 95％CI 3．21～26．53。结论经常吸烟、饮酒、食用烟熏食品及其父母患肿瘤可能是胃癌的危险因素。     

2型糖尿病危险因素的交互作用研究

目的探讨2型糖尿病危险因素及其交互作用，为开展糖尿病的预防、治疗工作提供科学依据。方法采用病例一对照研究方法．病例为在深圳市第一人民医院、深圳市第二人民医院及深圳市保健委员会办公室就诊及住院的2型糖尿病患者，共295例；对照为同期在门诊进行健康体检的非糖尿病人群，共214例。对研究因素进行单因素及多因素非条件Logistic回归分析．在此基础上进行对数线性模型分析。结果调查人群中，糖尿病家族史（OR=6．507，95％CI：3．788～11．178）、高血脂（TG：OR=2．625，95％CI：1．295—5．323；LDL—C：OR=6．337，95％CI：3．379-11．884）、工作压力（OR=1．901，95％CI：1．263—2．863）、高血压（SBP：OR=I．055，95％CI：1．022～1．089）是2型糖尿病的危险因素：文化程度（OR=0．724，95％CI：0．599—0．875）、运动锻炼（OR=0．499，95％CI：0．268～0．930）是保护因素。对数线性模型分析发现，糖尿病各危险因素之间广泛存在一阶或二阶交互作用，其中．糖尿病家族史、年龄和运动锻炼三者分别与多个危险因素有明显的交互作用。结论2型糖尿病是遗传因素与环境因素共同作用的结果。对糖尿病的防治应采取综合措施，尤其对于具有糖尿病家族史者以及中老年人群，更应控制各种危险因素。     

Chronic atrophic gastritis and Helicobacter pylori infection among Japanese Americans in Seattle

Gastric cancer is still a major cause of mortality due to cancer worldwide. The most common type of gastric cancer is intestinal type carcinoma, which usually occurs in stomachs containing chronic atrophic gastritis. Individuals with chronic atrophic gastritis are considered to be at increased risk for developing intestinal type carcinoma of the stomach. To examine the association between chronic atrophic gastritis and other gastric cancer risk factors, a cross-sectional study was conducted using serum samples and questionnaire information collected from 776 persons of full Japanese ancestry in the greater Seattle area in 1994. The presence of chronic atrophic gastritis and Helicobacter pylori infection was determined by measurement of serum pepsinogen levels and H. pylori antibodies, respectively. Based on multiple logistic regression, the significant predictors of chronic atrophic gastritis were age over 50 years, H. pylori infection, and 20 years or more lived in Japan. Alcohol consumption, smoking, prior peptic ulcer, and history of gastric cancer in parents were not significantly associated with chronic atrophic gastritis. The results imply that H. pylori infection since earlier life and other unknown exposure factors in Japan might have played an important role in the development of chronic atrophic gastritis.     

胃癌亚类危险因子的流行病学研究——多组Logistic回归分析

根据胃癌发生阶段模式的认识，我们设计实施了一析的病例对照研究，分析方法采用多组Ｌｏｇｉｓｔｉｃ分析法，研究对象９为四组病例和一组对照，他们分别是胃癌组、重度异型增生组、慢性萎缩性胃炎伴肠化生组和溃汤病组以及对照组。对照组是病理证实胃粘膜正常或仅有轻度性慢浅表性胃患者。研究结果显示：胃癌的危险因素是长期居住在高发区，经济收低下，动物蛋白摄入量少，地瓜、墨鱼摄入量大，暴饮暴食和精神创伤。重度异增生的危     

胃癌危险因素的病例对照研究

为探讨胃癌危险因素的致病作用,对１０２例胃癌患者进行了１：１配对病例对照研究。在单因素条件Ｌｏｇｉｓｔｉｃ回归分析中,慢性胃炎史、平时生活紧张、经常生闷气是胃癌发生的危险因素,饮茶和多食新鲜蔬菜则是胃癌的保护性因素。     

Implications of Helicobacter pylori infection for stomach cancer prevention

Accumulating evidence has implicated Helicobacter pylori, an established cause of chronic gastritis and peptic ulcer, in the etiology of gastric cancer. Control of this infection would reduce the occurrence of chronic gastritis and peptic ulcer and might substantially lower the risk of stomach cancer as well. The public health impact of this infectious agent warrants efforts to identify preventive measures. This paper reviews the evidence linking H. pylori infection to gastric cancer and evaluates the potential for control in high-risk populations. Current obstacles to H. pylori control are discussed, including the link to poor socioeconomic conditions, difficulty in identifying incident cases, lack of natural immunity to reinfection, limited effectiveness of antibiotic therapy in high-prevalence populations, and incomplete knowledge regarding the reservoir of infection, mode of transmission, host susceptibility factors, and the potential for developing an effective vaccine. Worthwhile avenues of research include studies designed to identify modifiable risk factors for acquisition of the infection, modifiable host factors that may increase resistance to chronic infection, more effective antibiotic therapies, and effective vaccines.     

胃癌危险因素的病例对照研究

目的：了解金坛，楚州两地胃癌高发的原因以及进一步验证某些胃癌可疑危险因素。方法：选取金坛，楚州两地2001年的104例新发胃癌病例并按性别。年龄，居住地为条件选取两地104例健康人作为对照，进行病例对照研究；资料分析采用单，多因素非条件Logistic回归。结果：多因素Logistic回归分析显示既往患慢性胃炎（OR=3.530），胃癌家族史（OR=6.958)，经常吃干硬的食物（OR=1.640)以及平时行事较为冲动（OR=2.105)与胃癌的发生有关。结论：改变不良的生活方式和控制易冲动的情绪，可降低胃癌发生的危险性。     

DNA损伤修复基因XRCC3 Thr241Met多态与贲门癌、非贲门部胃癌易感性关系的病例对照研究

目的探讨福建人群DNA损伤修复基因XRCC3 Thr241Met多态与贲门癌、非贲门部胃癌易感性的关系,分析基因与环境因素在癌症发生中的联合作用.方法采用共同对照组的病例对照研究方法,应用PCR-RFLP技术检测基因型,应用非条件logistic回归计算OR值及其95%CI.结果 XRCC3三种基因型（野生型CC、杂合突变型CT、纯合突变型TT）在贲门癌组的分布频率分别为43.2%、46.5%、10.3%;在非贲门部胃癌组的分布频率为53.2%、40.9%、5.8%;在对照组的分布频率分别为59.6%、35.1%、5.3%.经多因素分析结果显示携带变异基因型（CT＋TT）个体罹患贲门癌的风险增加（OR=1.76,95%CI：1.07～2.90）.XRCC3变异基因型与饮酒、新鲜蔬菜摄入和慢性胃炎对贲门癌发生存在协同作用;与吸烟、慢性胃炎对非贲门部胃癌发生存在协同作用.结论XRCC3基因多态与贲门癌发生有关,贲门癌与非贲门部胃癌的危险因素不尽相同.     

A study of Helicobacter pylori infection in patients with pernicious anemia

INTRODUCTION: Chronic atrophic gastritis presents with atrophy of the gastric mucosa, hypochlorhydria or achlorhydria and unstable gastrin level. Type A chronic atrophic gastritis associated with hypergastrinemia is regarded as the principle causative factor for pernicious anemia. AIM: The study aimed at evaluation of the incidence of H. pylori infection in patients with pernicious anemia and analyze its relation to the severity of gastritis. MATERIAL AND METHODS: Forty patients with pernicious anemia (group 1) were examined for presence of H. pylori infection. Sex- and age-matched patients with gastric ulcer (group 2) and chronic superficial gastritis (group 3) were used as controls. Three antral forceps biopsies were obtained from all patients during videogastroscopy. The presence of H. pylori was verified by urease test, histological and microbiological examination. RESULTS: All patients with pernicious anemia had chronic atrophic gastritis and several times lower incidence of H. pylori infection than the patients with gastric ulcer. Chronic atrophic gastritis was not diagnosed in group 3 patients. Statistically significant difference in Helicobacter pylori infection was found between groups 1 and 2 (P < 0.001) but not between groups 1 and 3 (P > 0.05). CONCLUSIONS: Atrophic gastritis was diagnosed in all patients with pernicious anemia. These patients showed significantly lower incidence of H. pylori infection than the gastric ulcer patients. The patients with pernicious anemia had lower gastritis index and quantitatively less expressed infection than the other two groups.     

慢性胃炎与胃癌组织中微血管密度和黏附分子表达的对比研究

目的 探讨慢性胃炎与胃癌组织中微血管密度、黏附分子的表达及对比意义.方法 选取56例慢性浅表性胃炎患者(慢性浅表性胃炎组)、55例胃癌无淋巴结转移患者(胃癌无淋巴结转移组),57例胃癌有淋巴结转移患者(胃癌有淋巴结转移组)的病理组织蜡块,用免疫组织化学Envision法显示微血管密度CD34和细胞黏附分子Syndecan-1的表达情况,112例胃癌患者中高、中分化47例,低分化65例.结果 CD14表达以微血管密度计算:慢性浅表性胃炎组为(13 ± 10)个/高倍镜视野(HP),胃癌无淋巴结转移组为(27 ± 11)个/HP;胃癌有淋巴结转移组为(28 ±10)个/HP.慢性浅表性胃炎组与胃癌无淋巴结转移组及胃癌有淋巴结转移组比较差异有统计学意义(t=7.044、7.908,P＜0.05),胃癌无淋巴结转移组与胃癌有淋巴结转移组比较差异无统计学意义(t=0.506,P＞0.05.慢性浅表性胃炎组、胃癌无淋巴结转移组、胃癌有淋巴结转移组Syndecan-1阳性表达率分别为96.43%(54/56)、45.45%(25/55)、24.56%(14/57),慢性浅表性胃炎组与胃癌无淋巴结转移组及胃癌有淋巴结转移组比较差异有统计学意义(X2=163.560、17.197,P＜0.01).胃癌无淋巴结转移组与胃癌有淋巴结转移组比较差异有统计学意义(x2=5.340,P＜0.05).结论 微血管密度增加与胃癌的发生有关;细胞黏附分子syndecan-1表达下调与胃癌的发生、发展有关,并可能进一步促进胃癌转移,检测微血管密度CD34及细胞黏附分子Syndecan-1的表达变化情况有助于胃癌的诊断及预后判断.

Abstract：

Objective To investigate the clinical significance of the expression of microvessel density and adhesion molecules in the tissue of chronic gastritis and gastric cancer. Methods Fifty-six patients with chronic superficial gastritis (chronic superficial gastritis group), 55 cases of gastric cancer without lymph node metastasis (gastric cancer without lymph node metastasis group) and 57 patients with gastric cancer and lymph node metastasis (gastric cancer with lymph node metastasis group) were included in this study. Gastric pathology paraffin blocks was studied using immunohistochemical Envision method. Microvessel density CD34 and cell adhesion molecule Syndecan-1 expression was examined. In 112 gastric cancer patients, 47 patients were highly differentiated, and 65 patients were poorly differentiated. Results Microvessel density CD34 results:in chronic superficial gastritis group was (13 ± 10)/HP,in gastric cancer without lymph node metastasis group was (27 ± 11 VHP, in gastric cancer with lymph node metastasis group was (28 ± 10)/HP. There were significant differences between chronic superficial gastritis group and gastric cancer without lymph node metastasis group,and between chronic superficial gastritis group and gastric cancer with lymph node metastasis group (t = 7.044,7.908, P ＜0.05), but there was no significant difference between gastric cancer without lymph node metastasis group and gastric cancer with lymph node metastasis group (t = 0.506,P ＞ 0.05). In chronic superficial gastritis group, gastric cancer without lymph node metastasis group and gastric cancer with lymph node metastasis group, Syndecan-1 positive expression ratewas 96.43%(54/56),45.45%(25/55),24.56%(14/57),and there was significant difference between chronic superficial gastritis group and gastric cancer without lymph node metastasis group,and between chronic superficial gastritis group and gastric cancer with lymph node metastasis group (x2 = 163.560,17.197,P＜ 0.01). There was significant difference between gastric cancer without lymph node metastasis group and gastric cancer with lymph node metastasis group (x2 = 5.340, P ＜ 0.05). Conclusions Microvessel density is related with the occurrence of gastric cancer;adhesion molecule Syndecan-1 expression reduces the incidence of gastric cancer development, and might further promote the metastasis of gastric cancer. Detecting the expression changes of microvessel density CD34 and cell adhesion molecule Syndecan-1 facilitates the diagnosis and prognosis of gastric cancer.     

Sociodemographic and Lifestyle Factors in Relation to Gastric Cancer in a High-Risk Region of China: A Matched Case–Control Study

Abstract

Objectives: To explore the role of sociodemographic and lifestyle factors in the development of gastric cancer in a high-risk region of China.

Methods: In a case–control study, all newly diagnosed patients with gastric cancer were compared with healthy controls matched (1:1) by sex, age (±3?years), and place of residence during 2013–2017.

Results: A total of 622 gastric cancer and 622 healthy controls were included. Larger household size (>4 family members) appeared to decrease gastric cancer risk for Helicobacter pylori-negative ones (odd ratio?=?0.43, 95% CI?=?0.26–0.70). Similarly, longer refrigerator ownership was associated with a 67% decreased risk in H. pylori-negative group (95% CI?=?0.15–0.77). Participants with a family history of gastric cancer had nearly fivefold higher risk (odd ratio?=?4.88, 95% CI?=?2.49–9.55). Smoking attributed to 83% increased risk (odd ratio?=?1.83, 95% CI?=?1.19–2.80). Tea consumption dramatically decreased risk in whole study population (odd ratio?=?0.28, 95% CI?=?0.17–0.45).

Conclusions: In summary, family history, smoking, H. pylori-related chronic atrophic gastritis, and H. pylori infection were positively associated with gastric cancer. Whereas, tea consumption and refrigerator use negatively associated with gastric cancer and could be promoted to reduce gastric cancer rate in high-risk populations, especially in the developing regions.     

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.