晚期日本血吸虫病的危险因素病例-对照研究

目的　探讨晚期血吸虫病 晚血 )发生的危险因素。　方法　 1∶ 1、1∶ 2配对病例 -对照研究。对照组为健康人 ,慢性血吸虫病 慢血 )患者 ,每组调查 2 13例。调查内容包括 :血吸虫病患病史、治疗史、疫水接触史、社会经济状况及营养状况等。检测细胞、体液免疫水平、 5项乙肝血清标志物 HBVMs)和 ABO血型及 B超等。用 SAS软件 ,以 1∶ 1、1∶ 2配对单因素和逐步条件 logistic回归分析。　结果　血吸虫病检查次数 OR=1.16 8～ 1.311)、首次患血吸虫病距末次治疗间期 OR=1.14 2 )和距本次调查间期 OR =1.0 89)、HBs Ag+ OR=4 .6 83～ 10 .75 9)、HBc Ab+ OR=2 .873)、HBs Ag+ +HBe Ab+ +HBc Ab+ OR=7.6 0 4 )为晚血发病危险因素 ;晚血患者人均住房面积较小、年均收入较低 ;未发现晚血与 ABO血型的关联性。　结论　晚血的发生与血吸虫的反复感染、血吸虫病治疗不及时、不彻底及感染间期长有关 ,合并乙肝感染、社会经济状况差及细胞免疫水平降低可增加其发病的危险性     

南阳市AIDS患者抗逆转录病毒治疗依从性影响因素的调查分析

目的为探寻影响艾滋病(AIDS)患者抗逆转录病毒治疗(ART)依从性的主要因素，提高社区、家庭抗病毒治疗模式的治疗效果。方法采取成组匹配(频数匹配)的病例对照研究方法，对224名在社区和家庭接受ART的艾滋病患者进行了调查，用非条件logistic回归对各种可疑影响因素进行分析。结果医务人员的指导、医生水平、亲人的协助、疗效、副反应都是影响患者退出治疗的因素。结论提高医生业务水平和责任心，加强对患者的依从性教育，对社区和家庭艾滋病患者救治极为重要；对患者的鼓励与家人协助也能有效提高患者的依从性；增加抗病毒药物的品质以提高疗效、降低副反应更应成为下一步努力的方向．     

钩虫感染因素的病例对照研究

目的探索人体钩虫易感因素。方法本研究采用1∶4的个体匹配方法,选择88例钩虫感染者和352名健康对照进行回顾性调查,进行条件 Lgistic 回归模型分析。结果单因素 Logistic 回归分析筛选出使用未处理人畜粪便(X9)、饭前洗手(X10)、便后洗手(X11)、吃洗净瓜果(X12)、饮生水(X14)和赤脚下地劳动(X16)等6个相关因素有显著意义;多因素 Logistic 回归分析表明,最终引入模型的3个因素饮生水(X14)、使用未处理人畜粪便(X9)和家庭总收入(X5)有显著意义(P<0.05)。其 OR 值分别为3.3609、2.4267和0.9998。结论认为影响钩虫感染的主要危险因素是:饮生水、使用未经无害化处理的人畜粪便和家庭经济状况。     

地方性砷中毒发病危险因素的病例对照研究

目的探讨地方性砷中毒（地砷病）的发病危险因素，评估p16甲基化在地砷病发病中的作用。方法采用两项1：1配对病例对照研究方法，40例病例选自病区确诊的地砷病患者，对照分别选自病区和非病区各40例健康人；采用标准化问卷进行调查，获取病例和对照组的有关暴露因素：采用甲基化特异性PCR（MS—PCR）技术，测定血样p16基因甲基化水平；并用条件logistic回归分析方法处理资料。结果病例与病区对照组分析结果表明，饮水含砷量（OR=4．2，P〈0．01）和饮水年限（OR=1．192．P〈0．05）对地砷病发病的影响有统计学意义。p16甲基化测定结果表明，病例组与非病区对照组比较，对地砷病发病的影响有非常显著的统计学意义（OR=10．0，P〈0．01）。结论饮水含砷量、饮水年限和p16基因甲基化可能都是地砷病发病的危险因素；但是，p16基因甲基化可能是地砷病发病的重要危险因素之一，这对阐明地砷病的病因和发病机制有着重要的理论意义。     

鄱阳湖地区影响晚期日本血吸虫病发生的因素分析

目的 分析鄱阳湖区晚期日本血吸虫病(晚血)发生的影响因素,为有效控制晚血的发生提供科学依据。方法 收集2002年以后发生的晚血病例169例作为观察组,按性别相同、年龄和居住地相近等原则进行1∶1配对,以慢性血吸虫病病例(慢血)作为对照组;采用自行设计的问卷进行回顾性调查,内容包括研究对象基本信息、确诊慢血前后可能与晚血发生的相关因素,以及通过查治病分户册收集2002年以来的查、治病情况,共计20项指标。结果 单因素分析显示,职业、职业改变、慢血后伴有消化系统疾病、查病间隔年限、服药依从性、累计服药次数、年间受检率、年间血阳检出率、年间粪阳检出率、年间治疗率等11项指标有统计学意义;logistic回归的多因素分析结果显示,离开疫源地累计年数越多、高暴露接触疫水方式的减少、累计服药次数越多是晚血发生的保护因素;而年间血阳检出率越高、高易感季节接触疫水、服药依从性越差、伴有乙肝是晚血发生的危险因素。结论 在今后血吸虫病控制措施中,健全有效地血吸虫病病例追踪管理体系,改进影响晚血发生相关因素的干预措施。     

先天性心脏病危险因素的病例对照研究

采用1:2配对病例对照研究,对200例先天性心脏病患者与400例相应对照的父母进行生活行为、饮食习惯等问卷调查.资料处理采用条件Logistic回归进行单因素和多因素分析.发现与先天性心脏病发生有关的危险因素有孕期被动吸烟、孕早期感冒、食熏制食品、食用瘦肉、母亲糖尿病、父亲饮酒、食用多种烹调油;而食豆制品、产前检查、服用叶酸为保护因素.     

我国胰腺癌部分发病危险因素的Meta分析

目的探讨我国胰腺癌发病的危险因素,为制定相关预防和控制策略提供参考依据.方法对国内外1978 ～ 2003年间公开发表的关于我国胰腺癌发病危险因素的独立病例对照研究进行综合定量分析,计算每个因素的综合OR值及95%可信区间.累积病例1 889例,对照10 304例.结果各危险因素与胰腺癌的OR值95%可信区间为:吸烟(总)2.43(1.27 ～ 4.63)、吸烟(男)1.86(1.23 ～ 2.83)、吸烟(女)1.97(1.06 ～ 3.64)、饮酒(总)1.10(0.72 ～ 1.67)(P ＞ 0.05)、饮酒(男)1.16(0.56 ～ 2.40)(P ＞ 0.05)、饮酒(女)0.89(0.45 ～ 1.78)(P ＞ 0.05)、男性每周摄入酒精量≥ 750 g 1.58(1.07 ～ 2.34)、糖尿病史4.65(3.16 ～ 6.85)、胆石症史4.13(2.92 ～ 5.83)、生育0 ～ 2胎1.23(0.88 ～ 1.72)(P ＞ 0.05)、生育3 ～ 4胎2.70(1.21 ～ 6.00)、生育数≥ 5胎2.57(1.64 ～ 4.01)、A型血1.02(0.66 ～ 1.57)(P ＞ 0.05)、B型血1.05(0.52 ～ 2.12)(P ＞ 0.05)、O型血0.99(0.84 ～ 1.17)(P ＞ 0.05)、AB型血0.92(0.72 ～ 1.17)(P ＞ 0.05).结论吸烟、大量饮酒(每周摄入酒精量≥ 750 g)、糖尿病史、胆石症史、多次生育(生育数≥ 3胎)为我国胰腺癌发病的部分危险因素.     

Alzheimer病危险因素1∶1配对病例对照研究

目的探索Alzheimer病(AD)的危险因素。方法采用1∶1配对的病例对照研究,于2003年3月至4月以及9月至10月,在南昌市及九江市共选择经检查确诊的AD病人127例,相应对照127例,收集相关的资料进行条件Logistic回归分析。结果在37个调查因素中,发现有精神压抑史为AD患病的危险因素,其OR值为2248。积极而有规律的参加体育活动,有业余爱好,喜交朋友为AD的保护因素,OR值分别为0638、0319和0297。结论AD的发病或患病与精神压抑史有关;积极参加体育活动、有业余爱好以及喜交朋友对该病发病或患病有一定的保护作用。     

Alzheimer病危险因素1:1配对病例对照研究

目的探索Alzheimer病(AD)的危险因素.方法采用1∶ 1配对的病例对照研究,于2003年3月至4月以及9月至10月,在南昌市及九江市共选择经检查确诊的AD病人127例,相应对照127例,收集相关的资料进行条件Logistic回归分析.结果在37个调查因素中,发现有精神压抑史为AD患病的危险因素,其OR值为2.248.积极而有规律的参加体育活动,有业余爱好,喜交朋友为AD的保护因素,OR值分别为0.638、0.319和0.297.结论 AD的发病或患病与精神压抑史有关;积极参加体育活动、有业余爱好以及喜交朋友对该病发病或患病有一定的保护作用.     

中老年知识分子骨质疏松危险因素病例—对照研究

对157例（男70,女87）以跟骨X线摄片和桡骨单光子骨密度测定诊断的骨质疏松患者进行了1∶1配对病例-对照研究。结果发现,与运动、饮食、喝茶及妇女月经情况有关的多种因素与骨质疏松发病危险存在密切的关联。经多因素条件Logistic回归分析:低钙饮食、40岁前综合运动指数、40岁后平均运动时间、妇女绝经年数及每月平均喝茶量是调查人群最重要、最有预测力的危险因素;无论男女,早期缺乏运动比晚期缺乏运动的危险性大,低钙饮食在女性的作用较男性大,缺乏运动对男性的发病风险更重要。提示在不同性别,骨质疏松危险因素存在差异。由于喝茶在调查人群的发病危险中也起着重要的、不可忽视的作用,而我国中老年知识分子有长期、大量饮茶的习惯,故值得作进一步的研究。     

Case-control study of diabetes-related genetic variants and pancreatic cancer risk in Japan

AIM: To examine whether diabetes-related genetic variants are associated with pancreatic cancer risk.METHODS: We genotyped 7 single-nucleotide polymorphisms (SNPs) in PPARG2 (rs1801282), ADIPOQ (rs1501299), ADRB3 (rs4994), KCNQ1 (rs2237895), KCNJ11 (rs5219), TCF7L2 (rs7903146), and CDKAL1 (rs2206734), and examined their associations with pancreatic cancer risk in a multi-institute case-control study including 360 cases and 400 controls in Japan. A self-administered questionnaire was used to collect detailed information on lifestyle factors. Genotyping was performed using Fluidigm SNPtype assays. Unconditional logistic regression methods were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between these diabetes-associated variants and pancreatic cancer risk.RESULTS: With the exception of rs1501299 in the ADIPOQ gene (P = 0.09), no apparent differences in genotype frequencies were observed between cases and controls. Rs1501299 in the ADPIOQ gene was positively associated with pancreatic cancer risk; compared with individuals with the AA genotype, the age- and sex-adjusted OR was 1.79 (95%CI: 0.98-3.25) among those with the AC genotype and 1.86 (95%CI: 1.03-3.38) among those with the CC genotype. The ORs remained similar after additional adjustment for body mass index and cigarette smoking. In contrast, rs2237895 in the KCNQ1 gene was inversely related to pancreatic cancer risk, with a multivariable-adjusted OR of 0.62 (0.37-1.04) among individuals with the CC genotype compared with the AA genotype. No significant associations were noted for other 5 SNPs.CONCLUSION: Our case-control study indicates that rs1501299 in the ADIPOQ gene may be associated with pancreatic cancer risk. These findings should be replicated in additional studies.     

Diabetes mellitus and risk of pancreatic cancer in China: A meta-analysis based on 26 case-control studies

AimsThe relationship between diabetes mellitus and pancreatic cancer risk from is uncertain based on the results of existing publications. The current report updated and re-evaluated the possible association between diabetes mellitus and pancreatic cancer risk in China.MethodsSix databases (PubMed, Embase, Web of Science, the Cochrane Library, the Chinese Biomedical Database, and the Chinese National Knowledge Infrastructure) were used for the literature search up to October 2017.ResultsTwenty-six case-control studies involving 7702 pancreatic cancer cases and 10186 controls were screened out. The overall summary estimate for the relationship between diabetes and pancreatic cancer was 3.69 (95% CI, 3.12–4.37). The subgroup analysis indicated positive associations among northern and southern Chinese, as well as studies with healthy population or hospital controls. In addition, the risk of developing pancreatic cancer was inversely associated with the duration of diabetes, with the highest risk of pancreatic cancer occurring among patients with diabetes <2 years. Individuals who had diabetes <2 years had a >2-fold higher risk of developing pancreatic cancer than individuals who had diabetes for 2–4 years or 5–10 years (OR, 4.92; 95% CI, 4.16–5.80 vs. OR, 1.92; 95% CI, 1.30–2.85/OR, 2.14; 95% CI, 1.49–3.09).ConclusionsThis meta-analysis strongly supports that an association exists between diabetes and an increased risk of pancreatic cancer in China, which should be confirmed with other ethnic groups.     

Association of smoking, alcohol drinking and dietary factors with esophageal cancer in high- and low-risk areas of Jiangsu Province, China

AIM: To study the main environmental and lifestyle factors that account for the regional differences in esophageal cancer (EC) risk in low- and high-risk areas of Jiangsu Province, China. METHODS: Since 2003, a population-based case-control study has been conducted simultaneously in low-risk (Ganyu County) and high-risk (Dafeng County) areas of Jiangsu Province, China. Using identical protocols and pre-tested standardized questionnaire, following written informed consent, eligible subjects were inquired about their detail information on potential determinants of EC, including demographic information, socio-economic status, living conditions, disease history, family cancer history, smoking, alcohol drinking, dietary habits, frequency, amount of food intake, etc. Conditional logistic regression with maximum likelihood estimation was used to obtain Odds ratio (OR) and 95 % confidence interval (95% CI), after adjustment for potential confounders. RESULTS: In the preliminary analysis of the ongoing study, we recruited 291 pairs of cases and controls in Dafeng and 240 pairs of cases and controls in Ganyu, respectively. In both low-risk and high-risk areas, EC was inversely associated with socio-economic status, such as level of education, past economic status and body mass index. However, this disease was more frequent among those who had a family history of cancer or encountered misfortune in the past 10 years. EC was also more frequent among smokers, alcohol drinkers and fast eaters. Furthermore, there was a geographic variation of the associations between smoking, alcohol drinking and EC risk despite the similar prevalence of these risk factors in both low-risk and high-risk areas. The dose-response relationship of smoking and smoking related variables, such as age of the first smoking, duration and amount were apparent only in high-risk areas. On the contrary, a dose-response relationship on the effect of alcohol drinking on EC was observed only in low-risk areas. CONCLUSION: The environmental risk factors, together with genetic factors and gene-environmental interactions might be the main reason for this high-risk gradient in Jiangsu Province, China.     

Incidence of and risk factors for pancreatic cancer in chronic pancreatitis: A cohort of 1656 patients

BackgroundRisk of pancreatic cancer may increase in chronic pancreatitis patients.AimsThis study aimed to identify the incidence of and risk factors for pancreatic cancer in chronic pancreatitis patients.MethodsChronic pancreatitis patients admitted to our center from January 2000 to December 2013 were enrolled. Cumulative rates of pancreatic cancer and survival rates were calculated. The standardized incidence ratio was calculated based on the pancreatic cancer incidence in general population of China. Risk factors for pancreatic cancer were identified.ResultsIn a total of 1656 patients, the median follow-up duration was 8.0 years. Pancreatic cancer was detected in 21 patients (1.3%). The expected number of cases of pancreatic cancer was 1.039, yielding a standardized incidence ratio of 20.22. The standardized incidence ratios for patients with a >60 pack-year smoking history were much higher (145.82). Two risk factors for pancreatic cancer were identified: age at the onset of chronic pancreatitis (hazard ratio, 1.05) and a >60 pack-year smoking history (hazard ratio, 11.83).ConclusionThe risk of pancreatic cancer is markedly increased in chronic pancreatitis patients compared with the general population, especially in patients with an older age at onset and a >60 pack-year smoking history. The high-risk populations were suggested to be followed up closely.     

Gynecological and reproductive factors and the risk of pancreatic cancer: A case-control study

Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) has a higher incidence in men compared to women, although the difference in known risk factors cannot explain this disparity completely. Reproductive and hormonal factors have been demonstrated in pre-clinical studies to influence pancreatic carcinogenesis, but the few published data on the topic are inconsistent. The aim was to investigate the role of reproductive and hormonal factors on PDAC occurrence in women.MethodsWe conducted a unicenter case-control study; PDAC cases were matched to controls by age with a 1:2 ratio. Risk factors were screened through questionnaires about gynecologic and medical history. Comparisons were made using Chi-square and Fisher’s exact tests where appropriate for categorical variables and Student’s t-test for continuous variables. Logistic regression was used to calculate Odds Ratios (ORs) and their 95% confidence intervals (CI). Multivariable logistic regression models were adjusted for potential confounders.Results253 PDAC and 506 matched controls were enrolled. At logistic regression multivariable analysis adjusted for confounding factors, older age at menopause (OR:0.95 per year; 95% CI:0.91–0.98; p = 0.007), use of Oral Contraceptives (OR:0.52; 95% CI:0.30–0.89; p = 0.018), use of Hormonal Replacement Therapy (OR:0.31; 95% CI:0.15–0.64; p = 0.001), and having had two children (OR:0.57; 95% CI:0.38–0.84; p = 0.005) were significant, independent protective factors for the onset of PDAC.ConclusionsThese data confirm some previous findings on menopause age and number of births while, to our knowledge, this is the first study to show a protective effect of HRT and OC use. The results collectively support the hypothesis that exposure to estrogens plays a protective role towards PDAC.     

Association of cholesterol with risk of pancreatic cancer:A meta-analysis

AIM: To evaluate the effect of dietary cholesterol and serum total cholesterol(TC) on the risk of pancreatic cancer. METHODS: A literature search was performed up to June 2014 in Pub Med, EMBASE, China National Knowledge Infrastructure and China Biology Medicalliterature database for relevant articles published in English or Chinese. Pooled relative risks(RRs) with 95% confidence intervals(CIs) were calculated with a random-effects model. RESULTS: We included 14 published articles with 439355 participants for dietary cholesterol, and 6 published articles with 1805697 participants for serum TC. For the highest vs lowest category of dietary cholesterol, the pooled RR(95%CI) of pancreatic cancer was 1.308(1.097-1.559). After excluding two studies(RR > 3.0), the pooled RR(95%CI) was 1.204(1.050-1.380). In subgroup analysis stratified by study design, the pooled RRs(95%CIs) were 1.523(1.226-1.893) for case-control studies and 1.023(0.871-1.200) for cohort studies. The association of dietary cholesterol with the risk of pancreatic cancer was significant for studies conducted in North America [1.275(1.058-1.537)] and others [2.495(1.565-3.977)], but not in Europe [1.149(0.863-1.531)]. No significant association [1.003(0.859-1.171)] was found between the risk of pancreatic cancer and serum TC. CONCLUSION: Dietary cholesterol may be associated with an increased risk of pancreatic cancer in worldwide populations, except for Europeans. The results need to be confirmed further.     

Research on the relationships between pancreatic cancer and hyperglycemia in Chinese populations

Aims/Introduction

Pancreatic cancer (PC) is related to diabetes. Long‐standing diabetes should be a prerequisite, whereas new‐onset hyperglycemia might be a result of PC. However, the association between diabetes and PC is still in dispute.

Materials and Methods

We investigated the relationship between glucose metabolism and other factors by retrospectively analyzing the clinical data of 331 PC patients. Any histopathological type was eligible. The patients were divided into three groups: group A, normal glucose metabolism; group B, hyperglycemia duration≤6 months; and group C, diabetes duration >24 months.

Results

The prevalence of hyperglycemia was 59.5%. Most patients were diagnosed with diabetes mellitus either concomitantly with cancer (39.0%) or within 6 months before cancer diagnosis (6.9%). There were more females in group C than group A (P = 0.005) and B (P = 0.018). Patients in group A were younger (A vs B, P < 0.001; A vs C, P = 0.032) and thinner (A vs B, P = 0.013; A vs C, P = 0.027). In group C, more individuals shared a family history of diabetes (A vs C, P = 0.004; B vs C, P = 0.023), but fewer smoked (A vs C, P = 0.027; B vs C, P = 0.020). Patients in group C had a larger proportion of poorly differentiated cancer (A vs C, P = 0.002; B vs C, P = 0.012). No differences in glucose metabolism were found among the different histological types.

Conclusions

We further support the notion that diabetes duration >24 months might not be cancer related. Older and fatter PC patients were more likely to develop hyperglycemia. More patients with long‐standing diabetes had poor tumor differentiation. We speculate that smoking and alcohol intake might advance PC onset.     

新疆维吾尔自治区伽师县荒漠型黑热病暴发流行危险因素分析

目的 探讨新疆维吾尔自治区伽师县荒漠型黑热病暴发流行的危险因素.方法 采用病例对照研究,自制凋查问卷,以2008年1月-2008年11月网络直报的47例黑热病患者为病例组,在同村按1:3匹配选择141名年龄相仿的健康儿童作为对照组,对性别、环境和行为等13个潜在危险因素进行单因素和多因素条件logistic回归分析.结果 单因素分析显示:户外露宿习惯、被叮咬、邻居有黑热病患者、黄昏时带孩子户外活动、驱避剂的使用等凶素与本次迦师县荒漠型黑热病暴发流行关系密切,危险比(HR)值和95%可信区间(95%CI)依次为73.846(10.070,541.510)、78.875(10.719,576.910)、15.149(5.876,39.054)、63.912(8.996,454.048)和0.020(0.005,0.008);多冈素回归分析显示:户外露宿习惯是危险冈素,HR值和95%CI为80.963(5.119,1 280.596),而驱避剂的使用是暴发流行的保护因素,HR值和95%CI为0.021(0.003,0.162).结论 在目前传染源尚不叫确的情况下,养成良好的生活习惯,尽量不在外露宿,安伞使用药浸蚊帐或纱窗,规范使用驱避剂和定期在院内喷洒杀虫剂是预防控制黑热病感染的有效措施.     

我国胰腺癌部分发病危险因素的Meta分析

目的探讨我国胰腺癌发病的危险因素,为制定相关预防和控制策略提供参考依据。方法对国内外1978-2003年间公开发表的关于我国胰腺癌发病危险因素的独立病例对照研究进行综合定量分析,计算每个因素的综合OR值及95％可信区间。累积病例1889例,对照10304例。结果各危险因素与胰腺癌的OR值95％可信区间为:吸烟(总)2.43(1.27-4.63)、吸烟(男)1.86(1.23-2.83)、吸烟(女)1.97(1.06-3.64)、饮酒(总)1.10(0.72-1.67)(P>0.05)、饮酒(男)1.16(0.56-2.40)(P>0.05)、饮酒(女)0.89(0.45-1.78)(P>0.05)、男性每周摄入酒精量≥750g1.58(1.07-2.34)、糖尿病史4.65(3.16-6.85)、胆石症史4.13(2.92-5.83)、生育0-2胎1.23(0.88-1.72)(P>0.05)、生育3-4胎2.70(1.21-6.00)、生育数≥5胎2.57(1.64-4.01)、A型血1.02(0.66-1.57)(P>0.05)、B型血1.05(0.52-2.12)(P>0.05)、O型血0.99(0.84-1.17)(P>0.05)、AB型血0.92(0.72-1.17)(P>0.05)。结论吸烟、大量饮酒(每周摄入酒精量≥750g)、糖尿病史、胆石症史、多次生育(生育数≥3胎)为我国胰腺癌发病的部分危险因素。