Transrectal versus transperineal prostate biopsy for cancer detection in patients with gray-zone prostate-specific antigen: a multicenter, real-world study.

Knowledge about the effect of different prostate biopsy approaches on the prostate cancer detection rate (CDR) in patients with gray-zone prostate-specific antigen (PSA) is limited. We performed this study to compare the CDR among patients who underwent different biopsy approaches and had rising PSA levels in the gray zone. Two hundred and twenty-two patients who underwent transrectal prostate biopsy (TRB) and 216 patients who underwent transperineal prostate biopsy (TPB) between June 2016 and September 2022 were reviewed in this study. In addition, 110 patients who received additional targeted biopsies following the systematic TPB were identified. Clinical parameters, including age, PSA derivative, prostate volume (PV), and needle core count, were recorded. The data were fitted via propensity score matching (PSM), adjusting for potential confounders. TPB outperformed TRB in terms of the CDR (49.6% vs 28.3%, P = 0.001). The clinically significant prostate cancer (csPCa) detection rate was not significantly different between TPB and TRB (78.6% vs 68.8%, P = 0.306). In stratified analysis, TPB outperformed TRB in CDR when the age of patients was 65-75 years (59.0% vs 22.0%, P < 0.001), when PV was 25.00-50.00 ml (63.2% vs 28.3%, P < 0.001), and when needle core count was no more than 12 (58.5% vs 31.5%, P = 0.005). The CDR ( P = 0.712) and detection rate of csPCa ( P = 0.993) did not significantly differ among the systematic, targeted, and combined biopsies. TPB outperformed TRB in CDR for patients with gray-zone PSA. Moreover, performing target biopsy after systematic TPB provided no additional benefits in CDR.

Occupational injuries and psychological support in Chinese nurses: a cross-sectional study.

OBJECTIVE: To assess the occupational injuries and psychological support received by nurses and to investigate the relationship between the two. METHOD: This was a nation-wide cross-sectional study of nurses working across 1858 hospitals in China. Data were collected using an online structured, self-administered questionnaire between 2016 and 2017. RESULTS: Nearly half of respondents had experienced aggressive behavior from patients or their attendants; 13.4% respondents had experienced aggressive behavior on more than three occasions. 78.96% respondents had experienced needle-stick injuries and 51.22% had experienced psychological trauma. 20.5% respondents believed that hospitals do not pay any attention to occupational safety. 86.1% respondents expressed the need for little or moderate psychological support. Nurses who had experienced aggressive behavior expressed a greater need for psychological support. Nurses working at hospitals that adequately addressed the occupational safety issues expressed the lowest need for psychological support. CONCLUSION: We found a high prevalence of psychological stress and occupational injuries among nurses. Nursing managers need to address this issue and implement interventions to prevent and reduce injuries.

p53-dependent elimination of aneuploid mitotic offspring by entosis.

Entosis was proposed to promote aneuploidy and genome instability by cell-in-cell mediated engulfment in tumor cells. We reported here, in epithelial cells, that entosis coupled with mitotic arrest functions to counteract genome instability by targeting aneuploid mitotic progenies for engulfment and elimination. We found that the formation of cell-in-cell structures associated with prolonged mitosis, which was sufficient to induce entosis. This process was controlled by the tumor suppressor p53 (wild-type) that upregulates Rnd3 expression in response to DNA damages associated with prolonged metaphase. Rnd3-compartmentalized RhoA activities accumulated during prolonged metaphase to drive cell-in-cell formation. Remarkably, this prolonged mitosis-induced entosis selectively targets non-diploid progenies for internalization, blockade of which increased aneuploidy. Thus, our work uncovered a heretofore unrecognized mechanism of mitotic surveillance for entosis, which eliminates newly born abnormal daughter cells in a p53-dependent way, implicating in the maintenance of genome integrity.

Burnout in nurses working in China: A national questionnaire survey.

AIM: This study aimed to assess the overall status of burnout in nurses in China on a national scale and investigate the demographic characteristics related to burnout and the relationships between demographics, job satisfaction and burnout. METHODS: This was a national cross-sectional study conducted by the Chinese Nursing Association between July 2016 and July 2017. Data were collected using a structured, self-administered questionnaire. RESULTS: A total of 51 406 registered nurses in 311 Chinese cities completed the questionnaire. Fifty per cent of the participants suffered burnout, and 33.8% of nurses had high scores on emotional exhaustion, 66.6% had high scores on depersonalization and 93.5% had low scores on personal accomplishment; 16.2% reported a high level of job satisfaction, only 0.4% was satisfied with their jobs and 70.7% intended to leave their jobs. Marital status, educational level, income and years of working experience affected job burnout. Nurses with a high level of burnout were more likely to have a high degree of job dissatisfaction and intend to leave their jobs. CONCLUSION: We found a high prevalence of burnout among nurses in China. Nursing managers need to pay more attention to job burnout and its influencing factors. Interventions to reduce nurse burnout should be implemented.

Effect of antibiotic therapy in patients with ulcerative colitis: a meta-analysis of randomized controlled trials.

BACKGROUND: Gut microbiota may play a role in the pathogenesis of ulcerative colitis (UC). Antibiotic therapy for patients with UC has shown conflicting results. OBJECTIVES: To evaluate the effect of antibiotic therapy in treating UC. METHODS: PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure (CNKI) databases were searched to identify randomized controlled trials (RCTs) that evaluated antibiotics compared with placebo or no antibiotics in patients with UC. We extracted and pooled the risk ratio (RR). RESULTS: Twelve RCTs were included in this systematic review and meta-analysis, which included 739 patients with active UC. Antibiotic therapy had statistically significant efficacy in inducing remission rate in patients with UC, observed at the end of trials (random-effect RR = 0.77; 95% confidence interval [CI] 0.60 to 0.98, p = .03) or at 12 months after trials (fixed-effect RR = 0.83; 95% CI 0.73 to 0.94, p = .003). CONCLUSIONS: Antibiotic therapy appeared to induce remission more effectively than a placebo or no antibiotic intervention not only in the short-term but also in the long-term for patients with UC. More high-quality clinical trials are needed before clinical recommendations for antibiotic therapy in UC management are made.

Occupational injuries and psychological support in Chinese nurses: a cross-sectional study / Lesiones laborales y apoyo psicológico en enfermeras chinas: un estudio transversal / Lesões ocupacionais e apoio psicológico em enfermeiras chinesas: um estudo transversal

ABSTRACT Objective: To assess the occupational injuries and psychological support received by nurses and to investigate the relationship between the two. Method: This was a nation-wide cross-sectional study of nurses working across 1858 hospitals in China. Data were collected using an online structured, self-administered questionnaire between 2016 and 2017. Results: Nearly half of respondents had experienced aggressive behavior from patients or their attendants; 13.4% respondents had experienced aggressive behavior on more than three occasions. 78.96% respondents had experienced needle-stick injuries and 51.22% had experienced psychological trauma. 20.5% respondents believed that hospitals do not pay any attention to occupational safety. 86.1% respondents expressed the need for little or moderate psychological support. Nurses who had experienced aggressive behavior expressed a greater need for psychological support. Nurses working at hospitals that adequately addressed the occupational safety issues expressed the lowest need for psychological support. Conclusion: We found a high prevalence of psychological stress and occupational injuries among nurses. Nursing managers need to address this issue and implement interventions to prevent and reduce injuries.

RESUMO Objetivo: Avaliar os acidentes de trabalho e o apoio psicológico recebido pelos enfermeiros e investigar a relação entre os dois. Método: Este foi um estudo transversal nacional de enfermeiras que trabalham em 1858 hospitais na China. Os dados foram coletados por meio de um questionário online estruturado e autoaplicável entre 2016 e 2017. Resultados: Quase metade dos entrevistados experimentou comportamento agressivo por parte dos pacientes ou de seus acompanhantes; 13,4% dos entrevistados experimentaram comportamento agressivo em mais de três ocasiões. 78,96% dos entrevistados sofreram ferimentos com agulhas e 51,22% sofreram traumas psicológicos. 20,5% dos entrevistados acreditam que os hospitais não dão atenção à segurança do trabalho. 86,1% dos entrevistados expressaram a necessidade de pouco ou moderado apoio psicológico. Enfermeiros que vivenciaram comportamento agressivo expressaram maior necessidade de apoio psicológico. Os enfermeiros que trabalham em hospitais que abordam de forma adequada as questões de segurança do trabalho expressam a menor necessidade de apoio psicológico. Conclusão: Encontramos alta prevalência de estresse psicológico e lesões ocupacionais entre os enfermeiros. Os gerentes de enfermagem precisam abordar essa questão e implementar intervenções para prevenir e reduzir lesões.

RESUMEN Objetivo: Evaluar las lesiones ocupacionales y el apoyo psicológico que reciben las enfermeras e investigar la relación entre ambos. Método: Este fue un estudio transversal a nivel nacional de enfermeras que trabajaban en 1858 hospitales en China. Los datos se recopilaron mediante un cuestionario autoadministrado estructurado en línea entre 2016 y 2017. Resultados: Casi la mitad de los encuestados había experimentado un comportamiento agresivo por parte de los pacientes o sus asistentes; El 13,4% de los encuestados había experimentado un comportamiento agresivo en más de tres ocasiones. El 78,96% de los encuestados había experimentado lesiones por pinchazos de aguja y el 51,22% había experimentado un trauma psicológico. El 20,5% de los encuestados cree que los hospitales no prestan atención a la seguridad laboral. El 86,1% de los encuestados expresó la necesidad de un apoyo psicológico escaso o moderado. Las enfermeras que habían experimentado un comportamiento agresivo expresaron una mayor necesidad de apoyo psicológico. Las enfermeras que trabajan en hospitales que abordaron adecuadamente los problemas de seguridad ocupacional expresaron la menor necesidad de apoyo psicológico. Conclusión: Encontramos una alta prevalencia de estrés psicológico y lesiones ocupacionales entre enfermeras. Los gerentes de enfermería deben abordar este problema e implementar intervenciones para prevenir y reducir las lesiones.

Percutaneous microwave ablation of renal cell carcinoma: practice guidelines of the ultrasound committee of Chinese medical association, interventional oncology committee of Chinese research hospital association.

Imaging-guided percutaneous microwave ablation (MWA) with high thermal efficiency comprises rapid, successful management of small renal cell carcinomas (RCCs) in selected patients. Ultrasound Committee of Chinese Medical Association, Interventional Oncology Committee of Chinese Research Hospital Association developed evidence-based guidelines for MWA of RCCs after systematically reviewing the 1969-2019 literature. Systematic reviews, meta-analyses, randomized controlled trials, cohort, and case-control studies reporting MWA of RCCs were included and levels of evidence assessed. Altogether, 146 articles were identified, of which 35 reported percutaneous MWA for T1a RCCs and 5 articles for T1b RCCs. Guidelines were established based on indications, techniques, safety, and effectiveness of MWA for RCCs, with the goal of standardizing imaging-guided percutaneous MWA treatment of RCCs. Key points Microwave ablation is recommended for managing small renal cell carcinoma in selected patients. Imaging protocols are tailored based on the procedural plan, guidance, and evaluation. Patient's selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management. A joint task force (multidisciplinary team) summarized the key elements of the standardized report.

Optimal Timing of Surgical Revascularization for Myocardial Infarction and Left Ventricular Dysfunction.

BACKGROUND: The optimal timing of surgical revascularization for patients presenting with ST-segment elevation myocardial infarction (STEMI) and impaired left ventricular function is not well established. This study aimed to examine the timing of surgical revascularization after STEMI in patients with ischemic heart disease and left ventricular dysfunction (LVD) by comparing early and late results. METHODS: From January 2003 to December 2013, there were 2276 patients undergoing isolated coronary artery bypass grafting (CABG) in our institution. Two hundred and sixty-four (223 male, 41 females) patients with a history of STEMI and LVD were divided into early revascularization (ER, <3 weeks), mid-term revascularization (MR, 3 weeks to 3 months), and late revascularization (LR, >3 months) groups according to the time interval from STEMI to CABG. Mortality and complication rates were compared among the groups by Fisher's exact test. Cox regression analyses were performed to examine the effect of the time interval of surgery on long-term survival. RESULTS: No significant differences in 30-day mortality, long-term survival, freedom from all-cause death, and rehospitalization for heart failure existed among the groups (P > 0.05). More patients in the ER group (12.90%) had low cardiac output syndrome than those in the MR (2.89%) and LR (3.05%) groups (P = 0.035). The mean follow-up times were 46.72 ± 30.65, 48.70 ± 32.74, and 43.75 ± 32.43 months, respectively (P = 0.716). Cox regression analyses showed a severe preoperative condition (odds ratio = 7.13, 95% confidence interval 2.05-24.74, P = 0.002) rather than the time interval of CABG (P > 0.05) after myocardial infarction was a risk factor of long-term survival. CONCLUSIONS: Surgical revascularization for patients with STEMI and LVD can be performed at different times after STEMI with comparable operative mortality and long-term survival. However, ER (<3 weeks) has a higher incidence of postoperative low cardiac output syndrome. A severe preoperative condition rather than the time interval of CABG after STEMI is a risk factor of long-term survival.

[Diagnostic value of TruScreen in cervical lesions screening].

OBJECTIVE: To investigate the diagnostic value of TruScreen (TS) as a novel option for cervical lesions screening. METHODS: A total of 218 cases were selected between 2013 December and 2014 November from outpatients of the Department of Gynecology, PLA General Hospital. Using histopathology as the gold standard for diagnosis, the diagnostic efficacy of TS was compared with that of high-risk human papillomavirus (Hr-HPV) test. RESULTS: (1) In 218 patients, there were 193 Hr-HPV positive cases accounting for 88.5%, 94 TS positive cases accounting for 43.1%. According to the histopathology, there were 112 cases of cervical intraepithelial neoplasia (CIN)1+, 71 cases of CIN2+, accounting for 51.4% and 32.6%, respectively. (2) The sensitivity of Hr-HPV was 98.2% and specificity was 21.7%. The sensitivity of TS was 51.8% and specificity 66.0%. (3) Sensitivity of TS for triaging cases of atypical squamous cells of undetermined signification (ASC-US) was 43.9%, specificity 65.7%, diagnostic accordance rate 53.9%. Those indexes for triaging cases of equivalent or more than atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) were 56.3%, 66.2% and 61.3%. With regard to Hr-HPV test, those indexes for triaging cases of equivalent or more than ASC-H were 97.2%, 32.4% and 64.8%. CONCLUSIONS: Hr-HPV test shows higher sensitivity while TruScreen shows higher specificity for cervical lesions screening. More studies with larger sample size are still needed to evaluate which method is a better triage tool.

The cutoffs and performance of glycated hemoglobin for diagnosing diabetes and prediabetes in a young and middle-aged population and in an elderly population.

The aims were to compare the appropriate cutoffs of glycated hemoglobin (HbA1c) in a population of varying ages and to evaluate the performance of HbA1c for diagnosing diabetes and prediabetes. A total of 1064 participants in the young and middle-aged group and 1671 in the elderly group were included and underwent HbA1c testing and an oral glucose tolerance test (OGTT). Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated to evaluate the optimal HbA1c cutoffs. Kappa coefficients were used to test for agreement between HbA1c categorization and OGTT-based diagnoses. The optimal HbA1c cutoffs for diagnosing diabetes were 5.7% (39 mmol/mol) in the young and middle-aged group with a sensitivity of 66.7%, specificity of 86.7%, and AUC of 0.821 (95% CI: 0.686, 0.955) and 5.9% (41 mmol/mol) in the elderly group with a sensitivity of 80.4%, specificity of 73.3%, and AUC of 0.831 (0.801, 0.861). The optimal cutoffs for diagnosing prediabetes were 5.6% (38 mmol/mol) and 5.7% (39 mmol/mol) in the young and middle-aged group and in the elderly group, respectively. Agreement between the OGTT-based diagnosis of diabetes or prediabetes and the optimal HbA1c cutoff was low (all kappa coefficients <0.4). The combination of HbA1c and fasting plasma glucose increased diagnostic sensitivities or specificities. In conclusion, age-specific HbA1c cutoffs for diagnosing diabetes or prediabetes were appropriate. Furthermore, the performance of HbA1c for diagnosing diabetes and prediabetes was poor. HbA1c should be used in combination with traditional glucose criteria when detecting and diagnosing diabetes or prediabetes.

[Correlation of food intolerance with hyperlipidemia: a cross-sectional survey in healthcare population].

OBJECTIVE: To explore the correlation of food intolerance and hyperlipidemia. METHODS: A cross-sectional survey was conducted from August 2008 to June 2009. It recruited a total of 11 434 adults from Health Sciences Center at our hospital. Non-conditional Logistic regression model was utilized for determining odd ratio (OR) and 95% confidencer interval (CI). And statistic analysis was performed with SPSS 13.0. RESULTS: Among them 6 897 participants were food intolerance positive and 4 537 food intolerance negative. The prevalence of food intolerance was 60.32%. Age, gender, smoking, body mass index, total cholesterol, triglycerides and high density lipoprotein (HDL) cholesterol were significantly different between positive and negative ones (all P < 0.05). Multiple regression analysis showed that food intolerance was significantly correlated with age, gender, body mass index, but negatively with hyperlipidemia. Compared with age group ≤ 40 years, the OR (95%CI) of age groups 41-50, 51-60 and >60 years were 1.125(1.021-1.238), 1.350(1.207-1.510) and 1.564(1.279-1.912) respectively. Compared with males, the OR (95%CI) of females was 1.528(1.382-1.689). Compared with normal weighters, the OR (95%CI) of low weighters was 1.720 (1.147-2.580). Compared with normal blood lipids, the OR (95%CI) of hyperlipidemia was 0.879 (0.810-0.955). CONCLUSION: Food intolerance may be negatively correlated with hyperlipidemia in healthcare population.

Association between heme oxygenase 1 gene promoter polymorphisms and susceptibility to coronary artery disease: a HuGE review and meta-analysis.

We performed a systematic review and meta-analysis of heme oxygenase 1 gene (HO-1) promoter polymorphisms and susceptibility to coronary artery disease (CAD) based on eligible studies retrieved from electronic databases from 2002 to 2013. Eleven studies, involving 10,170 patients with CAD and 6,868 controls, were included. Overall, no significantly decreased risk of CAD was found in persons with the SS genotype of the HO-1 (GT)n repeat length polymorphism compared with those with the LL + SL genotype. However, decreased risks of CAD were observed in the Asian subgroup, the coronary-artery-narrowing ≥50% subgroup, the myocardial infarction subgroup, the age- and sex-matched subgroup, and the good-quality-reports subgroup. The primary heterogeneity in the studies came from age and sex matching and the extent of coronary stenosis. CAD risk was significantly decreased for persons with the AA genotype of the T(-413)A single-nucleotide polymorphism versus those with the TT genotype, but most of the studies showed that the allele distribution was inconsistent with Hardy-Weinberg equilibrium. In this meta-analysis, we found that the (GT)n SS genotype was associated with decreased risk of CAD after controlling for biases due to age and sex matching, extent of coronary stenosis, ethnicity, and study quality. The relationship between the T(-413)A single-nucleotide polymorphism and CAD should be interpreted more cautiously.

Inhibitory effect of co-administration of atorvastatin and endothelin-1 receptor antagonist on the progression of atherosclerosis in rabbit.

Atorvastatin, a hydroxymethylglutaryl-CoA reductase inhibitor, and endothelin-1 (ET-1) receptor antagonist have been separately indicated to ameliorate disease progression in atherosclerosis. However, no study has evaluated the effect of their combination on atherosclerosis. The objective of the current study was to evaluate the direct in vivo effects of a combination regimen of atorvastatin and ET-1 receptor antagonist on male New Zealand white rabbit models of atherosclerosis (injury-induced). Thirty-two atherosclerotic rabbits were divided into four experimental groups: (a) injury group - fed high-fat diet; (b) ET-1 receptor antagonist preventive group - fed high-fat diet, but with intragastric administration of the ET-1 receptor antagonist, darusentan; (c) combined preventive group - fed high-fat diet, but with intragastric administration of both darusentan and atorvastatin; and (d) treatment group - fed high-fat diet for the first 8 weeks, followed by normal diet and intragastric administration of both darusentan and atorvastatin up to 16 weeks. A further eight non-atherosclerotic rabbits were fed normal diet and classified as the control group. At the end of 8 and 16 weeks, compared with the injury group, the combined preventive group had significant reduction in both the concentration of serum lipids and inflammatory factors and atherosclerosis formation, indicative of a multifaceted anti-atherosclerotic impact. The relative area of atherosclerotic lesions in the injury group (30.84%) was significantly higher than the control group (4.62%; p < 0.05). The combined preventive group showed a significantly robust effect on lowering serum lipid, inflammatory cytokines, and maintained homeostatic balance of free radicals, and important downstream effectors like ET-1 and matrixmetalloproteinase-9. Our data show that atorvastatin and ET-1 receptor antagonist co-administration may decrease lipid levels, stabilize plaques and relieve vascular inflammation. By reducing the plaque burden, this regimen may minimize the risk of atherosclerotic plaque rupture or arterial occlusion.

[A cross sectional survey on the prevalence of food intolerance and its determinants through physical checkup programs in the elderly].

OBJECTIVE: To explore the prevalence of food intolerance and its determinants in healthcare elderly in China. METHODS: A cross sectional survey was carried out from August 1(st), 2008 to June 30(th), 2009, that including 736 60-year-olds from a Health Management Research Institute, Chinese PLA General Hospital. Data was double entried in computer and organized by EpiData 3.0. Non conditional logistic regression model was used for odd ratio (OR) and 95% CI, with the use of SPSS 13.0. RESULTS: The three leading foodstuff on intolerance were crab, egg and shrimp, with the prevalence rates as 35.9% , 28.8% and 15.1% respectively. Results from the multiple regression analysis showed that the crab intolerance was associated with Helicobacter pylori infections (P < 0.05). The OR(95%CI) of Helicobacter pylori infections (DOB≥4) was 1.544 (1.139-2.091). CONCLUSION: The three leading intolerance foods were egg, crab and shrimp. Crab intolerance was associated with Helicobacter pylori infections. To reduce the risk of crab intolerance, it was necessary to control the infection caused by Helicobacter pylori.

[Application of intraoperative magnetic resonance imaging and multimodal navigation in surgical resection of glioblastoma].

OBJECTIVE: To evaluate the efficacy of intraoperative magnetic resonance imaging (iMRI) and multimodal navigation in surgical resection of glioblastoma. METHODS: Between February 2009 and July 2010, 76 glioblastoma patients underwent surgical resection guided by iMRI and multimodal navigation. The cohort consisted of 43 male and 33 female patients, with a mean age of 49 years (range: 14-79 years). Rates of gross total resection (GTR) and extent of resection (EoR) were calculated at first and final iMRI scans.Pearson χ(2) test was used to compare the rates of GTR. RESULTS: iMRI and multimodal navigation were successfully implemented in all cases. Rates of GTR were misestimated by neurosurgeons in 24 cases (31.6%), which were confirmed by first iMRI. Total tumor resection were achieved in 20 cases (26.3%) as a result of iMRI scan, increasing the rates of gross total resection from 52.6% to 78.9% (χ(2) = 11.692, P = 0.001). Extent of resection in 28 patients who underwent further tumor resection were increased from 81.5% to 98.1%, leading to the overall extent of resection improved from 92.3% to 98.4%. At 3-month follow-up, 3 cases (3.9%) developed permanent neurologic deficits. The mean clinical follow-up was 15.6 months (range 3.0-45.0 months). The 2-year overall survival rate was 19.7%. The median progression-free survival of gross total resection group was 12 months (95% CI: 10.1-13.9 months), compared with 9 months (95%CI: 7.9-10.1 months) of the subtotal resection group (χ(2) = 4.756, P = 0.029). The overall survival of gross total resection group was 16 months (95% CI: 13.7-18.3 months), compared with 12 months (95% CI: 9.7-14.3 months) of the subtotal resection group (χ(2) = 7.885, P = 0.005). CONCLUSION: Combined with multimodal navigation, iMRI helps maximize surgical resection of glioblastoma, preserving neurological function while increasing progression-free survival and overall survival.

Prevalence and risk factors for eye diseases, blindness, and low vision in Lhasa, Tibet.

AIM: To determine the prevalence and risk factors for eye diseases, blindness, and low vision in Tibet, and to assist the development of eye disease prevention and treatment schemes. METHODS: We carried out a survey of eye diseases among a population living at high altitude. A total of 1 115 Tibetan permanent residents aged 40 years or older from the towns and villages of Qushui County, Lhasa Prefecture, Tibet Autonomous Region, participated in this study. All participants completed a detailed questionnaire, and underwent presenting and pinhole visual acuity tests, and a comprehensive ophthalmic examination. RESULTS: There were 187 blind eyes (8.43%), 231 eyes with low vision (10.41%). The leading cause of visual impairment was cataract of 55.0% (101/187) blindness and of 50.2% (116/231) low vision, followed by fundus lesions of 22.9% blindness and 23.8% low vision, while only a low prevalence of glaucoma of 9.6% blindness and 1.7% low vision was observed. The analysis of 2 219 eyes showed that the most common external eye disease was pterygium (27.2%) in Tibet. CONCLUSION: The high prevalence of blindness and low vision in the Tibetan population at high altitude is a serious public health issue. There is a need to establish and maintain an appropriate effective eye care program in Tibet.

Synergistic effects of elevated homocysteine level and abnormal blood lipids on the onset of stroke.

Hyperhomocysteinemia and abnormal blood lipids are independent risk factors for stroke. However, whether both factors exert a synergistic effect in the onset of stroke remains unclear. The present study is a retrospective analysis of 2 089 cases of stroke and 2 089 control cases of simple intervertebral disk protrusion using a paired multivariate logistic regression method. Adjusting for known confounding variables including the patients' age, gender, smoking status, alcohol consumption status, patient and family medical history, and clinical biochemical indices, elevated homocysteine level was related to the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids showed a 40.9 % increase in the risk for stroke compared to patients with normal homocysteine levels and blood lipids (odds ratio 1.409; 95% confidence interval 1.127-1.761). These results indicate that elevated homocysteine and abnormal blood lipids exert synergistic effects in the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids are predisposed to stroke.

[A cross-sectional survey of crab intolerance positive rate and its determinants in healthy medical examination population in Beijing].

OBJECTIVE: To explore the positive rate of crab intolerance and its related factors in a healthy physical examination population in Beijing, China. METHODS: A cross-sectional survey was carried out from August 1, 2008 to July 30, 2009. It recruited a total of 12 765 adults with crab intolerance at Health Sciences Center, Chinese PLA General Hospital. The epidemiological data were entered into computer by two persons and organized by Epidata3.0. Non-conditional Logistic regression model was used to calculate the values of odd ratio (OR) and 95%CI. Statistic analysis was performed by SPSS 13.0. RESULTS: The incidence rate of crab intolerance was 24.5% (3128/12 765) and increased with age. Grades of crab intolerance were associated with age and gender and there was a linear correlation tendency (P < 0.05). Incidence rate of crab intolerance in females (27.5%, 1077/3912) was higher than that of males (23.2%, 2051/8853). Multiple regression analysis showed that crab intolerance was correlated with age, gender, body mass index and helicobacter infections(all P < 0.05). In comparison with age group < 40 years old, the values of OR (95%CI) of age groups 41 - 50, 51 - 60 and > 60 years old were 1.224 (1.095 - 1.368), 1.616 (1.431 - 1.827) and 2.177 (1.799 - 2.634) respectively. In comparison with males, the OR (95%CI) of females was 1.286 (1.174 - 1.408). The OR (95%CI) of Helicobacter pylori infections was 1.303(1.201 - 1.413). In comparison with normal weighters, the OR (95%CI) of obese subjects was 1.154 (1.026 - 1.298). CONCLUSIONS: Crab intolerance may be correlated with age, gender, Helicobacter pylori infections and body mass index. Health education should be targeted at its characteristics.

[A cross sectional survey on the relationship between intolerance to eggs and body mass index in Beijing, China].

OBJECTIVE: To explore the prevalence of intolerance to eggs and its relationship with body mass index in Beijing, China. METHODS: A cross sectional survey which included 12 766 adults from health sciences center of general hospital of the Chinese People's Liberation Army from August, 2008 to July, 2009 was carried out. Data was entered computer and organized by EpiData 3.0 software for epidemiological analysis. Nonconditional logistic regression model was used for odd ratio (OR) and 95%CI calculation, and statistics analysis was carried out by SPSS 13.0 software. RESULTS: Positive rate of intolerance to eggs in the cohort was 28.5%. Grades of intolerance to eggs were associated with sex (P < 0.05). Positive rate of intolerance to eggs in females (36.5%) was higher than those in males (24.9%). Data from multiple regression analysis showed that intolerance to eggs was associated with sex and body mass index. Compared with males, the OR (95%CI) of female was 1.732 (1.590 - 1.887). Compared with normal weights, the OR (95%CI) of low weights was 1.443 (1.018 - 2.045). CONCLUSION: Sex and body mass index mignt be associated with intolerance to eggs.