The blood pressure control and arteriosclerotic cardiovascular risk among Chinese community hypertensive patients.

The present study aimed to describe the blood pressure (BP) control rate and 10-years arteriosclerotic cardiovascular disease (ASCVD) risk estimation among community hypertensive patients. A total of 196,803 subjects were enrolled. The control rates calculated as the intensive (SBP < 130 mmHg and DBP < 80 mmHg) and standard (SBP < 140 mmHg and DBP < 90 mmHg) threshold. Multivariable logistic analysis was employed to assess the associations between cardiovascular factors and BP control. Sensitivity, specificity and Youden's index were used to identify the ability of high risk of ASCVD estimation by different thresholds. The control rate was 16.34% and 50.25% by the intensive and standard threshold, respectively. Besides regular medication, the risk factors for BP control included older age, male, unhealthy lifestyle, obesity, dyslipidemia and abnormal FPG. 25.08% of subjects had high risk of 10-years ASCVD estimation. The sensitivity, specificity and Youden's index of intensive threshold was 84.37%, 16.15% and 0.51%, and were significantly different from 50.55%, 50.42% and 0.98% of the standard threshold, respectively. Half of community hypertensive patients did not control BP, and nearly a quarter have high risk of 10-years ASCVD risk estimation. The intensive threshold resulted in a one-third reduction in the control rate compared to the standard threshold. No matter which threshold was used, a single BP control status seemed not a suitable indicator for identification of high risk of 10-years ASCVD risk estimation.

Attitudes of seasonal influenza vaccination among healthcare worker and general community population after pandemic influenza A/H1N1 in Hangzhou.

OBJECTIVE: To know the attitude toward seasonal influenza vaccination among healthcare worker (HCWs) and general community population (GCP s) in the post-pandemic influenza A/H1N1 period. RESULTS: A total of 489 participants including 126 HCWs and 363 GCP s completed the investigation. 33.33% individuals (34.92% HCWs vs. 32.78% GCP s, p > 0.05) intended to accept the seasonal influenza vaccination after pandemic influenza A/H1N1. Individuals received seasonal influenza vaccination in the prior 3 y and monovalent A/H1N1 vaccination in 2009 were aggressive to vaccinate seasonal influenza vaccine with adjusted OR = 5.21 (3.20 ~ 8.49) and 1.97 (1.18 ~ 3.30). According to the results of multivariable logistic regression model, the safety not efficacy of influenza vaccine was the significant factor for acceptability of seasonal influenza vaccination (OR: 3.11, 95% CI: 1.76 ~ 5.50). The positive attitude of serious degree of influenza A/H1N1 and occupational factor were also associated with the willingness of seasonal influenza vaccination and the adjusted ORs were 2.09 (1.14 ~ 3.83) and 1.62 (1.00 ~ 2.64). METHOD: We conducted a cross-sectional investigation in the beginning of seasonal influenza vaccination between 2010 and 2011, employed logistic regression analysis to compute the relationship between the willingness of seasonal influenza vaccination and variables after pandemic influenza A/H1N1. CONCLUSION: Participants showed low acceptability of seasonal influenza vaccination after pandemic influenza A/ H1N1. Need educational program concerning the advantages of vaccine, comprehensible information about possible adverse effects and the hazards of seasonal influenza disease, which might motivate individuals to accept seasonal influenza vaccination.

[Synergistic interaction between MMP-3, VDR gene polymorphisms and occupational risk factors on lumbar disc degeneration].

OBJECTIVE: To explore the synergistic interaction between MMP-3,VDR gene polymorphisms and occupational risk factors on lumbar disc degeneration. METHODS: A case-control study including 178 cases of lumbar disc degeneration and 284 controls was carried out through questionnaire and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology. Additive model was used to analyze the synergistic interaction between gene polymorphisms and occupational risk factors. RESULTS: The non-conditional logistic regression analysis showed that bending/twisting, whole-body vibration, heavy physical workload, alleles 5A of MMP-3 (6A5A/5A5A) and A of VDR-Apa (AA/Aa) were significantly associated with lumbar disc degeneration(OR = 4.06, 8.96, 5.46, 1.96 and 1.70, respectively, P < 0.05). There were synergistic interactions between the mutation genotype 5A of MMP-3 and whole-body vibration exposure, between the mutation genotype 5A of MMP-3 and bending/twisting, and between the mutation genotype A of VDR-Apa and whole-body vibration exposure (SI: 13.27, 2.91 and 2.35 respectively, P < 0.05). CONCLUSION: People with the mutation genotypes 5A of MMP-3 and/or A of VDR-Apa may have the increased risk of developing lumbar disc degeneration if they are exposed to whole-body vibration and/or bending/twisting.

Matrix metalloproteinase-3 and vitamin d receptor genetic polymorphisms, and their interactions with occupational exposure in lumbar disc degeneration.

OBJECTIVES: To investigate the occupational and genetic risk factors inducing lumbar disc degeneration in a Chinese population, and to explore their synergistic interactions. METHODS: A case-control study involving 178 low back pain patients with lumbar disc degeneration and 284 controls was carried out. Five types of work-related factors were investigated using questionnaires. Polymerase chain reaction and restriction fragments length polymorphism was used to detect the polymorphisms of MMP-3 (matrix metalloproteinase-3)(rs731236), VDR-Taq (vitamin D receptor-Taq) and VDR-Apa (vitamin D receptor-Apa)(rs35068180). Rothman's synergy index was used to measure the synergistic interactions between gene polymorphisms and occupational risk factors. RESULTS: Family history of lumbar disc diseases, back injury history, whole-body vibration, bending/twisting, heavy physical workload, age, mutation alleles 5A of MMP-3 and A of VDR-Apa were significantly associated with lumbar disc degeneration (OR=12.70, 11.79, 8.96, 5.46, 1.05, 1.96 and 1.70, respectively, p<0.05). Synergistic interactions existed between the mutation allele 5A of MMP-3 and whole-body vibration exposure, the mutation allele 5A of MMP-3 and bending/twisting, and the mutation allele A of VDR-Apa and bending/twisting (SI=13.27, 2.91, 2.35, respectively, p<0.05). CONCLUSIONS: The results of this study suggest that gene-occupation interaction might play a certain role in exaggerating lumbar disc degeneration. There is a possibility that subjects who carry mutation alleles 5A of MMP-3 and/or A of VDR-Apa are more vulnerable to lumbar disc degeneration when they are exposed to whole-body vibration and/or bending/twisting under ergonomic loads.