Inaccuracy of Self-reported Low Sodium Diet among Chinese: Findings from Baseline Survey for Shandong & Ministry of Health Action on Salt and Hypertension (SMASH) Project.

This study was aimed to evaluate the agreement between the self-reported sodium intake level and 24-h urine sodium excretion level in Chinese. The 24-h urine collection was conducted among 2112 adults aged 18-69 years randomly selected in Shandong Province, China. The subjects were asked whether their sodium intake was low, moderate, or high. The weighted kappa statistics was calculated to assess the agreement between 24-h urine sodium excretion level and self-reported sodium intake level. One third of the subjects reported low sodium intake level. About 70% of the subjects had mean 24-h sodium excretion>9 g/d, but reported low or moderate sodium intake. The agreement between self-reported sodium intake level and 24-h urine sodium excretion level was low in both normotensive subjects and hypertensive subjects. These findings suggested that many subjects who reported low sodium intake had actual urine sodium excretion>9 g/d. Sodium intake is often underestimated in both hypertensive and normotensive participants in China.

Do B Vitamins Enhance the Effect of Omega-3 Polyunsaturated Fatty Acids on Cardiovascular Diseases? A Systematic Review of Clinical Trials.

Studies have suggested that B vitamins or omega-3 polyunsaturated fatty acids (PUFAs) may deter the development of cardiovascular disease (CVD). This systematic review aims to examine whether the combined supplementation of both B vitamins and omega-3 PUFAs could provide additional beneficial effects to prevent CVD beyond the effect of each supplement based on clinical trials published up to December 2021. The overall findings are inconsistent and inconclusive, yet the combined supplementation of these two nutrients may be more effective at reducing plasma homocysteine, triglyceride, and low-density lipoprotein-cholesterol than the individual components. The underlying mechanisms mainly include alleviating endothelial dysfunction, inhibiting atherosclerosis and lesion initiation, reducing oxidative stress, suppressing activation of pro-inflammatory cytokines, regulating endothelial nitric oxide synthase, and interfering with methylation of genes that promote atherogenesis. Although biologically plausible, the existing literature is insufficient to draw any firm conclusion regarding whether B vitamins can further enhance the potential beneficial effects of omega-3 PUFA intake on either primary or secondary prevention of CVD. The inconsistent findings may be largely explained by the methodological challenges. Therefore, well-designed high-quality trials that will use the combined supplementation of B vitamins and omega-3 PUFAs or dietary patterns rich in these two types of nutrients are warranted.

Effect of soya protein on blood pressure: a meta-analysis of randomised controlled trials.

Observational studies have indicated that soya food consumption is inversely associated with blood pressure (BP). Evidence from randomised controlled trials (RCT) on the BP-lowering effects of soya protein intake is inconclusive. We aimed to evaluate the effectiveness of soya protein intake in lowering BP. The PubMed database was searched for published RCT in the English language through to April 2010, which compared a soya protein diet with a control diet. We conducted a random-effects meta-analysis to examine the effects of soya protein on BP. Subgroup and meta-regression analyses were performed to explore possible explanations for heterogeneity among trials. Meta-analyses of twenty-seven RCT showed a mean decrease of 2·21 mmHg (95 % CI - 4·10, - 0·33; P = 0·021) for systolic BP (SBP) and 1·44 mmHg (95 % CI - 2·56, - 0·31; P = 0·012) for diastolic BP (DBP), comparing the participants in the soya protein group with those in the control group. Soya protein consumption significantly reduced SBP and DBP in both hypertensive and normotensive subjects, and the reductions were markedly greater in hypertensive subjects. Significant and greater BP reductions were also observed in trials using carbohydrate, but not milk products, as the control diet. Meta-regression analyses further revealed a significantly inverse association between pre-treatment BP and the level of BP reductions. In conclusion, soya protein intake, compared with a control diet, significantly reduces both SBP and DBP, but the BP reductions are related to pre-treatment BP levels of subjects and the type of control diet used as comparison.

[A multi-center randomized controlled trial of intrauterine device use in Chinese women].

OBJECTIVE: To assess the safety and effectiveness of intrauterine device in Chinese women. METHODS: In this multicenter randomized controlled trial, a total of 24 000 women were randomly (1:1:1) into 3 groups of Yuangong Cu 365 (YCu365), Copper T 380A (TCu380A) and Multiload Cu 375 (MLCu375). Clinical outcomes were assessed at 12 months post-insertion, including discontinuation due to pregnancy, expulsion, hemorrhage and downward displacement, etc. The overall and causal-specific discontinuation rates for adverse events were calculated. RESULTS: At the end of the first year, the discontinuation rate of YCu365 (4.21%) was the lowest, followed by TCu380A (8.42%) and MLCu375 (13.91%) (P < 0.01). The differences of discontinuation rates for pregnancy, expulsion, hemorrhage and downward displacement between these IUDs were also significant. MLCu375, side effect without medical treatment, fewer follow-ups, deeper uterine cavity and previous IUD failure were significantly associated with an increased risk of IUD discontinuation. CONCLUSION: The newly developed indomethacin-releasing YCu365 IUD appears to perform the best. However, its long-term safety and cost-effectiveness should be further evaluated.

Combining previously published studies with current data in Bayesian logistic regression model: an example for identifying susceptibility genes related to lung cancer in humans.

A general analysis method is proposed that utilizes meta-analysis to incorporate similar studies in addition to our current investigation in order to obtain informative prior effect parameters in a logistic regression model. It is common in epidemiological studies that data from similar previous studies are available. The case of gene susceptibility association with increased lung cancer frequency was used to demonstrate this methodology. Results of Markov chain Monte Carlo (MCMC) iterations provided a more precise estimation of the regression coefficient in a logistic model with informative prior distribution compared to the noninformative prior distribution model. In situations where similar historical data are available, it is proposed to include as much relevant information as previously published results in the analysis of current data.

Adjuvant steroid treatment following Kasai portoenterostomy and clinical outcomes of biliary atresia patients: an updated meta-analysis.

BACKGROUND: It is controversial whether adjuvant steroid treatment should be given to biliary atresia (BA) patients following a Kasai portoenterostomy (KPE). This study aimed to quantitatively and systematically evaluate the effect of adjuvant steroid therapy post-KPE in relation to major clinical outcomes of BA patients. METHODS: We systematically reviewed the literature in PubMed, Embase, the Cochrane Library, China Knowledge Resource Integrated Database, Wanfang Database, Scholarly and Academic Information Navigator and manually searched for relevant papers published before August, 2015. We extracted data on the effects of steroid treatment following KPE on clinical outcome, including jaundice free rate and native liver survival rate at 6 months, 1 or 2 years after KPE. The weighted overall relative risk (RR) and 95% confidence intervals (CIs) were calculated by using a random-effects model. RESULTS: Eight cohort studies and two randomized controlled trials (RCTs) were identified (n=998). Of them, 6 cohort studies and 2 trials investigated the effect of steroid treatment as compared to non-users or placebo (n=566), and 2 cohort studies compared the effects of high-dose to low-dose steroid treatment (n=432). Steroid usage increased the clearance rates of jaundice at 6 months (pooled RR: 1.32; 95% CI: 0.995-1.76; I 2=72.6%) and 1 year (pooled RR: 1.35; 95% CI: 1.12-1.61; I 2=0.0%), but not 2 years (pooled RR: 0.82; 95% CI: 0.55-1.22; I 2=0.0%) after KPE. There was no solid evidence supporting that steroid treatment would improve native liver survival rate at 6 months (pooled RR: 1.02; 95% CI: 0.90-1.15; I 2=0.0%), 1 year (pooled RR: 1.10; 95% CI: 0.91-1.34; I 2=35.2%) or 2 years (pooled RR: 1.00; 95% CI: 0.73-1.35; I 2=57.4%) after KPE. CONCLUSIONS: Adjuvant steroid treatment following KPE may improve short-term (≤1 year) clearance rate of jaundice, but no significant effects on long-term (≥2 years) clearance rate of jaundice and native liver survival rate. Studies on doses and duration of steroids, and long-term follow-up studies are warranted.

Serum bile acid level and fatty acid composition in Chinese children with non-alcoholic fatty liver disease.

OBJECTIVE: To determine serum bile acid (BA) and fatty acid (FA) profiles in Chinese children with non-alcoholic fatty liver disease (NAFLD). METHODS: A total 76 children aged 4-17 years were categorized into three groups according to the presence and absence of as well as the severity of NAFLD, that is, non-NAFLD (control), mild and moderate to severe NAFLD groups, respectively, based on their liver ultrasonography findings. Serum BA and FA profiles were quantified separately by mass spectrometry and gas chromatography. General linear models were performed to assess the differences among the groups. RESULTS: After adjusted for potential confounders, children with NAFLD had higher levels of chenodeoxycholic acid (CDCA), unconjugated primary BAs (CDCA + cholic acid) but lower levels of deoxycholic acid (DCA), taurodeoxycholic acid (TDCA), glycodeoxycholic acid (GDCA), total DCA (DCA + TDCA + GDCA), glycolithocholic acid (GLCA) and total lithocholic acid (GLCA + taurolithocholic acid) than children without NAFLD. As for FAs, children with mild and moderate to severe NAFLD had higher levels of n-7 monounsaturated FA. CONCLUSIONS: Circulating BA and FA profiles may change in children with NAFLD. Further studies are needed to determine their associations and to understand the underlying mechanism of action.

[A cross-sectional survey of blindness and low vision among adults aged 60 years and above in Xinchengqiao Blocks, Nantong].

OBJECTIVE: To investigate the prevalence and causes of blindness and low vision among adults aged > or = 60 years in the urban population of Nantong. METHODS: Cluster sampling was used to select 8 from 14 communities in Xinchengqiao Blocks, in which all individuals aged > or = 60 years were visited. The visual acuity without correction and the presenting acuity with the participants' habitual distance correction were measured separately for each eye. In individuals with visual acuity less than 0.6, pinhole visual acuity was tested with pinhole spectacle. External eye, anterior segment and ocular fundus were examined by the ophthalmologist using a slit lamp-microscope and direct ophthalmoscopy. The survey was preceded by a pilot study. RESULTS: Of 3352 enumerated subjects, 3040 individuals participated in this survey (90.69% response rate). According to pinhole visual acuity and World Health Organization (WHO) visual impairment criterion (blindness: less than 0.05 in the better eye; low vision: less than 0.3 to 0.05 in the better eye), the prevalence of blindness and low vision was 1.35% and 1.84% respectively. The prevalence of blindness and low vision for females were 1.92% and 2.33%, respectively, which were differenced from that in males (0.66% and 1.24%, respectively). The prevalence of blindness and low vision increased with age. The survey showed that the most important cause leading to blindness and low vision was cataract. According to the presenting visual acuity and visual impairment criterion (blindness: less than 0.1 in both eyes), the prevalence of blindness and visual impairment was 1.58% and 13.59%, respectively, 2.10% and 15.98% in females and 0.95% and 10.66% in males, respectively. The prevalence of blindness and visual impairment was raised with increasing age. Cataract was also the leading cause for blindness. CONCLUSIONS: The prevalence of blindness in the Nantong area was lower than that in northern, southern and western China. Females and illiteracy were more likely to have blindness and low vision than that of males and literate. The leading causes of blindness in Nantong are, in descending sequence, cataract, ocular fundus diseases, ametropia and corneal scar/opacity.

[Effects of three madriatics on the human ocular aberrations].

OBJECTIVE: To evaluate the effects of three common madriatics-phenylephrine, tropicamide and Mydrin-P on aberrations in human eye. METHODS: General aberrations, lower- and higher-order aberrations (HOA) were measured at the pupil diameter 4.0 mm and 7.0 mm with Allegretto Wave Analyzer on 37 eyes of 19 young volunteers whose spherical equivalence (SE) ranged from -0.25 D to -6.00 D. Four measured conditions were used for each subject. (1) Topical installation of 3 drops 5.0% phenylephrine hydrochloride. (2) Topical installation of 3 drops 0.5% tropicamide. (3) Topical installation of 3 drops Mydrin-P. (4) Topical installation of 3 drops 0.3% Tarivid, prior to aberometry measurements. The differences were analyzed on the values of the root-mean-square (RMS) of general (RMSg) and higher-order aberrations (RMSh), coefficient of defocus, astigmatism, the third aberrations, primary spherical aberration and the dominating type of HOA among three madriatics or between the madriatics and Tarivid solution respectively. RESULTS: There was no significant difference among the three madriatics in the average value of RMSg, RMSh, C3-C9 and C12 (P > 0.05). However, small but statistically significant difference was found in the disparity between any madriatic and Tarivid at the condition of 4.0 mm diameter of pupil. The disparity of 5% phenylephrine over RMSg and C4 was the smallest, and showed significant difference (P < 0.05). The third order aberration was more frequent dominating type of HOA over a 4.0 mm and 7.0 mm pupil for 4 eye drops, and C7 was the most frequent one among all the volunteers; there were 28 eyes (75.7%), 20 eyes (54.1%) which dominating type of HOA changed. CONCLUSIONS: All the three madriatics can be used to measure the higher-order aberrations, spherical aberration and coma in the young myopic persons. However, phenylephrine measurement may be the choice for lower-order aberrations.

[Statistical methodologies used in genome-wide association studies].

In lieu of large samples of cases and/or controls with hundreds of markers spreading throughout the human genome, researchers started to notice the dramatic increase of genome-wide association study (GWAS) for complex disorders, in the last 5 years. This paper highlights the statistical challenges in such huge-scale genetic studies, and introduces the analytical strategies and steps for handling GWAS data. Such issues as quality control of data, population stratification, methods available to data analysis and results presentation, replication, as well as the limitations of GWAS studies and the challenges presenting for statistics, are addressed.

[Analysis on the risk factors of maternal weight for fetal macrosomia].

OBJECTIVE: To investigate the relationship between maternal weight gain and the increasing speed of weight in different pregnant terms and macrosomia. In order to reasonably manage pregnancy and decrease the morbidity of macrosomia. METHODS: 106 newborns whose birth weights were equal to or greater than 4000 g were specified as macrosomia, while 106 newborn with birth weights lying in 2500 - 3999 g were under the control group. A case-control study was conducted to compare the corresponding factors such as maternal BMI, weight before pregnancy and the change of weight during pregnancy respectively. RESULTS: Indicated by both simple and multiple unconditional logistic regression analysis, the cause of fetal macrosomia was mainly associated with the factors including the maternal weight before pregnancy (OR = 2.204, 95%CI: 1.377 - 3.529), maternal weight gain in 12-pregnant weeks (kg per week) (OR = 1.961, 95%CI: 1.204 - 3.194), maternal weight gain in 20-gestation weeks (kg per week) (OR = 1.811, 95%CI: 1.078 - 3.041), maternal weight gain in 30-pregnant weeks (kg per week) (OR = 1.858, 95%CI: 1.095 - 3.153) and virile newborn (OR = 2.630, 95%CI: 1.420 - 4.850. When in 30-pregnant weeks, the pregnant women with 0.5 - 1.0 kg weight gain per week had 1.13 fold risks comparing to those whose weight gains were less than 0.5 kg per week. CONCLUSION: Maternal weight before pregnancy, weight gain during pregnancy and fetal sex appeared a closer relation to macrosomia. It is necessary to monitor the change of maternal weight during different pregnancy periods, especially for the 30th-pregnant weeks.

[Estimation of gene-environment interaction regarding partial case-control study with missing data on gene information of the controls].

OBJECTIVE: To discuss the estimation on gene-environment interaction in partial case-control studies when gene information of the controls was partly missing. METHODS: The results of hot deck multiple imputation and listwise deletion analysis were compared when missing data was generated using Monte Carlo method in Stata 9.0. RESULTS: Coefficients of environment effect, gene effect and gene-environment interaction were respectively estimated by means of hot deck multiple imputation and listwise deletion when approaching to those complete data with missing part less than 50 percent. Both estimated variances of the two methods were increasing with the increased proportion of missing data, but the estimated variance of hot deck multiple imputation was smaller than the one with listwise deletion in each proportion. CONCLUSION: Hot deck imputation could be adopted to make full use of existing information to estimate gene-environment interaction in the partial case-control study when missing proportion of gene data of controls was less than 50 percent so as to increase the precision of the estimation.

[Estimation on gene-environment interaction in the partial case-control study].

OBJECTIVE: To introduce the approaches for estimating gene-environment interaction based on partial case-control studies. METHODS: The effects of logistic model and log-linear model for estimating the main effects and gene-environment interaction effect were estimated by means of maximum likelihood methods in traditional case-control studies, case-only studies and partial case-control studies, respectively. An example was also illustrated. RESULTS: In traditional case-control study with complete data, the results of logistic model and log-linear model were equivalent. In case-only study without any information about controls, the logistic model can also efficiently estimate gene-environment interaction. In partial case-control study, environmental information was collected from all of the cases and controls, while genetic information was only collected from cases. For this case-control study with incomplete data, a suitable parameterized log-linear model could simultaneously and efficiently estimate the main effect of environment and gene-environment interaction, whereas the logistic model could not. CONCLUSION: For a partial case-control study, log-linear model could estimate not only the main effect of environment but also gene-environment interaction. If genotype and exposure were independent, estimators from partial case-control were as precisely as those from complete-data case-control studies.

[Analysis on potential years of life lost of automobile drivers in Jiangsu in 1990 - 1999].

OBJECTIVE: To describe the health status of automobile drivers and to define their potential years of life lost (PYLL) resulting from main death causes in Jiangsu in 1990 - 1999. METHODS: The Reed-Merrell method and Makham-Gompertz equation were used to compile the abridged truncate life tables. PYLL and rate of PYLL was used to analyse death causes in 1990 - 1999. RESULTS: (1) The life expectancy of drivers at age 20 was 55.36, which was 0.70 year less than that of non-drivers. (2) Rate of PYLL was 35.07 per thousand in drivers, and 42.65 per thousand in non-drivers, and the corresponding standard rates of PYLL were 42.45 per thousand and 41.14 per thousand, respectively. (3) Damage and toxicosis ranked number 4 in terms of proportionate mortality ratio, but ranked first with the rate of PYLL. CONCLUSION: Special attention should be paid to the health status of automobile drivers, especially to those who are middle aged. Diseases that made the greatest contributions to drivers' "earlier death" were damage and toxicosis.