[Effectiveness on the education and food safety programs among senior primary students in 2 counties from west China-a cluster randomized trial].

OBJECTIVE: To evaluate the effectiveness of nutrition and food safety educational programs on primary students from grade 4 to 6 in impoverished areas of Western China, under a school-based cluster-randomized trial. METHODS: Twelve primary schools were selected from 2 impoverished counties in West China and assigned to intervention or control groups, randomly, with 6 schools in each group. Self-rating knowledge, attitude and practice questionnaires were used at both baseline and final stages. Textbooks and supportive materials were designed according to the characteristics of baseline data. All students in the intervention group were treated with targeted nutrition and food safety lectures of 0.5 hour per week for 2 semesters. Generalized linear mixed effects model was applied to fit the random effects on individual and clusters as well as to fit the fixed effect of the programs. RESULTS: Three hundred seventy-eight students from grade 4 to 6 were randomly selected at the baseline study and the differences of scores on knowledge, attitude and practice between the 2 groups were statistically insignificant (P > 0.05). No cluster was lost during the trial. In the final investigation, 478 students were randomly selected at the individual level. Scores on knowledge, attitude and practice among students in the intervention group were significantly higher, when comparing to the control group (P < 0.01). At the cluster level, more schools in the intervention group showed significant changes on knowledge and practice, yet the change in attitude was less obvious. Data from the mixed-effects model demonstrated that the program served as an influential factor on scores related to knowledge after the intervention(P = 0.015)but did not affect the scores on related attitude or practice (P > 0.05). CONCLUSION: Lectures seemed to have improved the cognition of nutrition and food safety among primary students from grade 4 to 6. However, long-term observation and larger sample size were needed to evaluate the changes on attitude and practice among the students.

[Diagnostic and therapeutic status of benign prostatic hyperplasia outpatients at department of geriatrics in China].

OBJECTIVE: To assess the diagnostic and therapeutic modality preferences of physician implementation of the Chinese Clinical Practice Guidelines for Benign Prostatic Hyperplasia (BPH) for geriatric BPH patients. METHODS: This cross-sectional survey was conducted at 33 medical centers located in 11 different cities in China (4 in north; 7 in south). A total of 190 physicians were requested to record their preferences in diagnostic tests and treatment options for elderly BPH cases. RESULTS: The physician response rate was 97.4%. Respondents generally selected those practices consistent with the guidelines, but their preferences for recommended tests varied. The use of medical history, ultrasonography and urinalysis was higher (> 90.0%) and that of uroflowmetry was lower (31.2%). In addition, the rate of use of recommended tests was higher among physicians in the north than those in the south. Drug therapy was the preferred treatment option. The proportion of drug treatment increased with the severity of symptoms in elder patients. In the south, the proportion of drug treatment in severe cases increased to 82.6% versus 61.9% in mild cases. In the north, the proportion of rug treatment in severe cases increased to 83.5% versus 54.6% in mild cases. CONCLUSION: This study provides insights into the physician preferences of diagnosis and treatment. The physicians generally comply with the BPH clinical practice guidelines. It may also serve as a practical reference for updating and improving the Chinese Clinical Practice Guidelines for BPH.

Relationships between serum adiponectin, leptin concentrations and bone mineral density, and bone biochemical markers in Chinese women.

BACKGROUND: Adiponectin and leptin, as the main circulating peptides secreted by adipose tissue, are potential contributors to bone metabolism. However, their association with bone mineral density (BMD) is unknown. We investigated whether these serum adipocytokines concentrations are associated with BMD and bone turnover markers. METHODS: Serum adiponectin, leptin concentrations, bone turnover biochemical markers, and BMD were determined in 265 premenopausal and 336 postmenopausal Chinese women. RESULTS: In postmenopausal Chinese women, the multiple linear stepwise regression analysis showed that year since menopause, lean mass, estradiol, and adiponectin, but not fat mass, leptin, were independent predictors of BMD in postmenopausal Chinese women. However, in premenopausal Chinese women, adiponectin was not the predictor of BMD. The significant positive correlations between adiponectin and bone-specific alkaline phosphatase (BAP), bone cross-linked N-telopeptides of type I collagen (NTX) were found only in postmenopausal women. Serum BAP, and NTX, but not adiponectin, decreased in response to alendronate therapy. CONCLUSIONS: Adiponectin was an independent predictor of BMD, and positively correlated with bone turnover biochemical markers in postmenopausal Chinese women, but not premenopausal women. It suggested that adiponectin may exert a negative effect on bone mass by promoting excessive bone resorption associated with bone loss. However, these effects may be mediated by menopausal status.

[Using multivariate multilevel model in studying the influential factors of violence among rural high school students in Changsha].

OBJECTIVE: To provide evidence for setting up violence intervention programs in rural middle schools, through studying the influential factors. METHODS: Taking variables including emotional, physical and sexual violence in the past year as the multi-dependent variables before multivariate multilevel model logistic regression model was adopted to analyze the correlations among the three kinds of violence and the influential factors. RESULTS: Among 3620 respondents, the incidence rates of emotional, physical and sexual violence weres 21.5%, 24.3% and 2.0% respectively. The correlation coefficients between emotional violence vs. physical violence, emotional violence vs. sexual violence, physical violence vs. sexual violence were 0.337, 0.133, 0.131 respectively when the random effect of class difference was separated by multivariate multilevel model. There was an internal aggregation of the incidence rate on physical violence in different grades (chi2=4.286, P = 0.038) and an internal relevant between emotional violence vs. sexual violence (chi2 = 4.239, P = 0.039), physical violence vs. sexual violence (chi2 = 4.482, P = 0.034). The influential factors on the incidence rates of violence would include: sex, smoking status, family without harmony, tendency of bullying others and the level on self-esteem etc. CONCLUSION: When the random effect of class difference was separated by multivariate multilevel model, the estimated results would be more precise. Other than paying more attention to both individual and family influential factors when taking measures to reduce the incidence rate of violence in high school students, the effect of environment in the class should not be ignored.

Relationships between serum adiponectin, leptin, resistin, visfatin levels and bone mineral density, and bone biochemical markers in Chinese men.

BACKGROUND: Adiponectin, leptin, resistin, and visfatin, as the main circulating peptides secreted by adipose tissue, are potential contributors to bone metabolism. We investigated whether these serum adipocytokines levels are associated with BMD and bone turnover biochemical markers in 232 Chinese men (20-80 y). METHODS: Serum adiponectin, leptin, resistin, and visfatin levels were determined by ELISA. RESULTS: Leptin had a positively correlation with fat mass, and remained significant after adjustment for age and BMI. There was a significant negative weak correlation between adiponectin and fat mass, and disappear after adjustment for age and BMI. Resistin and visfatin were not significantly correlated with fat mass. In the multiple linear stepwise regression analysis, lean mass and adiponectin, but not leptin, resistin and visfatin, were independent predictors of BMD. The significant positive correlations between adiponectin and bone-specific alkaline phosphatase (BAP), bone cross-linked N-telopeptides of type collagen (NTX) were found, and remained significant after adjustment for age and fat mass. CONCLUSIONS: Adiponectin was an independent predictor of BMD in Chinese men, and positively correlated with bone turnover biochemical markers. It suggested that adiponectin exert a negative effect on bone mass in men.

Organic anion transporting polypeptide-1B1 haplotypes in Chinese patients.

AIM: To detect 388G>A and 521T>C variant alleles in the organic anion transporting polypeptide-1B1 (OATP1B1, encoding gene SLCO1B1) gene. METHODS: One hundred and eleven healthy volunteers were screened for OATP1B1 alleles in our study. PCR-restriction fragment length polymorphism was used to identify the 388G>A polymorphism and a 1-step tetra-primer method was developed for the determination of 521T>C mutation. RESULTS: The frequencies of the 388G>A and 521T>C variant alleles in the Chinese population were 73.4% and 14.0%, respectively. The frequencies of the SLCO1B1*1b and *15 haplotypes were 59.9% and 14.0%, respectively. CONCLUSION: The SLCO1B1*1b and SLCO1B1*15 variants are relatively common in the Chinese population. Their frequencies are similar to that in the Japanese, but significantly different from that in Caucasians and blacks.

[An application of correspondence analysis method in the study of disease etiology].

OBJECTIVE: To explore the application value of correspondence analysis in ecological study. METHODS: We adopted correspondence analysis method to analyze the relationship between the amount of food intake in some cities in China and the male gastric carcinoma mortality. RESULTS: According to scatter plots of row and column points, there were regional differences among the male gastric carcinoma mortality in different cities of China. CONCLUSION: The scatter plot of row and column points indicated directly that there were regional differences among the male gastric carcinoma mortality in different cities of China. Males from the Southern part of the country ate more rice and salt, less wheaten food and fewer light vegetables than those from the northern parts, suggesting that there might be some carcinogenic factors in some food stuff involved.

Prognostic factors for primary superficial transitional cell carcinoma of the bladder: a retrospective cohort study.

BACKGROUND: Previous studies showed that the prognostic factors for superficial transitional cell carcinoma of the bladder varied with the findings of different cohorts. Few multivariate analyses of prognostic factors for superficial bladder tumors have been reported in China and bladder preservation as a prognostic index of superficial bladder tumors is limited and scarce in Chinese patients. This study was conducted to analyze a group of risk factors for prognostic outcomes for patients with primary superficial transitional cell carcinoma of the bladder. METHODS: Between January 1980 to December 2000, 198 patients [172 men and 26 women; mean age (52.98 +/- 11.28) years] with primary superficial transitional cell carcinoma who were pathologically classified as Ta or T1 in Hunan Provincial Tumor Hospital (Changsha, China) were enrolled in this study. Surgical methods included local resection and electric coagulation of bladder tumors, transurethral resection of bladder tumors and partial cystectomy. After initial surgical treatment, patients were followed through a cystoscopy every three months during the first two years and every six months thereafter in the design of retrospective cohort. Survival analysis was performed to analyze risk factors of the prognostic outcomes for transitional cell carcinoma of the bladder. Canonical correlation analysis was conducted to present and interpret synthetically the multi-correlation between all kinds of prognostic outcomes and risk factor in multiply dimensions. RESULTS: The average follow-up period was (6.65 +/- 4.74) years. Assessments at three, five, and 10 years showed recurrence rates, respectively, of (28.32 +/- 3.45)%, (35.31 +/- 3.83)%, and (42.48 +/- 4.40)%; progression rates of (8.89 +/- 2.14)%, (15.16 +/- 2.94)%, and (23.88 +/- 4.19)%; bladder-preservation rates of (94.68 +/- 1.74)%, (93.87 +/- 1.91)%, and (91.51 +/- 2.49)%; metastasis rates of (8.25 +/- 2.05)%, (11.24 +/- 2.47)%, and (28.94 +/- 4.93)%; and cancer-related survival rates of (95.02 +/- 1.62)%, (90.70 +/- 2.45)%, and (77.14 +/- 4.88)%. The main risk factors for recurrence were histological grade, blood transfusion during surgery and the duration of symptoms. Progression was affected by blood transfusion during surgery, histological grade, the number of re-examinations, and the length of the recurrence-free period. Metastasis was associated with tumor multifocality, hydronephrosis, microscopic growth pattern, and the recurrence-free period. Cancer-related survival was influenced by microscopic growth pattern and the recurrence-free period. Bladder preservation involved only the recurrence-free period. The comprehensive results from canonical correlation analysis showed that the main prognostic outcomes were cancer-related survival, metastasis and progression respectively, while the dominate risk factors were histological grade, tumor multifocality and blood transfusion. CONCLUSIONS: The risk factors were different for each prognostic outcome of transitional cell carcinoma of the bladder. This is helpful for predicting the prognosis of transitional cell carcinoma of the bladder and designing therapeutic and follow-up strategies for this cancer.

[Years of potential life of residents among different flood areas in Hunan province].

OBJECTIVE: To determine the damage of different types of floods on the residents health. METHODS: The methods of standard mortality rate (SMR) and years of potential life lost (YPLL) were used to analyze the death of sample residents from flood areas in Dongting Lake in Hunan province. RESULTS: The order of death causes in the soaked area, the collapsed area and the non-flood area was the same. But the mortality rates of residents injury, poisoning and malignant neoplasm diseases in the soaked area and the collapsed area were higher than those of non-flood area. The resident standard rates of years of potential life lost (SYPLL) in the soaked area and the collapsed area were higher than that of the controls, especially in the age group of 30 to 45. The flood-attributed SYPLL in the male was higher than that of the female. CONCLUSION: Flood actually affected the health of residents. The more serious the flood is, the worse the effect is. It is very important to decrease the resident mortality rate of the injury, poisoning and malignant neoplasm, and to pay attention to protect people of 30 to 45 years old in flood areas.

[Development of the quality of life scale specific for patients with benign prostatic hyperplasia].

OBJECTIVE: To develop a specific quality of life (QOL) scale for Chinese patients with benign prostatic hyperplasia (BPH). METHODS: The scale was developed with the programmed decision methods. The item pool was certified by experts. Five methods were used in item selection after a pilot study for which 256 BPH patients had been recruited. The scale was evaluated by its reliability and validity. RESULTS: We formed a 27-item quality of life scale specific for patients with benign prostatic hyperplasia prior test version (BPHSQL). The test-retest correlation coefficient and Cronbach's alpha coefficient of BPHSQL were 0. 774 and 0. 945. The structure of the scale was similar to the theory construction. The scale's correlation coefficients with criteria ranged from 0.531 to 0.700. BPHSQL could well discriminate the quality of life between BPH and non-BPH patients as well as patients with different degrees of symptoms, different sources and patients with or without urethral catheters. CONCLUSION: BPHSQL is reliable, valid and sensitive, and will be a convenient tool in clinical research to provide advice on different treatments for different patients.