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<p><b>BACKGROUND</b>Coronary heart disease (CHD) is a multifactorial disease and is thought to have a polygenic basis. Apolipoprotein E (APOE) gene is one such candidate with its common ε2/ε3/ε4 polymorphism in CHD. In recent years, numerous case-control studies have investigated the relationship of APOE polymorphism with CHD risk. However, the results are confusing.</p><p><b>METHODS</b>To clarify this point, we undertook a meta-analysis based on 14 published studies including 5746 CHD cases and 19,120 controls. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were assessed for association using a random-effects or fixed-effects model using STATA version 10 (StataCorp LP, College Station, TX, USA).</p><p><b>RESULTS</b>Overall, the analysis showed that carriers of APOE ε2 allele decreased risk for CHD (ε2 allele vs. ε3 allele: OR = 0.82, 95% CI: 0.75-0.90, P < 0.001; ε2 carriers vs. ε3 carriers: OR = 0.81, 95% CI: 0.73-0.89, P < 0.001), compared with those carrying ε3 allele, especially in Caucasian population. However, those with ε4 allele had a significant increased risk for CHD (ε4 allele vs. ε3 allele: OR = 1.34, 95% CI: 1.15-1.57, P < 0.001), especially in Mongoloid population. Potential publication bias was observed in the genetic model of ε4 versus ε3, but the results might not be affected deeply by the publication bias. When we accounted for publication bias using the trim and fill method, the results were not materially alerted, suggesting the stability of our results.</p><p><b>CONCLUSIONS</b>Taken together, our meta-analysis supported a genetic association between APOE gene and CHD. ε4 increased the risk of CHD, whereas ε2 decreased the risk of CHD.</p>
Subject(s)
Humans , Apolipoproteins E , Genetics , Coronary Disease , Genetics , Genetic Predisposition to Disease , Polymorphism, GeneticABSTRACT
Objective To analyze the prevalence of passive smoking among inland residents in China from 2000 to 2009 and to analyze the differences between sex, urban/rural geographic distribution, different levels of economic development etc.. Methods Electronic search strategy was carried out, using WanFang database, China Journal Full-text database, VIP database, CBM and PubMed database to collect data on smoking, and passive smoking status, among residents in China.Fixed effects model or random effects model was employed according to statistical tests for homogeneity. Publication bias was assessed by rank correlation test. All statistical analysis was conducted with R 2.8.0. Results Nineteen studies were selected with a total of 195 349 non-smokers and 70 781 passive smokers involved. The overall prevalence of passive smoking was 47.04%(95%CI: 38.88%-55.27%). The prevalence of passive smoking was stratified by factors as sex, urban/rural, year and areas of the study, and areas where passive smoking was studied. The pooled prevalence rates of passive smoking were as follows: 44.80% (95%CI: 34.07%-55.79%) and 49.09%(95%CI:39.62%-58.59%) ,P＜0.05 for male and female;46.10%(95%CI:28.88%-63.82%),47.55%(95% CI: 17.85%-78.25% ), P＜0.05 for urban and rural, respectively. The pooled prevalence rates of passive smoking were 47.59% (95% CI: 38.31%-56.95% ) in the study year of 2000-2004 and 46.90% (95%CI: 33.19%-60.87% ) in 2005-2009 (P＜0.05). The pooled prevalence rates of passive smoking for eastern and western areas were 41.38%(28.88%-54.47%) and 74.38%(95%CI: 59.08% -87.10% ) (P＜0.05), and 73.03% (95%CI: 60.41% - 84.00% ), 14.72% (95%CI: 8.83%-21.82% )and 25.90% (95% CI: 5.65% - 54.24% ) for family, workplace and public place, respectively (P＜0.05). Conclusion The pooled prevalence of passive smoking was higher in females than males, in rural than in urban and in the western area than in the eastern areas. The prevalence of passive smoking in the study year of 2005-2009 was lower than of 2000-2004. The pooled passive smoking rate in the family was higher than in the workplace or in public.
ABSTRACT
<p><b>BACKGROUND</b>There is a strong need for quick noninvasive diagnostic technique that can give a valid estimate of the status of the cartilage reliably, discriminating intact cartilage from various grades of impaired cartilage. The goal of this study was to assess the incidence of knee cartilage injuries and compare the accuracy of two-dimension spin echo (2D SE) and fast spin echo (FSE) (conventional MRI), three-dimensional spoiled gradient echo (3D SPGR), three-dimensional fast imaging employing steady state acquisition (3D FIESTA) MR imaging sequences with surgical examination of the articular cartilage.</p><p><b>METHODS</b>One hundred and thirty-eight knees with history of knee trauma received conventional MRI, 3D SPGR and 3D FIESTA MRI examination before surgery, and surgical examination of articular cartilage was used as reference standard. A modified version of the Noyes classification system was applied for the evaluation of the lateral femoral condyle (LFC), medial femoral condyle (MFC), lateral tibial plateau (LTP), medial tibial plateau (MTP), trochlea and patella. The incidence and distributions of different injured grades at different articular surfaces of knee were assessed. A series of assessment indeces of 3D SPGR, 3D FIESTA, and the combination of the conventional MRI and 3D SPGR imaging were calculated.</p><p><b>RESULTS</b>The incidence of cartilage defects (grade 2 to 4) was 22% (183/828), according to surgical examination. Grade 3 and 4 lesions were absent at the medial tibial plateau. The rates of exact match between the grading results of different MRI procedures and surgical examination were 49% of 3D SPGR, 61% of 3D FIESTA, and 82% of the combination of 3D SPGR and conventional MRI. Also, the combination of 3D SPGR and conventional MR imaging provided the highest sensitivity, specificity, accuracy, positive and negative predictive values, at 71%, 97%, 90%, 90% and 90%, respectively.</p><p><b>CONCLUSIONS</b>For all the articular surfaces of the traumatic knees, about one fifth (22%) were cartilage defects. Both 3D SPGR and 3D FIESTA imaging performed similarly in detecting cartilage lesions of the knee. The increased accuracy in chondral assessment can be achieved by combining 3D SPGR and conventional MRI within a reasonable time.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cartilage, Articular , Wounds and Injuries , Pathology , General Surgery , Knee Injuries , Pathology , General Surgery , Knee Joint , Pathology , General Surgery , Magnetic Resonance Imaging , MethodsABSTRACT
<p><b>BACKGROUND</b>It is of value to identify the non-invasive means that can accurately reflect the blood supply of epiphysis and is more sensitive in detection of early ischemia of epiphysis than the conventional gadoteridol (Gd)-enhanced SE T1WI. The aim of this study was to evaluate the blood supply of various anatomic regions at the end of normal growing long bone using dynamic Gd-enhanced MR imaging and compare the sensitivities between dynamic Gd-enhanced MR imaging and conventional Gd-enhanced SE T1WI in the detection of decreased blood perfusion of early epiphyseal ischemia.</p><p><b>METHODS</b>Twenty-seven two-week-old piglets were used in this study. For the study of the end of normal growing long bone, unilateral MR imaging of the distal femur and proximal tibia was performed on eleven piglets. The comparison was made among various anatomic regions (physeal and epiphyseal cartilage, metaphyseal spongiosa, the secondary ossification center and metaphysis) using MRI in terms of the enhancement ratio and speed. Their relationships with the histological findings, including RBC/mm(2) and vessel distribution, were evaluated. To examine ischemic femoral head, 16 piglets were divided into two groups, with the control group having 8 piglets (involving 16 normal hips) and an ischemic group having 8 piglets (involving 16 hips with hyperabduction). In the ischemic group, MR imaging was performed on the hips in the hyperabduction immobilized persistently for 30 minutes. After MRI, the piglets were allowed to ambulate freely for 1 day and the same MR scanning was then repeated in a neutral position. The difference in enhancement ratio and speed of the femoral head between the control and ischemic group were evaluated.</p><p><b>RESULTS</b>With regard to the end of normal growing long bone, the enhancement ratio of the metaphyseal spongiosa was greatest among all the anatomic regions (P < 0.001). The enhancement ratio of physeal cartilage was greater than that of epiphyseal cartilage (P < 0. 001), which was the lowest in all tissues (P < 0.001). The enhancement speed of the spongiosa was greater than that of physis but the difference was not significant (P > 0.05). The enhancement speed of physis was greater than that of epiphyseal cartilage (P < 0.05), which was the lowest among all the tissues (P < 0.05). The enhancement ratio and speed were found to be related to the histological findings, including RBC/mm(2) (R > 0.75) and distribution of vessels in the tissues. With ischemic femoral head, the enhancement ratios of physis, anterior part and posterior part of capital femoral epiphysis were significantly lower (P < 0.05) and enhanced more slowly (P < 0.05) than those of normal femoral head on dynamic Gd-enhanced MR imaging. On conventional Gd-enhanced SE T1WI, however, no apparent decrease in enhancement ratio and speed in ischemic hips was found (P < 0.05), when they were compared with those in the normal hips.</p><p><b>CONCLUSIONS</b>Dynamic gadoteridol-enhanced MR imaging can reveal the blood supply in various anatomic regions of the end of normal growing long bone. It is more sensitive than conventional Gd-enhanced SE T1WI in the detection of early epiphyseal ischemia.</p>