Risk factors for hemodynamically significant patent ductus arteriosus in preterm infants requiring surgical ligation: a nested case-control study / 中华实用儿科临床杂志

Objective:To analyze the risk factors for premature infants with hemodynamically significant patent ductus arteriosus (hs-PDA) requiring surgical treatment, and to explore the indications for surgical treatment in premature infants with hs-PDA.Methods:A nested case-control study was conducted.The data of premature infants with gestational age<30 weeks who were diagnosed with hs-PDA in the Neonatal Intensive Care Unit of Peking Union Medical College Hospital from January 2007 to May 2020 were analyzed retrospectively.The hs-PDA patients treated surgically were included in the operation group.The hs-PDA patients of the same gestational age and gender who were not treated surgically were taken as the control group.The ratio of the case number between the operation and control groups was 1∶2.The clinical data during pregnancy, at birth and after birth of premature infants were compared between the 2 groups.The measurement data were tested by the independent sample t test or Mann- Whitney U test.The classification and enumeration data were compared by the Fisher′ s exact probability method.The risk factors for premature infants with hs-PDA requiring surgical treatment were analyzed by the conditional Logistic regression method. Results:A total of 182 premature infants with hs-PDA were enrolled in the study, including 10 in the operation group and 20 in the control group.The patients underwent PDA ligation 30.5(22.7, 37.0) d after birth, and the median preo-perative invasive ventilation duration was 9.7(17.5, 27.2) d. Compared with the control group(20 cases), the preterm infants in the operation group had a lower birth weight [(891.5±118.0) g vs.(1 054.4±230.2) g, t=2.091], a wider arterial duct diameter [3.2(2.8, 4.0) mm vs.2.0(2.0, 3.0) mm, Z=-3.300], and longer invasive ventilation duration [25.0(18.7, 38.2) d vs.3.0(1.0, 7.5) d, Z=-3.688]. Besides, the operation group applied the pulmonary surfactant for more times [2(1, 3) times vs.1(1, 2) times, Z=-2.440], and inhaled a higher concentration of oxygen on the 14 th day after birth [29(25, 36)% vs.21(21, 29)%, Z=-2.358] than the control group.Moreover, compared with the control group, the operation group took longer to achieve adequate enteral feeding [48.2(51.5, 63.5) d vs.42.5(23.5, 48.0) d, Z=2.789], and gained a higher maximum vasoactive inotropic score (VIS) [3.0(0, 3.5) points vs.0(0, 0) points, Z=-2.630]. The difference in all the above-mentioned indicators between the 2 groups was statistically significant (all P<0.05). Univariate Logistic regression analysis showed that the arterial duct diameter, application times of the pulmonary surfactant, the maximum VIS score, and the time taken to achieve sufficient enteral feeding were all related to the need for surgical treatment of hs-PDA in the operation group (all P<0.05). Multivariate Logistic regression analysis revealed that the invasive ventilation duration ( OR=0.747, 95% CI: 0.560-0.998, P=0.048) was an independent risk factor for hs-PDA premature infants requiring surgical treatment. Conclusions:The factors related to the need for surgical treatment in preterm infants with hs-PDA include a wide arterial duct diameter, multiple applications of the pulmonary surfactant, a high concentration of inhaled oxygen on the 14 th day, and the long time to achieve sufficient enteral feeding.The independent risk factor for the surgical treatment in hs-PDA children is the long invasive ventilation duration.

A Nested Case-Control Study to Explore the Association between Immunoglobulin G N-glycans and Ischemic Stroke / 生物医学与环境科学（英文）

OBJECTIVE@#This study prospectively investigates the association between immunoglobulin G (IgG) N-glycan traits and ischemic stroke (IS) risk.@*METHODS@#A nested case-control study was conducted in the China suboptimal health cohort study, which recruited 4,313 individuals in 2013-2014. Cases were identified as patients diagnosed with IS, and controls were 1:1 matched by age and sex with cases. IgG N-glycans in baseline plasma samples were analyzed.@*RESULTS@#A total of 99 IS cases and 99 controls were included, and 24 directly measured glycan peaks (GPs) were separated from IgG N-glycans. In directly measured GPs, GP4, GP9, GP21, GP22, GP23, and GP24 were associated with the risk of IS in men after adjusting for age, waist and hip circumference, obesity, diabetes, hypertension, and dyslipidemia. Derived glycan traits representing decreased galactosylation and sialylation were associated with IS in men (FBG2S2/(FBG2 + FBG2S1 + FBG2S2): odds ratio ( OR) = 0.92, 95% confidence interval ( CI): 0.87-0.97; G1 n: OR = 0.74, 95% CI: 0.63-0.87; G0 n: OR = 1.12, 95% CI: 1.03-1.22). However, these associations were not found among women.@*CONCLUSION@#This study validated that altered IgG N-glycan traits were associated with incident IS in men, suggesting that sex discrepancies might exist in these associations.

Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study

BACKGROUND@#Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease.@*METHODS@#The nested case-control study collected birth records and the following health data in Tianjin Women and Children's Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease.@*RESULTS@#A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m3 increase of gestational exposure to PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1st-2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th-7th weeks in the first trimester, while no significant findings for other air pollutants.@*CONCLUSIONS@#This study highlighted that gestational exposure to PM2.5, O3, and SO2 had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.

A nested case-control study on association between self-reported occupational sulfur dioxide exposure and hypertension / 环境与职业医学

Background Current evidence on whether occupational sulfur dioxide (SO2) exposure affects the risk of hypertension is still limited, and the research results of the effect of environmental SO2 exposure on risk of hypertension remain inconsistent. Objective To analyze the association between self-reported occupational exposure to SO2 and the risk of hypertension, and the potential dose-response relationship between the years of exposure to SO2 and the risk of hypertension. Methods Based on the Jinchang cohort, a nested case-control study design was adopted. A total of 841 newly diagnosed hypertension patients were followed up as the case group, and the control group was selected with 1∶1 individual matching based on non-occupational factors and occupational factors, respectively. The former matching conditions included age ±2 years old, same gender, working age ±2 years, and home address in the same sub-district. The latter was limited to working in the same workshop on the basis of the former conditions. Finally, the former included 717 controls and the latter included 488 controls. A unified questionnaire was used to collect general demographic characteristics, lifestyle habits, history of diabetes, family history of hypertension, and information on occupational exposure to SO2 (self-reported history of occupational exposure to SO2 and years of exposure to SO2). Conditional logistic regression model was used to analyze the association between occupational exposure to SO2 and hypertension, and the dose-response relationship between the years of SO2 exposure and the risk of hypertension. Results In the nested case-control study matching with the non-occupational factors, the OR of hypertension in workers with self-reported occupational exposure to SO2 was 2.39 (95%CI: 1.68-3.39); while when matching with the occupational factors, the OR of hypertension in workers with self-reported occupational exposure to SO2 was 1.48 (95%CI: 1.04-2.12). The results of the dose-response relationship showed that as the SO2 exposure years increased from 1-9 years, 10-19 years, 20-29 years, and 30 years and above, in the nested case-control study matching with non-occupational factors, the ORs of hypertension were 1.85 (95%CI: 0.68-5.08), 1.46 (95%CI: 0.58-3.67), 1.64 (95%CI: 1.00-2.67), and 4.95 (95%CI: 2.63-9.31), respectively; in the nested case-control study matching with occupational factors, the ORs of hypertension were 0.98 (95%CI: 0.40-2.41), 1.84 (95%CI: 0.72-4.70), 1.37 (95%CI: 0.82-2.29), and 2.44 (95%CI: 1.37-4.35), respectively. The two dose-response relationships were positive by χ2 trend test (Ptrend<0.05). Conclusion Self-reported occupational exposure to SO2 is associated with the risk of hypertension in the study population, and the hypertension risk increases with the increase of SO2 exposure years.

Prognostic factors for failure of transvaginal repair of vesicovaginal fistula: A nested case-control study / 北京大学学报(医学版)

OBJECTIVE@#To analyze the prognostic factors affecting the failure of transvaginal repair of vesicovaginal fistula (VVF).@*METHODS@#A retrospective nested case-control study was conducted. A total of 15 patients who underwent unsuccessful transvaginal vesicovaginal fistula repair in the Department of Urology, Peking University First Hospital from January 2014 to December 2020 were enrolled as the case group. A total of 60 patients receiving transvaginal vesicovaginal fistula repair by the same surgeon within the same time range, were selected as the control group. The age, body mass index (BMI), etiology of vesicovaginal fistula, associated genitourinary malformation, frequency of repair, characteristics of fistula, surgical procedure, postoperative recovery and other factors were compared between the case group and the control group, and the influencing factors of failure were analyzed.@*RESULTS@#The BMI of the case group was (26.3±3.9) kg/m2, the diameter of vaginal fistula was (1.5±0.8) cm, and the operative time of transvaginal repair was (111.8±19.8) min. The proportion of the patients with genitourinary malformations was 4/15, the proportion of the patients with multiple vaginal repairs was 13/15, the proportion of the patients with concurrent ureteral reimplantation was 6/15, and the proportion of the patients with postoperative fever was 5/15. In the control group, the BMI was (23.9±3.0) kg/m2, the diameter of vaginal fistula was (0.8±0.5) cm, the operative time of transvaginal repair was (99.9±19.7) min, the rate of associated genitourinary malformation was 2/60, the rate of multiple transvaginal repair was 18/60, the rate of concurrent ureteral reimplantation was 5/60, and no postoperative fever was found. Compared with the control group, the case group had higher BMI (P=0.013), bigger vaginal fistula (P=0.002), longer time of operation (P=0.027), higher proportion of genitourinary malformations (P=0.013), higher proportion of repeated transvaginal repair (P < 0.001), higher proportion of ureter reimplantation (P=0.006), and higher proportion of postoperative fever (P < 0.001). Multivariate analysis showed that fistula diameter ≥1 cm (OR=10.45, 95%CI=1.90-57.56, P=0.007) and repeated transvaginal repair (OR=16.97, 95%CI=3.17-90.91, P=0.001) were independent prognostic factors for VVF failure in transvaginal repair.@*CONCLUSION@#Fistula diameter ≥1 cm and repeated transvaginal repair are independent prognostic factors of failure in transvaginal repair.

Asymmetric Dimethylarginine Predicts One-year Recurrent Cardiovascular Events: Potential Biomarker of "Toxin Syndrome" in Coronary Heart Disease / 中国结合医学杂志

OBJECTIVE@#To examine the prognostic value of serum levels of asymmetric dimethylarginine (ADMA) in patients with stable coronary heart disease (CHD) thus explore a potential biomarker of "toxin syndrome" in CHD.@*METHODS@#In this prospective nested case-control study, 36 of 1,503 Chinese patients with stable CHD experienced at least 1 recurrent cardiovascular event (RCE) during 1-year follow-up. Serum levels of ADMA at the start of follow-up were compared between these 36 cases and 36 controls which matched to cases in terms of gender, age, history of hypertension, and myocardial infarction.@*RESULTS@#Based on the crude model, subjects in the 2 highest ADMA quartiles showed significantly higher risk of developing RCE than those in the lowest ADMA quartile [odds ratio (OR) 4.09, 95% confidence interval (CI) 1.01 to 16.58; OR 6.76, 95% CI 1.57 to 29.07]. This association was also observed in the case-mix model (OR 5.51, 95% CI 1.23 to 24.61; OR 7.83, 95% CI 1.68 to 36.41) and multivariable model (OR 6.64, 95% CI 1.40 to 31.49: OR 13.14, 95% CI 2.28 to 75.71) after adjusting for confounders. The multivariable model which combined ADMA and high-sensitivity C-reactive protein (hsCRP) showed better predictive power with areas under the receiver operator characteristic curves (0.779) than the model of either ADMA (0.694) or hsCRP (0.636).@*CONCLUSION@#Serum ADMA level may be a potential biomarker of "toxin syndrome" in CHD which shows favorable prognostic value in predicting 1-year RCE in patients with stable CHD. [The registration number is ChiCTR-PRNRC-07000012].

Nested case-control study on the relationship between risk factors of pregnancy and infantile eczema in Uygur and Han ethnic / 中国实用护理杂志

Objective To investigate the prevalence of infantile eczema in Uygur and Han nationalities and the relationship between pregnancy factors and 0-6 months infant eczema, so as to provide a scientific basis for formulating preventive strategies. Methods From January-August 2016 in the Xinjiang Autonomous Region People's Hospital of obstetric and follow-up to fill out the questionnaire in 570 pregnant women and their babies as the research object to establish the baseline survey cohort, pregnancy related information to pregnant women, and 6 months (January, March, on maternal June) follow-up, observe the occurrence of infantile eczema a total of 502, successful follow-up to maternal and child. Using nested case-control study, the cohort occurred in 182 cases of infant eczema as case group, will be in the queue without eczema in 320 infants as control group, using multivariate logistic regression analysis of risk factors during pregnancy baby eczema. Results 0-6 months infant eczema incidence rate was 36.25％, the incidence of Uygur infant eczema (20.43％) was significantly lower than that of Han nationality infant eczema incidence (50.19％) (OR=0.45,95％CI:0.35-0.69) P<0.01). Social and economic factors affecting the occurrence of infantile eczema comparison results showed that the ethnic factors and infant eczema, and more prone to eczema than that of Uygur nationality; and Uygur compared mothers influence allergic history of Han infantile eczema more (χ2=7.09, P=0.008). Multivariate logistic regression analysis showed that the mother has a history of atopy (OR=7.17,95％CI:4.15-12.37), mother′s education level (OR=1.91,95％CI:1.51-2.74), the higher the monthly income (OR=2.68,95％CI:2.17-3.33), maternal smoking during pregnancy (secondhand smoke) (OR=2.42,95％CI:1.96-2.97), frequently eating spicy spicy foods during pregnancy (OR=1.94,95％CI: 1.41-2.68) will increase the risk of infant eczema Supplementation of probiotics (OR=0.13,95％CI:0.07-0.25) and vitamin D (OR=0.13,95％CI:0.06-0.26) during pregnancy is a protective factor in the development of infantile eczema. Conclusions Compared to Uygur, Han Chinese infants are more likely occur eczema, and family history of allergies, education, economic income, pregnancy dietand smoking are risk factors for infant eczema. The same risk factors among Uygur and Han ethnic ,but it had a different results. Compared to Han, Uygur pregnant women eating spicy food caused the risk of infant eczema occurrence is higher, but the short period of housing renovation caused the risk of infant eczema occurrence is lower. Therefore, it is necessary to strengthen nutrition andmonitor living environment during pregnancy. Avoiding to eat spicy food and supplying probiotics and vitamin D, it can prevent or reduce the occurrence of infantile eczema.

Nested case-control study on associated factors for anemia during pregnancy / 中华流行病学杂志

Objective To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy.Methods The pregnant women (≤ 12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study,and for them anemia had been excluded by physical examination.Baseline survey and follow up till childbirth were conducted for them.A queue-based nested case-control study (1 ∶ 2) was conducted (380 pregnant women with anemia detected in this study as case group,760 pregnant women without anemia randomly selected and matched by age,habitual residence during pregnancy as control group.And t test,x2 test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy.Results Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08,95％CI:1.22-3.59),low educational level (OR=2.09,95％CI:1.22-3.59),pre-pregnancy perm/hair dye (OR=2.23,95％ CI:1.63-3.05),early pregnancy vomiting (OR=2.51,95％ CI:1.56-4.03) were the risk factors for anemia during pregnancy.Intake of vitamin and trace element supplements (OR=0.69,95％ CI:0.50-0.94),frequent meat,fish,shrimp,egg intakes (OR=0.68,95％CI:0.49-0.92),frequent soy milk,milk intakes (OR=0.51,95％CI:0.27-0.95) were the protective factors for anemia during pregnancy.Conclusion A number of factors,such as family annual income level,education level,poisonous and harmful material contact,pregnancy reaction,nutrition,are related to the incidence of anemia during pregnancy,it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.

Nested case-control study on associated factors for anemia during pregnancy / 中华流行病学杂志

Objective To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy.Methods The pregnant women (≤ 12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study,and for them anemia had been excluded by physical examination.Baseline survey and follow up till childbirth were conducted for them.A queue-based nested case-control study (1 ∶ 2) was conducted (380 pregnant women with anemia detected in this study as case group,760 pregnant women without anemia randomly selected and matched by age,habitual residence during pregnancy as control group.And t test,x2 test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy.Results Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08,95％CI:1.22-3.59),low educational level (OR=2.09,95％CI:1.22-3.59),pre-pregnancy perm/hair dye (OR=2.23,95％ CI:1.63-3.05),early pregnancy vomiting (OR=2.51,95％ CI:1.56-4.03) were the risk factors for anemia during pregnancy.Intake of vitamin and trace element supplements (OR=0.69,95％ CI:0.50-0.94),frequent meat,fish,shrimp,egg intakes (OR=0.68,95％CI:0.49-0.92),frequent soy milk,milk intakes (OR=0.51,95％CI:0.27-0.95) were the protective factors for anemia during pregnancy.Conclusion A number of factors,such as family annual income level,education level,poisonous and harmful material contact,pregnancy reaction,nutrition,are related to the incidence of anemia during pregnancy,it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.

The expression of beta-tubulin gene in myelodysplastic syndrome evoluting to leukemia / 中华内科杂志

Objective Based on our previous established cohort of myelodysplastic syndrome (MDS), we investigated the potential effect of beta-tubulin (TUBB) gene in the transformation of MDS into acute leukemia Methods From our nested case-control study cohort of MDS patients, we chose 11 paired transformed and nontransformed MDS patients.TUBB gene expression was tested by quantitative real-time PCR.TUBB-siRNA transfection was used to down-regulate TUBB gene expression in SKM-1 cell line.The function of TUBB gene in SKM-1 cell line was evaluated by cell proliferation, soft agar clone formation and electron microscope.Results TUBB gene expression in MDS patients in transformed group were significantly higher than that in control group (2.91 ± 0.41 vs 0.90 ± 0.23, P ＜0.01).After TUBB-siRNA transfection, A450/630nm of SKM-1 cells at 24 h, 48 h and 72 h were 0.299 ± 0.045, 0.526 ± 0.034 and 0.652 ± 0.035, respectively, which were significantly decreased than those in negative-siRNA group (0.438 ±0.074, 0.858 ±0.064 and 0.974 ±0.044) (P ＜0.05).Soft agar clone formation in TUBB-siRNA group was (7.0 ±0.2)％, which was significantly reduced than that of negative-siRNA group (25.0 ± 0.2)％ (P ＜ 0.01).Electron microscope showed significant apoptotic signs in TUBB-siRNA group, including vacuoles in cytoplasm and karyorrhexis.Conclusion Our results indicate that TUBB gene may play a role in the transformation of MDS into acute leukemia by affecting the proliferation of malignant clones.

A nested case-control study of influencing factors of chronic brucellosis / 中华地方病学杂志

Objective To investigate the influencing factors of chronic brucellosis.Methods Nested case control method was used to study newly diagnosed patients (n =600) with brucellosis in a cohort study in 2012.Data of general characterstics,clinical presentation,treatment and prognosis of those patients were collected.These patients were followed up for one year,and the chronic patients as the case group (n =248) and the healed patients as a control group (n =260).By means of Logistic multivariate analysis,factors turned brucellosis into chronic were screened.Result The chronic brucellosis-related factors were:gender,veterinary or epidemic prevention staff,muscle and joint pain,fatigue symptoms,and substandard treatment (x2 =5.163,16.445,14.977,17.154,8.813,all P ＜ 0.05).Conclusion Gender (female),veterinary or epidemic prevention staff,muscle and joint pain,fatigue symptoms,and substandard treatment are probably the chronic brucellosis-related factors

A nested case-control study in studying the relationship between interleukin-6,endothelin-1, E-selectin and the risk of cardio-cerebrovascular events / 中华流行病学杂志

Objective To investigate the relationship between interleukin-6(IL-6),endothelin-1 (ET-1),E-selectin and the risk of cardio-cerebrovascular events. Methods Based on a cohort study in which 2 589 Mongolians had been followed up for 10 years,a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio(OR) and 95%confidence intervals(95%CI). Results The average level of IL-6(7.66 vs. 8.77 pg/ml), ET-1(0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml) were not significantly different between the case and the control groups(P>0.05). Data from the logistic regression analysis showed that IL-6,ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs(95%CI)on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16),1.10 (0.66-1.85) and 1.19(0.71-2.00) for the participants with IL-6>23.91 pg/ml ,ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml,respectively,compared with those having IL-6≤23.91 pg/ml ,ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml. Conclusion Data from our study indicated that the levels of IL-6,ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.

A nested case-control study in studying the relationship between interleukin-6,endothelin-1, E-selectin and the risk of cardio-cerebrovascular events / 中华流行病学杂志

Objective To investigate the relationship between interleukin-6(IL-6),endothelin-1 (ET-1),E-selectin and the risk of cardio-cerebrovascular events. Methods Based on a cohort study in which 2 589 Mongolians had been followed up for 10 years,a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio(OR) and 95%confidence intervals(95%CI). Results The average level of IL-6(7.66 vs. 8.77 pg/ml), ET-1(0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml) were not significantly different between the case and the control groups(P>0.05). Data from the logistic regression analysis showed that IL-6,ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs(95%CI)on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16),1.10 (0.66-1.85) and 1.19(0.71-2.00) for the participants with IL-6>23.91 pg/ml ,ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml,respectively,compared with those having IL-6≤23.91 pg/ml ,ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml. Conclusion Data from our study indicated that the levels of IL-6,ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.

Prenatal anxiety and cesarean section with non-medical indication / 中南大学学报(医学版)

Objective: To explore the relationship between prenatal anxiety and cesarean section (c-section) with non-medical indication. Methods: Nested case-control study was used to analyze the risk factors for c-section with no medical needs: 433 pregnant women with gestational age longer than 24 weeks were enroled in this study. According to the mode of delivery, we divided them into a vaginal delivery group, a c-section group without medical need and a c-section group with medical need. Results: The c-section rate was 62.1%, 55.8% of which was c-section without medical need at family request. The score of state anxiety (S-AI) and trait anxiety (T-AI) was 42.53±11.04 and 44.40±10.23 respectively, much higher than that of normal population. After the adjustment of maternal social economic status and other prenatal statuses for this pregnancy, the prenatal anxiety was still associated with c-section with non-medical indication. The adjusted odd ratio for prenatal anxiety state, prenatal trait anxiety state and c-section with non-medical indication was 1.41 (95%CI: 1.06-1.87) and 1.23 (95% CI: 1.08-1.40), respectively. Conclusion: Prenatal anxiety state is a risk factor for c-section with non-medical indication.

Association between serum calcium levels and the risk of liver cirrhosis / 中华流行病学杂志

Objective To examine the association between serum calcium levels and the risk of liver cirrhosis.Methods A nested case-control study was performed based on the nutritional intervention trial of esophageal carcinoma in Linxian,Henan province.Serum samples of 281 liver cirrhosis cases and 562 controls were tested for calcium concentrations,surface antigen (HBsAg) and core antibody (anti-HBc) on Hepatitis virus B and antibody on Hepatitis virus C (anti-HCV),using automatic serum biochemical analysis system and enzyme-linked immunoassay.Data on baseline characteristics were collected via a questionnaire.Serum calcium value was divided into tertiles and logistic regression model was used to calculate odds ratios and 95％ confidence intervals.Results Individuals in the case group showed higher calcium levels (1.81 ± 0.84)mmol/L when compared to the controls (1.65 ± 0.79)mmol/L,with t =-2.640 and P=0.008.The calcium levels were associated with the risk of liver cirrhosis (x2=6.888,P=0.0319).Risks for the individuals in the highest tertile were doubled when compared to the lowest (adjusted OR=2.261,95％CI:1.497-3.416,P=0.002).A positive correlation was observed between serum calcium level and the risk of liver cirrhosis (x2=6.842,P=0.0089).Conclusion Results from our study revealed that the elevated serum calcium level might be an independent risk factor for liver cirrhosis.However,further investigations are anticipated to explore its potential mechanisms.

A Pharmacologic Study on Risk Factors of Hyperkalaemia or Increased Blood Potassium Associated with ACE-Inhibitor Therapy / 薬剤疫学

<b>Objective:</b> To investigate quantitatively the risk factors of hyperkalaemia or increased blood potassium associated with ACE-inhibitor therapy<br><b>Design:</b> Nested case-control study<br><b>Methods:</b> We used the antihypertensive drug database(72,379 subjects)developed by the RAD-AR Council, Japan and the Institute of Statistical Mathematics based on the post-marketing surveillance(PMS) data of pharmaceutical companies. Of 37,372 subjects taking ACE-inhibitors, the case group was composed of 64 patients who experienced hyperkalaemia or blood potassium increase while taking ACE-inhibitors, and the control group was composed of 1,280 patients(20 patients per case)randomly selected from patients who did not experience hyperkalaemia or blood potassium increase while taking ACE-inhibitors. The relevant factors that can be extracted from the database were the followings: age, WHO classification of hypertension, complications, antihypertensive drugs used before the PMS survey, and concomitant drugs.<br><b>Results:</b> Among the subjects taking antihypertensive agents, 65 patients experienced hyperkalaemia orincreased blood potassium, 64(98.5%)of whom were taking ACE-inhibitors. The factors that were significantly different between two groups(p<0.05)by univariate analysis were WHO classification of hypertension(p=0.005), complications of nephritis/nephrosis(p<0.001), other disorder of urinary system(p<0.001), unclear symptom or diagnosis(p=0.005), taking diuretics as antihypertensive drugs before study(p=0.032), and concomitant treatment with diuretics(p=0.004), vasodilators(p<0.001), and antigout agents(p=0.001). Conditional multivariate logistic analysis of these factors yielded adjusted odds ratio of 21.31 for complications of nephritis/nephrosis(p<0.001), 6.83 for other disorder of urinary system(p<0.001), and 2.30 for concomitant therapy with diuretics(p=0.049).<br><b>Conclusion:</b> The risk factors of hyperkalaemia or blood potassium increase associated with taking ACE-inhibitors were nephritis/nephrosis, other disorder of urinary system and concomitant therapy with diuretics.

A nested case-control study on the relationship between occupational physical activity,heredity factors and metabolic syndrome / 中华流行病学杂志

Objective To examine the associations between occupational physical activity,heredity factors and metabolic syndrome (MS) in a Chinese population.Methods Based on the MS cohort study in Jiangsu province,subjects were followed-up,and blood samples were collected at the same time for biochemical indicators measurement.Newly confirmed MS patients according to US.National Cholesterol Education Program Adult Treatment Guidelines Ⅲ (NCEP-ATP Ⅲ ) were recruited as eases.Controls were 1 :1 matched with eases by region,gender and age (±2 years).In total,389 MS patients and 389 eontrols were recruited as study subjects.Nested ease-control study was applied for the present analysis.TaqMan fluorescence probe method was used to detect the genetic polymorphism of PPARα intron 1A/C (rs135539).Results (1)Compared to low physical activity group,the subjects with heavy physical activity were positively associated with MS (OR=2.18,95%CI:1.08-4.38).(2)The subjects,with a family history of hypertension (OR= 1.44,95% CI:1.02-2.03 )or type 2 diabetes (OR=3.25,95CI:1.28-8.20),were significantly indreased the occurrence of MS.(3)The genotype(AA,AC,CC) of PPARα intron 1A/C was not found to be related to MS.The OR of AC and CC genotype (compared to the genotype AA) were 0.98(95%CI:0.70-1.36) and 0.75 (95% CI:0.44-1.29) ,respectively.(4) Effect modifications were observed between family history of hypertension and moderate physical activity (OR=2.47,95% CI:1.00-6.06 ) or heavy physical activity (OR=3.82,95%CI:1.31-11.15) on the development of MS.Conclusion Heavy physical activity,with family history of hypertension or type 2 diabetes,seemed to be positively correlated with the risk of MS.Effect modifications were observed between occupational physical activity and family history of hypertension which might be associated with an increased risk of MS.

A nested case-control study on the influencing factors of tuberculosis among people living with HIV/AIDS in Hunan province / 中华流行病学杂志

Objective To determine the risk factors related to tuberculosis infection among people living with HIV/AIDS and to develop strategies for preventing the co-infection.Methods A 1:2matched nested case-control study was carried out to analyze the influencing factors of tuberculosis among people living with HIV/AIDS.Results 1018 people living with HIV/AIDS were followed up for one year with a total number of 736.75 person-years,among them 62 tuberculosis cases were diagnosed.The incidence density of tuberculosis among people living with HIV/AIDS was 8.42 persons per 100 person-years.Factors as education level(OR=0.483),vaccination history of Bacille Calmette Guerin(OR=0.561),CD_4~+ count T-lymphocyte(OR=0.356),unemployment(OR=1.976),living alone(OR=2.646),and smoking(OR=2.215)were significantly related to the prevalence of tuberculosis among people living with HIV/AIDS.Conclusion High education level,with vaccination history of Bacille Calmette Guerin and high level of CD_4~+ T-lymphocyte count were protective factors while being unemployed,living alone,and smoking habit were risk factors related to the prevalence of tuberculosis among people living with HIV/AIDS.

The Relationship between Cerebrovascular Hemodynamics and Risk of Ischemic Stroke / 中国慢性病预防与控制

Objective To probe into the relations between cerebrovascular hemodynamics indexes(CVHI),risk factors of stroke and risk of ischemic stroke.Methods A nested case-control design was used in the study.Participants were selected from a cohort in the northeast of China.151 ischemic stroke patients occurred during the follow-up term were defined as case group,and the same numbers of individuals,free of stroke,were selected randomly in the cohort and defined as control group.Odds ratio(OR) of CVHI score as well as other risk factors of stroke were estimated.Results Univariate analysis indicated that there were significant etiological relations between stroke and CVHI score,hypertension,heart disease and family history of stroke(P

Case-cohort Study and PMS / 薬剤疫学

Pharmacoepidemiological studies are often conducted to evaluate the association between the event with low incidence and exposure with low prevalence. To overcome the difficulty due to low event incidence and low exposure prevalence, White proposed a two-stage design in 1982 and Cain and Breslow further developed this design.<BR>In this article, the case-cohort and nested case-control designs are reviewed in contrast with the two-stage design. In addition, the usefulness of the case-cohort design in pharmacoepidmiology is assessed in comparison with that of the nested case-control design. In the nested case-control study, the control subjects are selected only after cases occur irrespective of whether the method of “risk set matching” or “unmatched density sampling” is used. Therefore, all of the events evaluated in the study must be clearly defined in advance. On the other hand, in a prospective case-cohort study, a single subcohort, selected independent of cases, is used to analyze multiple outcomes. Owing to this feature, the case-cohort design may be useful to study unknown adverse events that have not been specified as a target event prior to the study but are recognized as a problem that requires in-depth evaluation during or after the study is conducted. Weaknesses and limitations of the case-cohort design as compared to the nested case-control design are also discussed.<BR>Data yielded by simulations for hypothetical case-cohort studies are analyzed by the SAS PHREG procedure with the robust variance estimation. The program used and results of simulations are presented.<BR>The case-cohort study design may be useful for various pharmacoepidemiological studies in Japan where no large medical database is available.