The Correlation between Traditional Chinese Medicine Constitution and the Progression of Abnormal Glucose Metabolism in Community Population： A Case-control Study / 中医杂志

ObjectiveTo investigate the role of traditional Chinese medicine （TCM） constitution in the progression of abnormal glucose metabolism among community population. MethodsA total of 393 community residents who participated in community diabetes screening from 2019 to 2021 and had complete physical examination data at baseline and at the 2nd year follow-up were selected. According to the results of glucose tolerance tests， community residents were divided into the abnormal glucose metabolism progression group and non-progression group， and were matched at the ratio of 1∶2 using the propensity score matching. The influencing factors related to diabetes at baseline were collected for both groups. The traditional Chinese medicine constitution was determined among population in two groups. The differences of influencing factors and traditional Chinese medicine constitution between the two groups were compared. Logistic regression analysis was used to analyze the risk factors for the progression of abnormal glucose metabolism. ResultsFinally， 131 patients were included in the progression group and 262 patients in the non-progression group. Compared to the non-progression group， the progression group had significantly higher proportion of hyperlipidemia history ， hyperglycemia history， phlegm-dampness constitution， and blood stasis constitution （P＜0.05 or P＜0.01）. Univariate logistic regression analysis revealed that the history of hyperlipidemia （P=0.011）， history of hyperglycemia （P＜0.001）， the family history of diabetes （P＜0.001）， yin-deficiency constitution （P=0.047）， phlegm-dampness constitution （P=0.011） and blood-stasis constitution （P=0.008） were risk factors for the progression of abnormal glucose metabolism. Multivariate logistic regression analysis indicated that the history of hyperglycemia （P＜0.001）， yin-deficiency constitution （P=0.026） and blood-stasis constitution （P=0.032） were independent risk factors for the progression of abnormal glucose metabolism. ConclusionThe history of hyperglycemia， yin-deficiency constitution and blood-stasis constitution may be the risk factors for the progression of abnormal glucose metabolism.

Nested case-control study on children with severe birth defects in Shanghai / 上海预防医学

ObjectiveTo design a prospective nested case-control study based on a city-wide birth cohort of Shanghai， so as to understand their health status and explore the influencing factors of birth defects. MethodsBased on the birth registration covering the entire city of Shanghai， the nested case-control study of children with severe birth defects was designed. Children born with severe birth defects were selected as the case group， and healthy children were matched as the control group. Basic information， health status， maternal pregnancy history， and survival outcome of children both in the case group and the control group were collected through medical history review and home visits. The logistic regression model was used for multivariate analysis. ResultsA total of 18 875 infants born between January 1， 2011， and December 31， 2021， were included， among which 11 500 （60.93%） were children with severe birth defects and 7 375 （39.07%） were healthy children. The logistic regression model analysis showed that being male （OR=1.20， 95%CI：1.13‒1.29）， non-Shanghai residency （OR=1.16， 95%CI： 1.06‒1.25）， multiple births （OR=8.41， 95%CI：6.25‒11.30）， artificial insemination （OR=2.31， 95%CI：1.34‒3.99）， in vitro fertilization （IVF） （OR=1.85， 95%CI：1.44‒2.38）， maternal exposure to radiation （OR=1.83， 95%CI：1.07‒3.14）， maternal illness during pregnancy （OR=1.61， 95%CI：1.49‒1.74）， experiencing a traumatic event during pregnancy （OR=2.34， 95%CI：1.88‒2.92）， paternal chemical exposure （OR=1.88， 95%CI：1.32‒2.69）， paternal radiation exposure （OR=1.65， 95%CI： 1.18‒2.33）， family history of birth defects （OR=8.18， 95%CI： 3.96‒16.89）， being overweight before pregnancy （OR=1.16， 95%CI： 1.07‒1.27）， being obese before pregnancy （OR=1.15， 95%CI：1.03‒1.30）， and being excessively obese before pregnancy （OR=1.52， 95%CI：1.26‒1.83） were risk factors for the occurrence of birth defects. Analysis by type of birth defect found that prematurity was a risk factor for cardiac malformations and cheilopalatoschisis （OR=27.87， 95%CI： 20.84‒37.27）， especially ranking first in cardiac malformations. ConclusionAfter controlling for influencing factors， maternal overweight， obesity， and excessive obesity before pregnancy， artificial insemination， and IVF are independent risk factors for the occurrence of birth defects. Choosing a healthy lifestyle， improving physical and mental health during pregnancy， and controlling BMI during pregnancy are beneficial in reducing the risk of birth defects.

A spatial case-control study on symptomatic and inapparent primary dengue infections in an endemic city in Brazil

ABSTRACT We conducted a spatial case-control study nested in a dengue incidence cohort to explore the role of the spatial and socioeconomic factors in the proportion of symptomatic (cases) and inapparent primary dengue virus infections (controls). Cohort participants were children and adolescents (2 to 16 years of age) at the beginning of the follow-up. Case definitions were, for symptomatic cases, fever plus a positive lab result for acute dengue (NS1, RT-PCR, ELISA IgM/IgG), and for inapparent infection a positive result for dengue IgG (ELISA) in subjects without symptoms and with a previously negative result at baseline. The covariates included sociodemographic factors, residential location, and socioeconomic context variables of the census tracts of residence of cases and controls. We used principal component analysis to reduce the contextual covariates, with the component values assigned to each one based on their residences. The data were modeled in a Bayesian context, considering the spatial dependence. The final sample consisted of 692 children, 274 cases and 418 controls, from the first year of follow-up (2014-2015). Being male, older age, higher educational level of the head of the family and having a larger number of rooms in the household were associated with a greater chance of presenting dengue symptomatic infection at the individual level. The contextual covariates were not associated with the outcome. Inapparent dengue infection has extensive epidemiological consequences. Relying solely on notifications of symptomatic dengue infections underestimates the number of cases, preserves a silent source of the disease, potentially spreading the virus to unaffected areas.

The unexpected silent manifestation of myocardial infarctions in ischemic heart failure patients: Insights from a case-control study

Abstract Background: Recent studies show Silent Myocardial Infarction (SMI) as a quite frequent event. However, regarding severe tertiary care patients that frequently present consequences of Coronary Artery Disease (CAD) and Left Ventricular Dysfunction (LVD), the occurrence of this manifestation is unexpected and its associated factors aren't clear in the literature. Aim: To compare clinical, laboratorial, ventricular and angiographic factors between silent and classical presentation of MI in patients with CAD and LVD. Methods: Patients with multivessel CAD with over 70 % obstructive lesions and LVD with EF less than 35 % were evaluated for MASS VI trial and later included in the present study. The ventricular function and coronary assessment were measured by echocardiography and SYNTAX score, respectively. The population was stratified in a SMI group and Clinically Manifested Myocardial Infarction (CMMI) group based on MI presentation for a comparison of medical parameters. Results: From 132 patients, 47 (35.6 %) were classified as SMI and 85 (64.4 %) as CMMI. No differences were observed between groups regarding age, sex, diabetes mellitus, SYNTAX score, or collateral circulation. Higher proportion of NYHA II classification, inferior wall MI and lower creatinine clearance were found in SMI group. After multivariate analysis, peripheral diabetic neuropathy (OR = 4.6 [1.1-12.7] p = 0.032) and inferior wall MI (OR = 4.1 [1.5-11.4] p = 0.007) were significantly associated with SMI. Conclusion: Peripheral diabetic neuropathy and inferior wall MI were associated with SMI presentation. Overall, associated factors tend to be similar comparing SMI and CMMI, but in the specific population of diabetic patients with chronic neuropathy a special care should be taken.

Impact on quality of life among health care workers: a case-control study of COVID-19 pandemic situation

Background: Quality of Life (QoL) as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. Methods: A Case-control study was conducted to assess the QoL among health care workers (HCW) during the Covid-19 Pandemic and to compare QOL in cases and controls among HCW. The sample size was calculated to be 98 in each group comes around 196. QOL was assessed by using WHOQOL-BREF scale. The QoL comparison in both Covid-19 positive and negative and its association was done by mean and standard deviation with correlation coefficient using unpaired T test. Results: Among 196, majority 157 (79.2%) were doctors and 39 (19.8%) were other health care providers like lab technicians and nursing staff. The health care workers with COVID-19 positive were had low QoL than the negative with respect to physical (46.90±9.60 vs 59.01±15.60), psychological (44.51±7.44 vs 51.13±15.68), social (39.82±15.98 vs 56.11±23.92), and environmental (48.33±10.28 vs 57.57±20.22) domains and all the domains showing highly statistically significant result with the P-value <0.001. The correlation coefficient between four domains was statistically significant and with overall QOL and satisfaction on health. Conclusions: The QoL was poor among COVID-19 positive patients compared to negative with respect to physical, social, psychological, and environmental and age, marital status and occupation during the covid-19 pandemic.

The understanding of epidemiology and study designs

The goal of health care systems is to keep patients healthy by monitoring, diagnosing, and treating their illnesses. These complex systems have many objectives, such as improving the quality of health care, making healthcare accessible to all people who are in need, extending people’s life span, preventing illnesses, etc. Promoting healthy lifestyles along with the prevention of illnesses to improve people’s health is also a fundamental principle of public health, and now it also become a fundamental principle of health care and integrating into health and social care strategies across the world. Epidemiology is the system of ultimate reasoning focused on creating and examining theories in systematic fields such as biology, physics, behavioral sciences. Epidemiology rationalize the health-associated states and events and provide the justification for further suitable real-world public health measures. While working in the field, I observed that allied healthcare professionals lacked basic knowledge about epidemiology and related study designs. The input from this healthcare professional not only assists in building meaningful research studies but also demonstrates its powerful impact on patients’ healthcare through preventive measures and study results. The goal of this article is to provide basic knowledge of epidemiology and its various study designs in a simplistic language to allied healthcare professionals working in the field. In this article, I have described a general overview of epidemiology and various study designs, along with examples. I hope this information could be beneficial for a better understanding of epidemiology to healthcare professionals working in the field.

Association of modifiable risk factors among stroke patients attending a tertiary care hospital at Durg district of Chhattisgarh: a case-control study

Background: Non-communicable diseases (NCDs) are medical conditions or illnesses that are not caused by infectious agents. Modifiable behavioural risk factors, such as tobacco use, physical inactivity, unhealthy diet, stress and the harmful use of alcohol and metabolic risk factors, such as hypertension, diabetes, dyslipidemia, obesity, increase the risk of stroke. Strokes in Asian patients account for more than two-thirds of the overall stroke incidence worldwide. Methods: The Hospital based case-control study was carried out on 88 hospitalized patients with history of first time stroke and Controls were selected from hospital with no history of stroke. For each case gender, age (+5 years) matched control was selected in 1:1 ratio. A predesigned pretested questionnaire was used to collect data. Data were compared between case and control groups using chi-squared test, Students t-tests as appropriate and Uni-variate odds ratio (ORs) for these risks factors were calculated. Results: We recruited 88 cases of stroke and 88 controls for this study. In the current study Hypertension was found to be significantly associated with stroke. The stroke cases had significantly higher proportion of diabetes mellitus and the risk of developing stroke with diabetes mellitus was high and significant. Similarly, stroke was associated with alcohol, family history of stroke and obesity. Risk of developing stroke was not associated with cardiac disease. Conclusions: Hypertension, alcohol, obesity are the biggest risk factors for stroke. This could be helpful in early identification of subjects at risk of stroke and formulation of public health strategy. Additional studies of large patient cohorts will be essential to validate these findings.

Association of drugs, reproductive and lifestyle factors with carcinoma breast among women in a tertiary care center - a case–control study

Background: Breast Cancer is the most common cancer in the world and a leading cause of cancer deaths. The incidence and mortality vary widely. Multiple factors are found to be associated with the development of breast cancer. Aims and Objectives: To study the role of drugs and other selected factors in the development of carcinoma breast. Materials and Methods: A case–control study was done at Government Medical College Thrissur. Selected 125 cases and 250 controls. Data were collected by interview using a semi-structured proforma. The role of drugs, Body Mass Index (BMI), lifestyle, and reproductive factors were studied. Results: The cases and controls were matching in their sociodemographic characteristics. The mean age of cases was 53 years (SD = 11.5) and that of controls was 51.74 years (SD = 11.5). Hysterectomy was found to be a risk factor of breast cancer, Odds Ratio 2.3 (1.05–5.05). Heavy work, with an Odds Ratio 0.89 (0.12–0.66), and milk consumption with an odds ratio 0.46 (0.27–0.78) were found to be protective factors. contraceptive pill, hormone replacement therapy, prolonged drug intake, BMI, age of menarche, parity, abortion, or infertility were not found to have significant association. Conclusion: The history of drug intake is not having a role in the development of breast cancer. Hysterectomy is a risk factor while heavy work and milk consumption are protective factors in breast cancer development.

Factores de riesgo para infecciones asociadas al cuidado de la salud en recién nacidos sometidos a cirugía en una unidad de cuidados intensivos neonatales / Risk factors for healthcare-associated infections in newborns after surgery in a neonatal intensive care unit

Resumen Antecedentes: Las infecciones asociadas a la atención de la salud (IAAS) son causa frecuente de morbilidad y mortalidad. Objetivo: Identificar los factores de riesgo para el desarrollo de IAAS en recién nacidos (RN) sometidos a cirugía. Material y métodos: Estudio de casos y controles anidado en una cohorte. Los casos fueron RN sometidos a cirugía, con IAAS y los controles, RN sometidos a cirugía sin IAAS. Se registraron datos perinatales, uso de profilaxis antimicrobiana, de catéter venoso central (CVC), ventilación mecánica, nutrición parenteral y sondas; edad y peso al momento de la cirugía, tipo de cirugía, clasificación de la herida quirúrgica, duración de la cirugía, número de procedimientos quirúrgicos y tipo de infección. Se realizó análisis univariado y multivariado. Resultados: Se incluyeron 71 casos y 142 controles. Las IAAS más frecuentes fueron las infecciones sanguíneas (36.6 %); los principales microorganismos aislados en hemocultivos fueron cocos grampositivos. Los factores de riesgo asociados a IAAS en el análisis multivariado fueron duración del CVC > 8 días (RMa = 17.2), ≥ 2 intervenciones quirúrgicas (RMa = 16.5) y cirugía abdominal (RMa = 2.6). Conclusiones: Los RN sometidos a cirugía, principalmente aquellos con factores de riesgo, requieren vigilancia estrecha durante el posoperatorio. El CVC debe ser retirado tan pronto sea posible.

Abstract Background: Healthcare-associated infections (HAIs) are a common cause of morbidity and mortality. Objective: To identify the risk factors for the development of HAIs in newborns (NBs) undergoing surgery. Material and methods: Nested case-control study. Cases were NBs undergoing surgery with HAIs, while controls were NBs undergoing surgery with no HAIs. Perinatal data, use of antimicrobial prophylaxis, use of central venous catheter (CVC), mechanical ventilation, parenteral nutrition, and other medical devices were recorded, as well as age and weight at the time of surgery, type of surgery, surgical wound classification, duration of surgery, number of surgical procedures, and type of infection. Univariate and multivariate analyses were performed. Results: Seventy-one cases and 142 controls were included. The most frequent HAI was bloodstream infection (36.6%); the main microorganisms isolated in blood cultures were gram-positive cocci. The risk factors associated with HAIs in the multivariate analysis were CVC duration > 8 days (aOR = 17.2), ≥ 2 surgical interventions (aOR = 16.5) and abdominal surgery (aOR = 2.6). Conclusions: NBs undergoing surgery, mainly those with risk factors, require close monitoring during the postoperative period. CVC should be withdrawn as soon as possible.

Determinants of patients’ delay with disability in the diagnosed leprosy cases in the three major states of India: A case-control study

Background: Skin lesions are the most common early symptoms of leprosy, often ignored by patients at an early stage and misdiagnosed as other dermatological diseases by healthcare personnel, leading to delay in diagnosis and treatment of leprosy precipitating permanent neurological deficit, deformities and serious disabilities. Aims: The objective is to evaluate the duration of delay and factors responsible for the delay in reporting of patients, among the newly detected leprosy cases (Grade 1 and Grade 2 disability patients). Methods: A case-control study was conducted during 2014–2016 in three major states of India (Delhi, Gujarat and West Bengal) in 140 randomly recruited newly registered adult leprosy patients (aged 18 years and above) with Grade 2/1 disabilities (cases) and 140 Grade 0 disability patients (controls) in each of these Indian states. Results: It is established that the major contributors for the delay in the early diagnosis of leprosy have been patient-related factors. The median patient delay in the three states of Delhi, Gujarat and West Bengal were five months (0.7–1.8), 2.8 months (2–14) and 12 months (2–24), respectively. Limitations: The study design is case-control and has an inbuilt reporting bias due to the retrospective nature of data collection but the data collection was carried with caution to reduce the recall bias. As the study is carried out in three states, generalisation of interpretation was cautiously executed. The matching ratio of cases and controls was 1:1 in this study, but we could not increase the controls due to operational feasibility during the conduct of the study. Conclusion: Patient delay is a crucial factor responsible for the disability among new leprosy cases. A higher patient delay in these three states reflects that the community is not aware about the signs and symptoms of leprosy. Reducing patient delay is very important for reducing disabilities in the newly diagnosed cases.

A case-control study on the risk of stroke in the elderly in Shanghai community / 上海预防医学

ObjectiveTo explore the risk factors of stroke， and to provide reference for the prevention and health management of stroke. MethodsFrom February 2022 to March 2022， four community residents over 60 years old with stroke in Shanghai were randomly selected as the case group （n=100）， and non-stroke residents were selected as the control group （n=100）. The survey was in the form of questionnaires to record and compare the age， body mass index （BMI）， blood lipids， blood pressure-related indicators， family history of other diseases， living habits， mood and sleep conditions of all subjects. The value of predicting the incidence of stroke among the elderly in Shanghai community was analyzed by receiver operating characteristic （ROC）， and the influencing factors of stroke were analyzed by logistic model. ResultsBMI， hypertension， heart disease， diabetes， transient ischemic attack （TIA）， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP， DBP， TG levels were significantly higher in the case group （P<0.05）. The level of HDL-C was significantly lower than that in the control group （P<0.05）. BMI， SBP， DBP， TG， HDL-C predicted the incidence of stroke by ROC analysis （P<0.05）. Logistic regression analysis showed that BMI≥23.820 kg·m-2， heart disease， diabetes， TIA， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP≥139.535 mmHg， DBP≥89.605 mmHg， TG≥1.565 mmol·L-1 and HDL-C≤1.105 mmol·L-1 were risk factors for stroke （P<0.05）. ConclusionPhysical health status including blood lipids and blood pressure， family history of certain diseases， and living habits could be important risk factors for stroke in the elderly in Shanghai community. Preventive intervention measures for the above factors have important clinical significance.

Risk factors of sarcopenia among the elderly: a case-control study / 预防医学

Objective@#To investigate the risk factors of sarcopenia among the elderly, so as to provide insights into prevention of sarcopenia among the elderly.@*Methods@#A case-control study was conducted. A total of 371 patients with sarcopenia at ages of 60 years and older admitted to the First Affiliated Hospital of Xinjiang Medical University were selected as the case group, while 1∶1 matching healthy volunteers by gender, age and ethnicity in the hospital during the study period served as controls. Participants' demographics, disease history and nutrition were collected using questionnaire surveys, and factors affecting the development of sarcopenia were identified using a multivariable conditional logistic regression model. @*Results@#Participants in the case group included 171 men (46.09%), 254 Han ethnic populations (68.46%) and had a mean age of (73.04±7.83) years. Univariable conditional logistic regression analysis showed that participants with smoking, alcohol consumption, hypertension, diabetes, dyslipidemia, thyroid dysfunction and malnutrition had higher risk of developing sarcopenia (all P<0.05). Multivariable conditional logistic regression analysis identified hypertension (OR=1.851, 95%CI: 1.344-2.549), diabetes (OR=1.537, 95%CI: 1.068-2.213), dyslipidemia (OR=1.542, 95%CI: 1.112-2.140) and thyroid dysfunction (OR=2.575, 95%CI: 1.838-3.609) as risk factors of sarcopenia among the elderly. @*Conclusion@#Hypertension, diabetes, dyslipidemia and thyroid dysfunction may be risk factors of sarcopenia among the elderly.

Risk factors for yersiniosis: a case-control study / 预防医学

Objective@#To investigate the risk factors for yersiniosis, so as to provide insights into prevention of yersiniosis.@*Methods@#The patients with yersiniosis admitted to the clinics in the surveillance site of Chengbei Township of Jin'an District and Chengnan Township of Yu'an District in Lu'an City from 2013 to 2021 were included as the case group, and the healthy family members matched to cases were selected as the family control group, while normal residents with a 1︰2 match in the same village, gender, and age difference within 5 years were included in the community control group. Participants' demographics, hand-washing and eating habits, living environment hygiene, poultry and livestock feeding were collected using questionnaire surveys, and factors affecting yersiniosis were identified using a multivariable conditional logistic regression model.@*Results@#There were 43 cases in the case group, with a median (interquartile range) age of 45 (34) years, 91 cases in the family control group, with a median (interquartile range) age of 36 (36) years and 86 cases in the community control group, with a median (interquartile range) age of 46 (34) years. Multivariable conditional logistic regression analysis showed that compared with the family control group, the habit of drinking unboiled water (OR=6.721, 95%CI: 1.765-25.588), and direct consumption of food stored in the refrigerator (OR=7.089, 95%CI: 1.873-26.829) were risk factors for yersiniosis in the case group; and compared with the community control group, not washing hands after contacting with poultry and livestock (OR=50.592, 95%CI: 2.758-927.997), habit of eating raw vegetables and fruits (OR=5.340, 95%CI: 1.022-27.887), direct consumption of food stored in the refrigerator (OR=19.973, 95%CI: 2.118-188.336), and unclean refrigerator (OR=12.692, 95%CI: 1.992-80.869) were risk factors for yersiniosis in the case group. Compared with the family and community control groups, not washing hands after contacting with poultry and livestock (OR=4.075, 95%CI: 1.427-11.637), habit of drinking unboiled water (OR=4.153, 95%CI: 1.331-12.957), habit of eating raw vegetables and fruits (OR=4.744, 95%CI: 1.609-13.993), and direct consumption of food stored in the refrigerator (OR=5.051, 95%CI: 1.773-14.395) were risk factors for yersiniosis in the control group.@*Conclusion@#Unhealthy habits such as eating raw vegetables and fruits, drinking unboiled water, direct consumption of food stored in the refrigerator, unclean refrigerator, and not washing hands after contacting poultry and livestock may increase the risk of yersiniosis.

Establishment of the data capture and management platform for case-control study on precocious puberty based on REDCap system / 西安交通大学学报(医学版)

【Objective】 To conduct a case-control study on precocious puberty as an example to introduce the establishment and design of the electronic Data capture and management platform using Research Electronic data Capture (REDCap) system and support the development of clinical research. 【Methods】 Based on the clinical REDCap system, the case-control research project of precocious puberty was created, the case report forms were designed, the user rights were set, and the data quality control rules were formulated. 【Results】 We established the electronic data capture and management platform for our research, which had 15 case report forms, to collect the data of the participants, including sociodemographic information, time for rest and activities, diet, exposure to environmental internal-secretion interfering-substances, physical examination and biochemical indicators. We conducted project management by setting up features such as user permissions and workgroups, and added data quality verification rules to control data quality. The data could be exported in various file formats for analysis and sharing. 【Conclusion】 The application of REDCap to establish the data capture and management platform of precocious puberty case-control study has promoted the efficient implementation of clinical research, which can be further popularized and applied to clinical researches in other fields.

Association between oral health behavior during pregnancy and premature birth based on case-control study / 西安交通大学学报(医学版)

【Objective】 To investigate the relationship between maternal oral health behavior during pregnancy and premature birth. 【Methods】 A total of 248 preterm and 700 non-preterm pregnant women who delivered in Northwest Women’s and Children’s Hospital in Shaanxi Province from January to December 2022 were included in case group and control group, respectively. General demographic characteristics and oral health behavior during pregnancy were collected by questionnaires, and the oral health impact profile-14 (OHIP-14) was used to assess the oral health related life quality of pregnant women. Logistic regression model was used to analyze the relationship between maternal oral health behavior during pregnancy and premature birth. 【Results】 During pregnancy, maternal frequent eating after brushing teeth (OR=1.62, 95% CI: 1.03-2.57), unused fluoride toothpaste (OR=2.03, 95%CI: 1.25-3.05), late visit to the doctor for oral discomfort (OR=1.41, 95%CI: 1.02-1.96), brushing teeth less than twice one day (OR=1.77, 95%CI: 1.13-2.78) or less than 3 minutes each time (OR=1.52, 95%CI: 1.09-2.11), and elevated OHIP-14 score (OR=1.07, 95%CI: 1.04-1.10) increased the risk of premature birth. 【Conclusion】 Poor oral health behavior during pregnancy may increase the risk of premature birth. Therefore, more efforts should be made to publicize oral health knowledge and guide pregnant women to establish good oral health habits so as to improve oral health and promote maternal and child health.

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.

Case-control study on fragility fractures in coal miners: A comparison between surface and underground workers / 环境与职业医学

Background The prevalence of osteoporosis and osteopenia is higher among underground coal miners than surface workers. The special underground work environment and unhealthy habits such as smoking, drinking, and a high-salt diet may lead to changes in bone metabolism, increasing the risk of fragility fractures and placing a heavy economic burden on individuals and society. Objective To identify potential factors influencing fragility fractures among coal miners in different working environments and to provide a basis for targeted preventive measures to reduce the occurrence of fragility fractures. Methods Male participants who attended at least one of the physical examinations in Kailuan Group between June 2006 and December 2020 were included in the study. The participants were divided into two groups based on their working environment: surface or underground. A case-control study was conducted, where patients with new fragility fractures served as the case group and participants without fragility fractures served as the control group. The two groups were matched with a case:control ratio of 1:4 by age (±1 year) and the same year of physical examination. The matching process was repeated twice, once for the surface working population and once for the underground working population. The analysis of risk factors was conducted using conditional logistic regression models. Results Among a total of 113138 employees in Kailuan Group, 82631 surface workers and 30507 underground workers were included, respectively. The number of individuals who suffered fragility fractures was 1375, accounting for 1.22% of the total population. The incidence of fragility fractures in underground workers was significantly higher than that in surface workers (1.63%>1.07%, P<0.001). The results of conditional logistic regression model showed that current smoking (OR=1.26, 95%CI: 1.05, 1.51), manual labor (OR=1.37, 95%CI: 1.06, 1.78), diabetes (OR=1.26, 95%CI: 1.04, 1.54), sinus tachycardia (OR=1.81, 95%CI: 1.23, 2.66), history of stroke (OR=1.51, 95%CI: 1.09, 2.09), education at college and above (OR=0.65, 95%CI: 0.45, 0.95), high income level (OR=0.69, 95%CI: 0.54, 0.90), elevated hemoglobin (OR=0.91, 95%CI: 0.85, 0.98), and elevated total cholesterol (OR=0.90, 95%CI: 0.82, 0.99) were associated with fragility fractures in the surface working population of coal mines; current smoking (OR=1.48, 95%CI: 1.17, 1.87), current drinking (OR=1.26, 95%CI: 1.01, 1.56), manual labor (OR=2.64, 95%CI: 1.41, 4.94), history of dust exposure (OR=1.28, 95%CI: 1.03, 1.58), and obesity (OR=0.72, 95%CI: 0.52, 0.96) were associated with fragility fractures in the underground working population of coal mines. Conclusion In preventing fragility fractures, special attention should be paid to the bone health of underground workers engaged in manual labor or having a history of dust exposure. It is important to correct their unhealthy behaviors in a timely manner, such as smoking and drinking, and to appropriately increase body weight to prevent fragility fractures. For surface workers, particular attention should be given to the high-risk group for fragility fractures, such as low family income per capita, manual labor, and having a history of stroke or diabetes; in addition, close monitoring of their resting heart rate, hemoglobin levels, and total cholesterol levels may help prevent fragility fractures.

Transabdominal ultrasound measurement of cervical length in mid-pregnancy for prediction of spontaneous preterm birth / 中华围产医学杂志

Objective:To explore the clinical significance of cervical length (CL) measured by transabdominal ultrasound during fetal structural anomalies screeing at 20-24 +6 weeks of gestation. Methods:This was a retrospective nested case-control study based on a prospective longitudinal cohort of "Prediction and Prevention of Early-onset Preeclampsia", which recruited 4 995 singleton pregnant women at the gestational age of 11-13 +6 weeks in Nanjing Drum Tower Hospital from April 2019 to August 2022. All the subjects underwent second-trimester ultrasound screening for fetal structural anomalies in our hospital with image records. This study excluded the women who were lost to follow-up, underwent cervical cerclage, terminated the pregnancy due to personal or social factors, or had miscarriage before 20 weeks of gestation, and those with iatrogenic preterm births, intrauterine fetal death or no second-trimester cervical sonography images. Propensity score matching was used to match pregnant women with spontaneous preterm birth ( n=101) and those with full-term delivery ( n=101) in a 1∶1 ratio, with factors of maternal age, body mass index, preterm birth history, cesarean section history, and pregnancy interval ≥5 years. CL was measured based on the retained ultrasound images. Nonparametric test or Chi-square test were used for statistical analysis. Receiver operating characteristic (ROC) curve was used to evaluate the correlation between CL measured by transabdominal ultrasound in the second trimester and spontaneous preterm birth. Results:The CL measured by transabdominal ultrasound at 20-24 +6 weeks of gestation was significantly shorter in the spontaneous preterm birth group than that in the full-term group [2.8 cm (2.5-3.3 cm) vs. 3.4 cm (3.0-3.9 cm), Z=－5.85, P<0.001]. If CL<3.4 cm was used as the cut-off value for predicting spontaneous preterm birth (20-36 +6 weeks), the specificity and the sensitivity were 0.50 and 0.77, respectively, and the sensitivity reached 0.92 for predicting preterm birth before 32 weeks and 1.00 for predicting preterm birth before 28 weeks. If CL<3.7 cm was used as the cut-off value, the specificity and the sensitivity were 0.36 and 0.87, respectively, and the sensitivity was 1.00 for predicting preterm birth before 32 weeks. The efficacy of preterm birth screening at 28-36 +6 weeks of gestation was comparable to that at 20-36 +6 weeks, if CL<3.4 cm and CL<3.7 cm were used as the cut-off value, the sensitivity were 0.76 and 0.86, respectively. Conclusion:Transabdominal ultrasound measurement of CL in the second trimester can be a preliminary screening to determine whether further transvaginal ultrasound measurement of CL is needed for women without a history of preterm birth or late spontaneous abortion.

Influence of dietary composition of residents in endemic fluorosis area on the prevalence of skeletal fluorosis / 中华地方病学杂志

Objective:To analyze the relationship between dietary composition of residents in endemic fluorosis areas and skeletal fluorosis.Methods:A case-control study was used to analyze the difference of dietary composition between patients with skeletal fluorosis (case group) and residents without skeletal fluorosis (control group). In August 2019, taking the drinking water-borne endemic fluorosis area in Wenshui County, Lvliang City, Shanxi Province as the survey site, a cluster sampling method was adopted to select local residents aged over 18 years old, and a questionnaire survey was conducted by face-to-face interview. The survey contents included gender, age and consumption frequency of various foods. Binary logistic regression was used to analyze the relationship between food consumption frequency and skeletal fluorosis. The diagnosis of skeletal fluorosis was made by using portable digital radiography (DR) to take X-ray films of forearm and lower leg, combining with clinical signs, and according to the Diagnostic Standard for Endemic Skeletal Fluorosis (WS/T 192-2008) to determine.Results:A total of 1 061 subjects were included in this study, including 376 in the case group and 685 in the control group. The age composition of patients in the case group (≤60, > 60 years old: 162, 214 cases) was significantly different from that in the control group (≤60, > 60 years old: 423, 261 cases, χ 2 = 34.52, P < 0.001). There was no statistically significant difference in gender ratio (χ 2 = 1.37, P = 0.251). The proportion of patients in the case group who ate meat and eggs > 1 time/week was lower than that in the control group (χ 2 = 8.06, 5.46, P < 0.05), the proportion of patients who ate milk > 1 time/week was higher than that in the control group (χ 2 = 4.01, P = 0.046), and the proportion of patients who ate seafood ≥1 time/week was lower than that in the control group (χ 2 = 4.16, P = 0.046). The results of binary logistic regression analysis showed that after adjusting for age, sex, and urinary fluoride, the frequency of eating meat, eggs or milk > 1 time/week and the frequency of eating seafood ≥1 time/week were not related to the risk of skeletal fluorosis ( P > 0.05); however, in the group ≤60 years old, the frequency of eating eggs > 1 time/week was associated with the risk of skeletal fluorosis [odds ratio ( OR) = 0.59, 95% confidence interval ( CI): 0.39, 0.88]. Conclusions:The consumption frequency of meat, milk, eggs and seafood is significantly different between the skeletal fluorosis patients and the control people. In the population ≤60 years old, consumption frequency of eggs > 1 time/week may reduce the risk of skeletal fluorosis.