Efficacy and safety of a novel acetylcholinesterase inhibitor octohydroaminoacridine in mild-to-moderate Alzheimer's disease: a Phase II multicenter randomised controlled trial.

Background: inhibition of acetylcholinesterase (AChE) has been a effective treatment for Alzheimer's disease (AD). Octohydroaminoacridine, a new AChE inhibitor, is a potential treatment for AD. Method: we conducted a multicenter, randomised, double blind, placebo-controlled, parallel-group Phase II clinical trial to investigate the effects of octohydroaminoacridine in patients with mild-to-moderate AD. Patients were randomised to receive placebo thrice daily, octohydroaminoacridine 1 mg/thrice daily (TID) (low-dose group), 2 mg/TID (middle-dose group) or 4 mg/TID (high-dose group). Doses in the middle-dose and high-dose group were titrated over 2-4 weeks. Changes from baseline to Week 16 were assessed with the AD Assessment Scale-Cognitive Subscale (ADAS-cog), Clinician's Interview-Based Impression of Change Plus (CIBIC+), activities of daily living (ADL) and the neuropsychiatric inventory (NPI). ADAS-cog was the primary end point of the study. A two-way analysis of covariance and least squares mean t-test were used. Results: at Week 16, the changes from baseline in ADAS-cog were 1.4, -2.1, -2.2 and -4.2 for placebo, low-, middle- and high-dose groups, respectively. Patients in the high-dose group had better performance in CIBIC+ and ADL scores at the end of the study. There was no significant difference in the change in NPI score among the groups. The effects of octohydroaminoacridine were dose dependent, and were effective within 16 weeks of treatment. No evidence was found for more adverse events that occurred in different drug groups than placebo group. Conclusions: octohydroaminoacridine significantly improved cognitive function and behaviour in patients with mild-to-moderate AD and this effect was dose dependent.

Zero-Inflated Models for Identifying Relationships Between Body Mass Index and Gastroesophageal Reflux Symptoms: A Nationwide Population-Based Study in China.

BACKGROUND AND AIM: That obesity leads to gastroesophageal reflux is a widespread notion. However, scientific evidence for this association is limited, with no rigorous epidemiological approach conducted to address this question. This study examined the relationship between body mass index (BMI) and gastroesophageal reflux symptoms in a large population-representative sample from China. METHODS: We performed a cross-sectional study in an age- and gender-stratified random sample of the population of five central regions in China. Participants aged 18-80 years completed a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire. The zero-inflated Poisson regression model estimated the relationship between body mass index and gastroesophageal reflux symptoms. RESULTS: Overall, 16,091 (89.4 %) of the 18,000 eligible participants responded. 638 (3.97 %) and 1738 (10.81 %) experienced at least weekly heartburn and weekly acid regurgitation, respectively. After adjusting for potential risk factors in the zero-inflated part, the frequency [odds ratio (OR) 0.66, 95 % confidence interval (95 % CI) 0.50-0.86, p = 0.002] and severity (OR 0.66, 95 % CI 0.50-088, p = 0.004) of heartburn in obese participants were statistically significant compared to those in normal participants. In the Poisson part, the frequency of acid regurgitation, overweight (OR 1.10, 95 % CI 1.01-1.21, p = 0.038) and obesity (OR 1.19, 95 % CI 1.04-1.37, p = 0.013) were statistically significant. BMI was strongly and positively related to the frequency and severity of gastroesophageal reflux symptoms. Additionally, gender exerted strong specific effects on the relationship between BMI and gastroesophageal reflux symptoms. CONCLUSIONS: The severity and frequency of heartburn were positively correlated with obesity. This relationship was presented distinct in male participants only.

The relation between health insurance and management of hypertension in Shanghai, China: a cross-sectional study.

BACKGROUND: We aimed to investigate the management of hypertension in Shanghai, China and to examine whether there was any difference of hypertension management among people enrolled in different health insurances. METHODS: In this cross-sectional study, a total of 31,531 residents were selected in Shanghai, using a randomized, stratified, multi-stage sampling method, and were asked to provide their status of hypertension, condition of hypertension management, health insurances and other demographic information. A weighted propensity score model was used to adjust confounders and to analyze the differences on hypertension management among hypertension patients enrolled in different health insurances. RESULTS: In Shanghai, most hypertension patients achieved good management of hypertension. However, patients enrolled in the New Cooperative Medical Scheme or the Urban Resident Basic Medical Insurance scheme were more likely to achieve publicity of precautionary knowledge about hypertension (OR = 2.36 [95 % CI :1.96,2.85] and 1.28 [95 % CI:1.12,1.45], respectively) and had their blood pressure under control (OR = 1.33 [95 % CI :1.09,1.62] and 1.22 [95 % CI:1.05,1.42], respectively) than patients enrolled in the Urban Employee Basic Health Insurance scheme. CONCLUSION: The study provided a comprehensive description of hypertension in Shanghai, China. To support the management of hypertension, publicity of hypertension prevention knowledge should be improved, especially to people enrolled in the Urban Employee Basic Health Insurance scheme.

Prevalence of esophageal eosinophilia and eosinophilic esophagitis in adults: a population-based endoscopic study in Shanghai, China.

BACKGROUND AND AIM: Population-based endoscopic studies of esophageal eosinophilia and eosinophilic esophagitis are limited in the world. This study was aiming to describe features of esophageal eosinophilia and eosinophilic esophagitis in a representative sample of the adult in Shanghai, China. METHODS: As part of a large epidemiological study, 3,600 individuals (aged 18-80 years) were randomly selected in Shanghai, China. They were asked to undergo endoscopy and have at least four esophageal biopsies taken from 0.5 cm above the Z-line and any abnormal areas. Any eosinophil infiltration of the epithelium was defined as esophageal eosinophilia. Eosinophilic esophagitis was defined as ≥15 eosinophils/high-power field in esophageal biopsies. RESULTS: A total of 1,030 individuals accepted to have endoscopy and 1,021 individuals with biopsy results were suitable for analysis. Esophageal eosinophilia was present in 67 subjects (6.6 %). Eosinophilic esophagitis was present in four cases (0.4 %). No significant association was found between the presence of esophageal eosinophilia and reflux esophagitis, Barrett's esophagus, symptom-defined gastroesophageal reflux disease or H. pylori infection. Most individuals with esophageal eosinophilia (80.6 %) did not have any of the upper gastrointestinal symptoms. CONCLUSIONS: Esophageal eosinophilia was present in nearly 6.6 % of the general adult population of China; 0.4 % had eosinophilic esophagitis. Most of individuals with esophageal eosinophilia were asymptomatic.

Abdominal obesity and its association with health-related quality of life in adults: a population-based study in five Chinese cities.

BACKGROUND: This study aimed to investigate the prevalence of abdominal obesity and its association with the health-related quality of life (HRQOL) in a randomly selected Chinese sample. METHODS: A population-based sample of 3,600 residents aged 18-80 years was selected randomly from 5 Chinese cities. Demographic information, and waist and hip circumference measurements were obtained. The Mandarin version of the Short Form 36 Health Survey questionnaire (SF-36) was used to assess the HRQOL. Waist circumference (WC) and waist-to-hip ratio (WHR) were used as measures of abdominal obesity, and the prevalence of abdominal obesity and its association with HRQOL were analysed. RESULTS: Among the 3,184 participants included in the analysis, the prevalence of abdominal obesity was about 45% in both women and men as evaluated by WC, and about 40% in women and 33% in men as evaluated by WHR. The prevalence varied by city, region, age, marital status, education level, family income, smoking, and the presence of chronic diseases. Both WC and WHR increased with age, and men had larger WC and WHR than women in most age groups. In women, abdominal obesity, as determined by both WC and WHR, was associated with meaningful impairments in 4 physical health scales and 2 mental health scales. In men, abdominal obesity, as determined by WC, was associated with 1 physical health scale and 1 mental health scale, and it was associated with 2 physical health scales based on WHR. CONCLUSIONS: Physical health, but not mental health, was more vulnerable to impairment with abdominal obesity, and the impairments varied between genders. Public health agencies should emphasize that abdominal obesity impairs physical health.

The relationship between self-rated health and objective health status: a population-based study.

BACKGROUND: Self-rated health (SRH), a subjective assessment of health status, is extensively used in the public health field. However, whether SRH can reflect the objective health status is still debatable. We aim to reveal the relationship between SRH and objective health status in the general population. METHODS: We assessed the relationship between SRH and objective health status by examining the prevalence of diseases, laboratory parameters, and some health-related factors in different SRH groups. Data were collected from 18,000 residents randomly sampled from the general population in five cities of China (3,600 in each city). SRH was assessed by a single-item health measure with five options: "very good," "good," "fair," "bad," and "very bad." The differences in prevalence of diseases, laboratory parameters, and health-related factors between the "healthy" (very good plus good), "relatively healthy" (fair), and "unhealthy" (bad plus very bad) groups were examined. The odds ratios (ORs) referenced by the healthy group were calculated using logistic regression analysis. RESULTS: The prevalence of all diseases was associated with poorer SRH. The tendency was more prominent in cardio-cerebral vascular diseases, visual impairment, and mental illnesses with larger ORs. Residents with abnormalities in laboratory parameters tended to have poorer SRH, with ORs ranging from 1.62 (for triglyceride) to 3.48 (for hemoglobin among men) in a comparison of the unhealthy and healthy groups. Most of the health-related factors regarded as risks were associated with poorer SRH. Among them, life and work pressure, poor spiritual status, and poor quality of interpersonal relationships were the most significant factors. CONCLUSIONS: SRH is consistent with objective health status and can serve as a global measure of health status in the general population.

Excessive daytime sleepiness assessed by the Epworth Sleepiness Scale and its association with health related quality of life: a population-based study in China.

BACKGROUND: Excessive daytime sleepiness (EDS) is a common condition worldwide that has many negative effects on people who were afflicted with it, especially on their health-related quality of life (HRQOL). The Epworth Sleepiness Scale (ESS) is a commonly used method for evaluating EDS in English-speaking countries. This paper reported the prevalence of subjective EDS in China as assessed by the Mandarin version of the ESS; tested the scale's response rate, reliability and validity; and investigated the relationship between ESS scores and HRQOL. METHODS: A population-based sample of 3600 residents was selected randomly in five cities in China. The demographic information was collected, subjective EDS was assessed by the Mandarin version of the ESS (ESS scores >10), and HRQOL was evaluated by the Mandarin version of the 36-item Short Form Health Survey (SF-36). RESULTS: The Mandarin version of ESS had very few missing responses, and the average response rate of its eight items was 97.92%. The split-half reliability coefficient and Cronbach's α coefficient were 0.81 and 0.80, respectively. One factor was identified by factor analysis with an eigenvalue of 2.78. The ESS scores showed positive skewness in the selected sample, with a median (Q1, Q3) of 6 (3, 0). 644 (22.16%) respondents reported subjective EDS, and all of the scores of the eight dimensions of the SF-36 were negatively correlated with ESS scores. CONCLUSIONS: The Mandarin version of ESS is an acceptable, reliable, and valid tool for measuring EDS. In addition, subjective EDS is common in China, based on the ESS results, and impairs HRQOL.

Body mass index and health-related quality of life in adults: a population based study in five cities of China.

BACKGROUND: To investigate the relationship between obesity and health-related quality of life (HRQL) in a randomly selected Chinese sample. METHODS: A total of 3600 residents aged 18-80 years were sampled in five cities of China using a randomized stratified multiple-stage sampling method to receive the interview, with a self-completed questionnaire to collect demographic information, and the Mandarin version of Short Form 36 Health Survey questionnaire (SF-36) to assess HRQL, followed by height and weight measurements for calculating body mass index (BMI). Cross-sectional association between BMI and HRQL was analysed. RESULTS: Among the 3207 participants (mean age 42 years) suitable for analysis, BMI differed by age and gender. Based on the international or the Asian BMI categories, in women, meaningful impairments were seen between obese and normal weight participants in four physical health scales, and only one scale of the four mental health scales--vitality scale was affected by obesity; in men, impairments by obesity were not found in all of the eight SF-36 scales, and better HRQL in two mental health scales were observed in obese participants compared to normal weight ones; after adjusting related variables, several physical but not mental health scales were found impaired by obesity. CONCLUSION: Obesity impaired physical but not mental health, and the impairments varied between genders. Public health agencies and government should emphasize the impairments of obesity on physical health.

Epidemiology of symptom-defined gastroesophageal reflux disease and reflux esophagitis: the systematic investigation of gastrointestinal diseases in China (SILC).

OBJECTIVE: Gastroesophageal reflux disease (GERD) is thought to be less prevalent in China than in Western countries. However, essential population-based endoscopy data are lacking for this country. MATERIAL AND METHODS: As part of a wider study, 3600 individuals selected randomly from the Shanghai region were asked to undergo endoscopy. Participants completed a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire. When sufficient numbers were available, associations were assessed using multiple logistic regression or the Wilcoxon rank-sum test. RESULTS: Of 3153 (87.6%) individuals who completed the survey, 1030 (32.7%) agreed to endoscopy and 1029 endoscopies were suitable for analysis. Symptom-defined GERD was more prevalent in the endoscopy group (4.7%) than in the non-endoscopy group (1.7%). Prevalence estimates were 6.4% for reflux esophagitis, 1.8% for endoscopically suspected esophageal metaplasia and 0.7% for hiatus hernia. Reflux esophagitis was more prevalent in patients with symptom-defined GERD than in those without (12.5% [6/48] vs. 6.1% [60/981]), and was significantly associated with reflux symptoms of any frequency or severity (OR = 2.10, 95% CI 1.13-3.89) and with negative Helicobacter pylori infection (OR = 0.44, 95% CI 0.25-0.80). Only 28.8% of participants with reflux esophagitis had heartburn and/or regurgitation symptoms. Epigastric burning was significantly more severe and frequent in participants with reflux esophagitis than in those without (p = 0.05). CONCLUSIONS: Reflux esophagitis is less prevalent in China than reported in Western countries. Further work is needed to establish why reflux esophagitis appears less symptomatic in China than in Western countries.

Helicobacter pylori infection and gastritis: the Systematic Investigation of gastrointestinaL diseases in China (SILC).

BACKGROUND AND AIM: Helicobacter pylori infection remains common in East Asia, though its prevalence is decreasing in Western countries. H. pylori-related atrophic gastritis (AG) may reduce the likelihood of gastroesophageal reflux disease (GERD). We investigated the prevalence of H. pylori infection and AG and their association with endoscopic findings and symptom-defined GERD in Shanghai. METHODS: A representative random sample of 3600 Shanghai residents aged 18-80 years was invited to complete a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire, to provide blood samples for H. pylori serology and pepsinogen (PG) I/II assay (to detect AG, defined as PGI < 70 µg/L and/or PGI/PGII < 7), and to undergo endoscopy. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multivariate logistic regression. RESULTS: A total of 1022 Shanghai residents underwent endoscopy and were valid for inclusion in the study. Of these, 71.7% tested positive for H. pylori, 63.8% had AG and 30.5% had moderate/severe AG (PGI < 50 µg/L and/or PGI/PGII < 5). Helicobacter pylori infection was equally common in all age groups. Severity of AG increased with age in women. Reflux esophagitis was inversely associated with AG (OR, 0.23 [CI, 0.09-0.55] for moderate/severe AG compared with no H. pylori or gastritis). However, symptom-defined GERD showed no clear association with AG. CONCLUSIONS: Helicobacter pylori infection and AG are very common in Shanghai, and the infection is acquired early in life. Atrophic gastritis is inversely associated with reflux esophagitis but is not significantly associated with symptom-defined GERD.

Health-related quality of life in Chinese people: a population-based survey of five cities in China.

AIMS: The current study aimed at undertaking an investigation to describe health-related quality of life (HRQL) in Chinese people, with a Mandarin version of the 36-item short-form health survey (SF-36) validated. METHODS: A total of 3,219 respondents were successfully interviewed under a randomized stratified multi-stage sampling design from April 2007 to January 2008 in five cities of mainland China. Self-finished interview method was applied and the Mandarin version of SF-36 was used for assessing HRQL. RESULTS: As a result, the reliability and validity of SF-36 were acceptable, although some deviations from the hypothesized model still existed. The Chinese population scored higher than other populations in five of the eight SF-36 scales and Chinese men scored higher than women in six of the eight SF-36 scales. CONCLUSIONS: Basically, the Mandarin version of SF-36 is a reliable instrument, although minor modifications are needed. The health-related quality of life in Chinese people were quite high based on the sample of five cities in China; further research is needed to establish the countrywide norm of health-related quality of life in mainland China.

Misuse of statistical methods in 10 leading Chinese medical journals in 1998 and 2008.

Statistical methods are vital to biomedical research. Our aim was to find out whether progress has been made in the last decade in the use of statistical methods in Chinese medical research. We reviewed 10 leading Chinese medical journals published in 1998 and in 2008. Regarding statistical methods, using a multiple t-test for multiple group comparison was the most common error in the t-test in both years, which significantly decreased in 2008. In contingency tables, no significant level adjustment for multiple comparison significantly decreased in 2008. In ANOVA, over a quarter of articles misused the method of multiple pair-wise comparison in both years, and no significant difference was seen between the two years. In the rank transformation nonparametric test, the error of using multiple pair-wise comparison for multiple group comparison became less common. Many mistakes were found in the randomised controlled trial (56.3% in 1998; 67.9% in 2008), non- randomised clinical trial (57.3%; 58.6%), basic science study (72.9%; 65.5%), case study or case series study (48.4%; 47.2%), and cross-sectional study (57.1%; 44.2%). Progress has been made in the use of statistical methods in Chinese medical journals, but much is yet to be done.

Epidemiology of peptic ulcer disease: endoscopic results of the systematic investigation of gastrointestinal disease in China.

OBJECTIVES: Complications of peptic ulcer disease (PUD) are common in China. Population-based estimates of the prevalence of PUD are needed to quantify and characterize the population at risk of these complications. METHODS: As part of a large epidemiological study, 3,600 randomly selected residents of Shanghai (aged 18-80 years) were asked to undergo endoscopy and to provide blood samples for Helicobacter pylori serology. All participants also completed a general information questionnaire and Chinese versions of the reflux disease questionnaire (RDQ) and Rome II questionnaire. Associations between PUD and other factors were analyzed using a multiple logistic regression model. RESULTS: In total, 3,153 individuals (87.6%) completed the survey. All underwent blood tests, and 1,030 patients (32.7%) agreed to undergo endoscopy. Results from 1,022 patients were suitable for analysis. In all, 176 participants (17.2%) had PUD (62 with gastric ulcer; 136 with duodenal ulcer). The prevalence of H. pylori infection was 73.3% in the total population and 92.6% among those with PUD. H. pylori infection was associated with the presence of PUD (odds ratio (OR), 6.77; 95% confidence interval (CI), 2.85-16.10). The majority (72.2%) of individuals with PUD had none of the upper gastrointestinal symptoms assessed by the RDQ. PUD was not significantly associated with symptom-defined gastroesophageal reflux disease (GERD) (OR, 0.80; 95% CI, 0.32-2.03), reflux esophagitis (OR, 1.46; 95% CI, 0.76-2.79) or dyspepsia (OR, 1.69; 95% CI, 0.94-3.04). CONCLUSIONS: The prevalence of endoscopically confirmed PUD in this Shanghai population (17.2%) is substantially higher than in Western populations (4.1%). The majority of individuals with PUD were asymptomatic.

Epidemiology of gastroduodenal erosions in the general population: endoscopic results of the systematic investigation of gastrointestinal diseases in China (SILC).

OBJECTIVE: Population-based endoscopic studies of gastroduodenal erosions are limited in the world. This study describes features of gastroduodenal erosions in a representative sample of the population in Shanghai, China. MATERIAL AND METHODS: A total of 3600 individuals (aged 18-80 years) were randomly selected from the Shanghai region and asked to undergo endoscopy and provide a blood sample to test for H. pylori infection. Participants completed a general information questionnaire, and a Chinese version of the Reflux Disease Questionnaire; 20% were also invited to complete the 36-item Short Form Health Survey and Epworth Sleepiness Scale. Associations between gastroduodenal erosions and other factors were analyzed using a multiple logistic regression model. RESULTS: In total, 3153 individuals (87.6%) completed the survey and provided blood samples, 1030 (32.7%) agreed for endoscopy and 1022 participants were suitable for analysis. In all, 510 participants (49.9%) had gastroduodenal erosions (502 with gastric erosions; 26 with duodenal erosions). No significant association was found between H. pylori infection and gastroduodenal erosions. Increasing age, increasing BMI and current smoking were independent predictors for the presence of gastric erosions, but not of duodenal erosions. Duodenal erosions were more prevalent among men, which were not found in gastric erosions. The majority of individuals with gastroduodenal erosions were asymptomatic. CONCLUSIONS: Gastroduodenal erosions are more common in China than in Europe, North America, and South America. No significant association was found between H. pylori infection and gastroduodenal erosions in China. The majority of individuals with gastroduodenal erosions were asymptomatic.

A population-based survey of the epidemiology of symptom-defined gastroesophageal reflux disease: the Systematic Investigation of Gastrointestinal Diseases in China.

BACKGROUND: The epidemiology of gastroesophageal reflux disease (GERD) has yet to be investigated using the symptomatic threshold criteria recommended by the Montreal Definition. This study aimed to determine the prevalence of symptom-defined GERD across five regions of China, and to investigate variables associated with GERD. METHODS: A representative sample of 18 000 adults (aged 18-80 years) were selected equally from rural and urban areas in each region (n = 1800). According to the Montreal Definition, GERD is present when mild symptoms of heartburn and/or regurgitation occur on >or=2 days a week, or moderate-to-severe symptoms of heartburn and/or regurgitation occur on >or=1 day a week. RESULTS: In total, 16 091 participants completed the survey (response rate: 89.4%) and 16 078 responses were suitable for analysis. Applying the Montreal criteria, the prevalence of symptom-defined GERD was 3.1% and varied significantly (p < 0.001) among the five regions (from 1.7% in Guangzhou to 5.1% in Wuhan) and between rural and urban populations (3.8% vs 2.4%). Factors significantly associated with GERD included living in a rural area and a family history of gastrointestinal diseases. CONCLUSIONS: This population-based survey found that the prevalence of symptom-defined GERD in China was 3.1%, which is lower than that found in Western countries.

Impact of gastroesophageal reflux disease on daily life: the Systematic Investigation of Gastrointestinal Diseases in China (SILC) epidemiological study.

BACKGROUND: Gastroesophageal reflux disease imposes a significant burden of illness in Western populations. However, data on the impact of reflux symptoms on daily life in Asian populations are scarce. The current study aimed to evaluate the impact of GERD (defined on the basis of symptoms) on health-related quality-of-life (HRQoL) in individuals from five regions in China, as part of the Systematic Investigation of Gastrointestinal Diseases in China (SILC) study. METHODS: In total, 18 000 residents were randomly selected from across five regions of China and asked to complete a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire (RDQ). A randomly selected subsample of one-fifth of subjects (20% from each region) completed Chinese versions of the 36-item self-administered (SF-36) questionnaire and Epworth Sleepiness Scale (ESS) questionnaire. Reflux symptoms were defined as the presence of heartburn and/or regurgitation. Symptom-defined GERD was diagnosed as mild heartburn and/or regurgitation ≥2 days per week, or moderate/severe heartburn and/or regurgitation ≥1 day a week, based on the Montreal Definition of GERD for population-based studies. RESULTS: The response rate was 89.4% for the total sample (16 091/18 000), and for the 20% subsample (3219/3600). Meaningful impairment was observed in all 8 SF-36 dimensions in participants with symptom-defined GERD, in 7 of the 8 SF-36 dimensions in participants with troublesome reflux symptoms, and in 6 of the 8 SF-36 dimensions in participants with reflux symptoms below the threshold for symptom-defined GERD. Meaningful daytime sleepiness was also observed in each of these groups. The proportion of individuals reporting troublesome symptoms increased as reflux symptom frequency and severity approached the threshold for symptom-defined GERD, and this was associated with concomitant decreases in all HRQoL measures. Troublesome symptoms were reported by 68.2% (75/110) of individuals with symptom-defined GERD. CONCLUSIONS: GERD diagnosed using symptom/frequency criteria (recommended for population-based studies), or based on troublesome reflux symptoms (recommended for the clinic), is associated with significantly impaired HRQoL in Chinese individuals. However, patient groups identified using these definitions do not overlap completely, suggesting that they capture slightly different, though clinically relevant, GERD populations.

Systematic investigation of gastrointestinal diseases in China (SILC): validation of survey methodology.

BACKGROUND: Symptom-based surveys suggest that the prevalence of gastrointestinal diseases is lower in China than in Western countries. The aim of this study was to validate a methodology for the epidemiological investigation of gastrointestinal symptoms and endoscopic findings in China. METHODS: A randomized, stratified, multi-stage sampling methodology was used to select 18,000 adults aged 18-80 years from Shanghai, Beijing, Xi'an, Wuhan and Guangzhou. Participants from Shanghai were invited to provide blood samples and undergo upper gastrointestinal endoscopy. All participants completed Chinese versions of the Reflux Disease Questionnaire (RDQ) and the modified Rome II questionnaire; 20% were also invited to complete the 36-item Short Form Health Survey (SF-36) and Epworth Sleepiness Scale (ESS). The psychometric properties of the questionnaires were evaluated statistically. RESULTS: The study was completed by 16,091 individuals (response rate: 89.4%), with 3219 (89.4% of those invited) completing the SF-36 and ESS. All 3153 participants in Shanghai provided blood samples and 1030 (32.7%) underwent endoscopy. Cronbach's alpha coefficients were 0.89, 0.89, 0.80 and 0.91, respectively, for the RDQ, modified Rome II questionnaire, ESS and SF-36, supporting internal consistency. Factor analysis supported construct validity of all questionnaire dimensions except SF-36 psychosocial dimensions. CONCLUSION: This population-based study has great potential to characterize the relationship between gastrointestinal symptoms and endoscopic findings in China.

Validation of a survey methodology for gastroesophageal reflux disease in China.

BACKGROUND: Gastroesophageal reflux disease (GERD) causes a wide range of clinical symptoms and potentially serious complications, but epidemiological data about GERD in China are limited. The aim of this pilot study was to develop and validate a methodology for the epidemiological study of GERD in China. METHODS: Regionally stratified, randomized samples of Shanghai residents (n = 919) completed Mandarin translations of the Reflux Disease Questionnaire (RDQ), GERD Impact Scale, Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire and 36-item Short Form Health Survey (SF-36). Reliability and construct validity were tested by appropriate statistical analyses. RESULTS: The response rate was 86%. The test-retest reliability coefficients for the RDQ, GERD Impact Scale, QOLRAD and SF-36 were 0.80, 0.71, 0.93 and 0.96, respectively, and Cronbach's alpha coefficients were 0.86, 0.80, 0.98 and 0.90, respectively. Dimension scores were highly correlated with the total scores for the QOLRAD and SF-36, and factor analysis showed credible construct validity for the RDQ, GERD Impact Scale and SF-36. The RDQ GERD score was significantly negatively correlated with QOLRAD dimensions of food and drink problems and social functioning, and was significantly negatively correlated with all dimensions of the SF-36. All eight of the SF-36 dimensions were significantly correlated with the QOLRAD total score. CONCLUSION: This study developed and tested a successful survey methodology for the investigation of GERD in China. The questionnaires used demonstrated credible reliability and construct validity, supporting their use in larger epidemiological surveys of GERD in China.

Therapeutic effects and anti-inflammatory mechanisms of heparin on acute lung injury in rabbits.

OBJECTIVES: The objectives were to investigate the potential beneficial effects and molecular mechanisms of heparin and low-molecular-weight heparin (LMWH) on acute lung injury (ALI). METHODS: Forty-eight rabbits were randomized into four groups: normal control group (Group A), lipopolysaccharide (LPS) group (Group B), LPS + heparin group (Group C), and LPS + LMWH group (Group D). The rabbit ALI model was established by intravenous (IV) injection with LPS. Alveolar-arterial O2 difference (P(A-a)O2), serum tumor necrosis factor alpha (TNF-alpha), circulating p38 mitogen-activated protein kinase (p38 MAPK) levels, lung nuclear factor (NF)-kappaB levels, and lung dry/wet (D/W) ratio were measured, and the lung injury scores were calculated. RESULTS: Lipopolysaccharide caused significant increases in P(A-a)O2, serum TNF-alpha, expression of p38 MAPK in polymorphonuclear neutrophils (PMNs), the lung injury scores, and nuclear factor-kappaB (NF-kappaB) activity in the lung tissue and caused a decrease in lung D/W ratio. A positive linear correlation was found between p38 MAPK and TNF-alpha at 1, 2, 4, and 6 hours (r = 0.68, 0.92, 0.93, and 0.93, respectively) and between NF-kappaB and p38 MAPK and TNF-alpha at 6 hours (r = 0.94 and 0.83, respectively). IV heparin or LMWH given after LPS treatment attenuated these changes in inflammatory response, oxygenation, p38 MAPK expression, and NF-kappaB activation. CONCLUSIONS: The anti-inflammatory mechanisms of heparin in ALI may be inhibiting p38 MAPK and NF-kappaB activities, and then TNF-alpha overexpression, thus alleviating the inflammatory reaction.

Classification of amine type G-protein coupled receptors with feature selection.

G-protein coupled receptors (GPCRs) are involved in various physiological processes. Therefore, classification of amine type GPCRs is important for proper understanding of their functions. Though some effective methods have been developed, it still remains unknown how many and which features are essential for this task. Empirical studies show that feature selection might address this problem and provide us with some biologically useful knowledge. In this paper, a feature selection technique is introduced to identify those relevant features of proteins which are potentially important for the prediction of amine type GPCRs. The selected features are finally accepted to characterize proteins in a more compact form. High prediction accuracy is observed on two data sets with different sequence similarity by 5-fold cross-validation test. The comparison with a previous method demonstrates the efficiency and effectiveness of the proposed method.