[Association of single nucleotide polymorphisms of transcription factors with congenital heart diseases in the Chinese population: a Meta analysis].

OBJECTIVE: To study the association of single nucleotide polymorphisms (SNPs) of transcription factors (NKX2.5, GATA4, TBX5, and FOG2) with congenital heart disease (CHD) in the Chinese population. METHODS: PubMed, Google Scholar, CNKI, Wanfang Data, and Weipu Data were searched for articles on the association of SNPs of target genes with CHD in the Chinese population. If one locus was mentioned in at least two articles, the random or fixed effect model was used to perform a pooled analysis of study results and to calculate the pooled OR and its 95%CI. If a locus was mentioned in only one article, related data were extracted from this article to analyze the association between the SNPs of this locus and CHD. RESULTS: Twenty-three articles were included. The Meta analysis showed that there were significant differences between the CHD and control groups in the genotype and allele frequencies of GATA4 rs1139244 and rs867858 and the genotype frequency of GATA4 rs904018, while there were no significant differences in the SNPs of the other genetic loci between the two groups. The single-article analysis showed that there were significant differences between the two groups in the allele frequencies of NKX2.5 rs118026695/rs703752, GATA4 rs884662/rs12825/rs12458/rs3203358/rs4841588, and TBX5 rs6489956. There were no significant differences in the SNPs of FOG2 locus between the two groups. CONCLUSIONS: The SNPs of some loci in NKX2.5, GATA4, and TBX5 are associated with CHD in the Chinese population, but the association between the SNPs of FOG2 locus and the development of CHD has not been found yet.

Worldwide prevalence of adverse pregnancy outcomes associated with in vitro fertilization/intracytoplasmic sperm injection among multiple births: a systematic review and meta-analysis based on cohort studies.

PURPOSE: To perform a systematic review and meta-analysis of reported estimates of adverse pregnancy outcomes among multiple births conceived with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). METHODS: PubMed, Google Scholar, Cochrane Libraries and Chinese databases were searched through May 2016 for cohort studies assessing adverse pregnancy outcomes associated with IVF/ICSI multiple births. Random-effects meta-analyses were used to calculate pooled estimates of adverse pregnancy outcomes and, where appropriate, heterogeneity was explored in group-specific analyses. RESULTS: Sixty-four studies, with 60,210 IVF/ICSI multiple births and 146,737 spontaneously conceived multiple births, were selected for analysis. Among IVF/ICSI multiple births, the pooled estimates were 51.5% [95% confidence interval (CI): 48.7-54.3] for preterm birth, 12.1% (95% CI: 10.4-14.1) for very preterm birth, 49.8% (95% CI: 47.6-52.0) for low birth weight, 8.4% (95% CI: 7.1-9.9) for very low birth weight, 16.2% (95% CI: 12.9-20.1) for small for gestational age, 3.0% (95% CI: 2.5-3.7) for perinatal mortality and 4.7% (95% CI: 4.0-5.6) for congenital malformations. When the data were restricted to twins, the pooled estimates also showed a high prevalence of adverse outcomes. There was a similar prevalence of poor outcomes among multiple births conceived with IVF/ICSI and naturally (all P ≥ 0.0792). Significant differences in different continents, countries, and income groups were found. CONCLUSIONS: The IVF/ICSI multiple pregnancies have a high prevalence of adverse pregnancy outcomes. However, population-wide prospective adverse outcomes registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.

Worldwide prevalence of adverse pregnancy outcomes among singleton pregnancies after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis.

PURPOSE: The worldwide prevalence of adverse pregnancy outcomes (APOs) in singleton pregnancies after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) is suggested to vary; however, a complete overview is missing. The aim of this review is to estimate the worldwide prevalence of APOs associated with IVF/ICSI singleton pregnancies. METHODS: PubMed, Google Scholar, Cochrane Libraries, and Chinese databases were searched for studies assessing APOs among IVF/ICSI singleton births through March 2016. The prevalence estimates were summarized and analyzed by meta-analysis. RESULTS: Fifty-two cohort studies, with 181,741 IVF/ICSI singleton births and 4,636,508 spontaneously conceived singleton births, were selected for analysis. Among IVF/ICSI singleton pregnancies, pooled estimates were 10.9% [95% confidence interval (CI) 10.0-11.8] for preterm birth, 2.4% (95% CI 1.9-3.0) for very preterm birth, 8.7% (95% CI 7.4-10.2) for low birth weight, 2.0% (95% CI 1.5-2.6) for very low birth weight, 7.1% (95% CI 5.5-9.2) for small for gestational age, 1.1% (95% CI 0.9-1.3) for perinatal mortality, and 5.7% (95% CI 4.7-6.9) for congenital malformations. The IVF/ICSI singleton pregnancies have higher prevalence of APOs compared with those conceived naturally (all P = 0.000). Significant differences in different continents, countries, income groups, and type of assisted conception were found. CONCLUSIONS: The IVF/ICSI singleton pregnancies are at a higher prevalence of adverse perinatal outcomes compared with those conceived naturally. Important geographical differences were found. Yet, population-wide prospective APO registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.

Single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone after arthroscopic knee surgery: a meta-analysis of randomized controlled trials.

PURPOSE: The purpose of this meta-analysis was to compare the efficacy and safety of single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone for pain management following arthroscopic knee surgery. METHOD: A comprehensive literature search was conducted to identify randomized controlled trials that used single-dose intra-articular bupivacaine plus morphine and bupivacaine alone for post-operative pain, using MEDLINE (1966-2014), Cochrane Library and EMBASE databases. The weighted mean difference (WMD), relative risk (RR) and their corresponding 95 % confidence intervals (CIs) were calculated using RevMan statistical software. RESULT: A total of twenty-nine trials (n = 1167) were included. The post-operative visual analog scale (VAS) pain score of the bupivacaine plus morphine group compared with the bupivacaine alone group was significantly lower (WMD -1.15, 95 % CI -1.67 to -0.63, p < 0.0001). As far as safety, there was no significant difference in side effects between the two groups (RR 1.10, 95 % CI 0.59-2.04, n.s.). Sensitivity analyses suggested that the results of these two primary outcomes were stable and reliable. However, the current evidence did not suggest a superior effect with respect to the time to first analgesic request (WMD 51.33, 95 % CI -110.99 to 213.65, n.s.) and the number of patients requiring supplementary analgesia (RR 1.13, 95 % CI 0.92-1.39, n.s.). CONCLUSIONS: On the basis of the currently available literature, this study is the first to suggest that single-dose intra-articular bupivacaine plus morphine was shown to be significantly better than bupivacaine alone at relieving post-operative pain after arthroscopic knee surgery without increasing the short-term side effects. Routine use of single-dose intra-articular bupivacaine plus morphine is an effective way for pain management after arthroscopic knee surgery. LEVEL OF EVIDENCE: II.

Association between serum selenium level and type 2 diabetes mellitus: a non-linear dose-response meta-analysis of observational studies.

BACKGROUND: The association between serum selenium levels and type 2 diabetes mellitus (T2DM) is controversial. We performed a systematic review and non-linear dose-response meta-analysis of observational studies to investigate the association in the present study. METHODS: A comprehensive literature search was conducted using MEDLINE and EMBASE databases. A pooled odds ratio (OR) and related 95 % confidence interval (95 % CI) for T2DM between the highest and lowest serum selenium categories, and a non-linear dose-response relationship between selenium and T2DM were estimated. RESULTS: A total of five studies (of 13,460 participants) were identified as meeting the inclusion criteria. The pooled OR indicated that there was a significantly higher prevalence of T2DM in the highest category of blood selenium compared with the lowest (OR = 1.63, 95 % CI: 1.04-2.56, P = 0.033). Moreover, a significant non-linear dose-response relationship was observed between serum selenium levels and T2DM (P < 0.001). Serum selenium levels were positively associated with T2DM in populations with relatively low serum selenium levels (<97.5 µg/l) and those with high serum selenium levels (>132.5 µg/l). CONCLUSIONS: The positive association between serum selenium levels and T2DM existed in populations with relatively low levels and high levels of serum selenium, indicating a likely U-shaped non-linear dose-response relationship between serum selenium and T2DM.

Single-dose intra-articular ropivacaine after arthroscopic knee surgery decreases post-operative pain without increasing side effects: a systematic review and meta-analysis.

PURPOSE: The purpose of this study was to appraise the efficacy and safety of single-dose intra-articular ropivacaine administered for pain relief after arthroscopic knee surgery. METHODS: PubMed, Embase, and Cochrane Library databases were searched in October 2014 to identify randomized controlled trials of single-dose intra-articular ropivacaine for post-operative pain relief. Post-operative pain intensity, the amount of rescue analgesia required, and side effects including local anaesthetic toxicity were assessed. The relative risk (RR), the weighted mean difference (WMD), and their corresponding 95 % confidence intervals (CIs) were calculated. RESULTS: Eight randomized controlled trials were included in the analysis. Statistically significant differences in the visual analogue scale for pain intensity value were observed during the immediate post-operative period (WMD -10.35, 95 % CI -17.12 to -3.59, p = 0.003) and the early post-operative period (WMD -11.90, 95 % CI -18.12 to -5.69, p = 0.0002), but not during the late post-operative period (WMD -2.89, 95 % CI -7.46 to 1.68, n.s.). There was no significant difference in the amount of rescue analgesia required (RR 0.76, 95 % CI 0.52-1.11, n.s.). Only two trials reported the incidence of drug-related side effects (including nausea and vomiting): the incidence in the ropivacaine groups was no higher than that in the control groups. Only one trial assessed local anaesthetic toxicity as an outcome, but it was not detected. CONCLUSIONS: Single-dose intra-articular ropivacaine administered at the end of arthroscopic knee surgery provides effective pain relief in the immediate and early post-operative periods without increasing short-term side effects.

The association between dietary selenium intake and diabetes: a cross-sectional study among middle-aged and older adults.

BACKGROUND: Selenium is an important trace element for human health. Although numerous epidemiological and interventional studies have examined the association between selenium and diabetes, their findings have been inconclusive. Moreover, no research has specifically focused on the association between dietary selenium and diabetes in the Asian population. The objective of this study was to evaluate the relationship between dietary selenium and diabetes in middle-aged and elderly Chinese adults. METHODS: A cross-sectional study including 5,423 subjects was carried out. The basic characteristics, biochemical test results, and dietary intake were collected from each subject for analysis. The adjusted odds ratio (OR) and the corresponding 95% confidence interval (CI) were used to determine the relationship between dietary selenium intake and diabetes through logistic regression. RESULTS: The prevalence of diabetes in the study population was 9.7%, and the average level of dietary selenium intake was 43.51 µg/day. The multivariate adjusted OR was 1.52 (95% CI: 1.01 to 2.28, P = 0.04) for the highest quartile of dietary selenium intake in comparison with the lowest quartile. There was a significant positive association between dietary selenium intake and diabetes (P for trend = 0.03). CONCLUSION: There was a significant positive correlation between dietary selenium intake and the prevalence of diabetes.

Risk factors for congenital syphilis and adverse pregnancy outcomes in offspring of women with syphilis in Shenzhen, China: a prospective nested case-control study.

BACKGROUND: Despite existence of a highly effective intervention, maternal syphilis still causes substantial perinatal morbidity and mortality, even in China, where antenatal health services are strong. This study sought to address personal, programmatic, and other risk factors for congenital syphilis (CS) and adverse pregnancy outcomes (APOs) among pregnant women in Shenzhen, China. METHODS: Pregnant women attending antenatal services were offered serologic tests, and those diagnosed as having syphilis were recruited from April 2007 to October 2012. In a nested case-control study for the pregnancy outcomes of syphilis-infected women, we assessed risk factors comparing infants born with CS (group II) and with any APOs (group III) to infants without CS or APOs (group I). RESULTS: During the 66-month study period, we screened 279,334 pregnant women and identified 838 (0.3%; 95% confidence interval, 0.28%-0.32%) women infected with syphilis. Among infants born to syphilitic mothers, 8.2% (34/417) were diagnosed as having CS and 24.7% (103/417) were diagnosed as having APOs. Compared with group I, maternal baseline titers of nontreponemal antibodies (adjusted odds ratio [aOR], 2.13), stage of syphilis (aOR, 21.56), length of time between the end of the first treatment to childbirth (aOR, 11.93), gestational week at treatment (aOR, 2.63), and fathers' cocaine use (aOR, 15.44) and syphilis infection status (aORpositive vs. negative, 5.84; aORunknown vs. negative, 5.55) were positively associated with CS, but prenatal care (aOR, 0.11) and complete treatment (aOR, 0.20) were negatively associated with CS. Maternal age (aOR, 1.43), marriage (aOR, 2.41), history of cocaine use (aOR, 3.79) and ectopic pregnancy (aOR, 5.91), baseline titers of nontreponemal antibodies (aOR, 1.30), stage of syphilis (aOR, 8.89), length of time between the end of the first treatment to childbirth (aOR, 2.52), gestational week at treatment (aOR, 1.78), and fathers' syphilis infection status (aORunknown vs. negative, 2.02) were also positively associated with APOs, but maternal history of syphilis (aOR, 0.44), prenatal care (aOR, 0.29), and complete treatment (aOR, 0.25) were negatively associated with APOs, CONCLUSIONS: Syphilis was an important cause of pregnancy loss and infant disability, particularly among women who did not receive prenatal care or had late or inadequate treatment. These study results can inform antenatal programs on the importance of early syphilis testing and prompt and appropriate treatment. Some strategies targeted at other risk factors areas may be helpful.

Single-dose intra-articular bupivacaine after knee arthroscopic surgery: a meta-analysis of randomized placebo-controlled studies.

PURPOSE: The purpose of this meta-analysis was to examine the efficacy and safety of single-dose intra-articular bupivacaine in the management of pain after knee arthroscopic surgery. METHOD: The comprehensive literature search, using MEDLINE, the Cochrane Central Register of Controlled Trials, and Embase databases, was conducted to identify randomized controlled trials that used single-dose intra-articular bupivacaine for postoperative pain. The relative risk (RR), weighted mean difference (WMD), and their corresponding 95 % confidence intervals (CIs) were calculated using RevMan(®) statistical software. RESULT: Twenty-three studies (n = 1287) were included (647 subjects in bupivacaine group and 640 subjects in the control group). Statistically significant differences were observed in the VAS values (WMD -1.1; 95 % CI -1.7 to -0.5), number of patients requiring supplementary analgesia (RR 0.83; 95 % CI 0.74-0.94), and time to first analgesic request (WMD 129.3; 95 % CI 15.4-243.1) among the bupivacaine group when compared to the control group. However, short-term side effects had no significant difference between these two groups (RR 0.73; 95 % CI 0.44-1.24). CONCLUSIONS: On the basis of the currently available literature, single-dose intra-articular bupivacaine was shown to be significantly better than placebo at relieving pain after knee arthroscopic surgery. More high-quality randomized controlled trials with long follow-up are highly required for examining the safety of single-dose intra-articular bupivacaine. Besides, routine use of single-dose intra-articular bupivacaine is still an effective way for pain management after knee arthroscopic surgery.

The influence of the tibial plateau slopes on injury of the anterior cruciate ligament: a meta-analysis.

PURPOSE: The purpose of this meta-analysis was (1) to examine the effect of the tibial plateau slopes (medial and lateral) on anterior cruciate ligament (ACL) injury and (2) to investigate gender differences between ACL-injured subjects and gender-matched controls. METHODS: The PubMed database was searched through to 1 November 2011 to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Two authors independently extracted information on the designs of the studies, the characteristics of the study participants, exposure and outcome assessments, and control for potential confounding factors. A meta-analysis was conducted, and either a fixed- or a random-effects model was used to calculate the overall weighted mean difference (WMD). RESULTS: Twelve studies (n = 1,871: 923 patients in the ACL-injured group and 938 patients in the control group) were included. The medial tibial plateau slope in the ACL group ranged from 1.8° ± 3.7° to 12.1° ± 3.3° while it ranged from 2.9° ± 2.8° to 9.5° ± 3° among the controls. The lateral tibial plateau slope in the ACL ranged from 1.8° ± 3.2° to 11.5° ± 3.5° and 0.3° ± 3.6° to 9° ± 4° in the control group. Statistically significant increased angles were observed in ACL-injured group compared to control group for medial tibial plateau slope (WMD, 1.1°; 95 % confidence interval, 0.5°-1.7°) and lateral tibial plateau slope (WMD, 1.8°; 95 % confidence interval, 1.3°-2.3°). Sensitivity analysis and subgroup analysis proved this to be a reliable result. CONCLUSIONS: The current meta-analysis suggests that both, increased medial and lateral tibial plateau slopes, are associated with increased susceptibility to ACL injury regardless of gender. In addition, this study indicates a stronger evidence for lateral tibial plateau slope to be associated with ACL injury compared with medial tibial plateau slope due to the larger increased angle value and on the basis of consistency among the included studies.

The influence of the intercondylar notch dimensions on injury of the anterior cruciate ligament: a meta-analysis.

PURPOSE: The aim of this meta-analysis was to examine the effect of the intercondylar notch dimensions, intercondylar notch width index (NWI) and intercondylar notch width (NW), separately in anterior cruciate ligament (ACL) injury. METHODS: The PubMed and Wanfang database were searched through until 1 November 2011 to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Two authors independently extracted information on the designs of the studies, the characteristics of the study participants, exposure and outcome assessments and control for potential confounding factors. Either a fixed- or a random-effects model was used to calculate the overall weighted mean difference (WMD). RESULTS: Sixteen studies (n = 4,291) were included (1,222 subjects in ACL-injured group and 3,069 subjects in the control group). Statistically significant differences were observed in the NWI (WMD, -0.02; 95 % confidence interval, -0.04 to -0.01), and in the NW (WMD, -2.15; 95 % confidence interval, -3.09 to -1.21) among the ACL-injured group when compared to the control group. CONCLUSION: The meta-analysis findings concluded that narrow intercondylar notch dimensions were associated with the risk of ACL injury. A lower NWI or NW stenosis predisposes an individual to ACL injury. Further original studies should include more anatomical risk factors that could be associated with the risk of ACL injury.

[Current situation and cause analysis of physical activity in Chinese primary and middle school students in 2010].

OBJECTIVE: To analyze the characteristics of physical activity in Chinese primary and middle school students, and to provide scientific basis for school physical education and health work. METHODS: The data were collected from 166 812 Han primary school pupils above grade 4, junior and senior middle school students who participated in 2010 National Physical Fitness and Health Surveillance in 30 provinces (excluding autonomous regions, municipalities). RESULTS: Nationwide in 2010, 22.7% of the students had been physically active doing any kind of physical activity for a total of at least 60 minutes per day, the prevalence rates of the 9 to 13, 13 to 16, 16 to 19 age groups were 32.7%, 20.7% and 12.5%, respectively (P<0.01). The prevalence of having been physically active for a total of at least 60 minutes per day was higher among the Eastern Region's students than the Western Region's students in the different age groups (P<0.05), of whom 61.8% reported that they sweated and felt a little bit tired in physical education, 68.6% thought that they liked their physical education, 72.4% were willing to take part in extracurricular physical activities organized by their school, and 46.4% were willing to participate in the long distance running exercise. "Fear of fatigue or/and hardship" was the most important reason why the students did not actively participate in physical activities and long-distance running exercise among both the boys and girls in the different age groups. CONCLUSION: The prevalence of having been physically active for a total of at least 60 minutes per day in Chinese students is still low, and there is an obvious difference in the different groups. In the future, not only should the students' physical exercise time and intensity be further guaranteed, but also their awareness strengthened and their habits of physical exercise cultured.

[Analysis of current situation of physical activity and influencing factors in Chinese primary and middle school students in 2010].

OBJECTIVE: To find out the current situation of physical activity and its influencing factors among Chinese primary and middle school students. METHODS: A total of 166 812 students aged 9 - 18 finished the questionnaires of physical activities and lifestyle behaviors who were selected from "2010 National Physical Fitness and Health Surveillance". The subjects were sampled by stratified cluster sampling method in 30 provinces (autonomous regions, municipalities) except Tibet. The physical activity for a total of at least 60 minutes per day, attitudes on physical activity, parents' supports toward physical activity of children, development of school physical education, the schoolwork burden and sedentary lifestyle were all analyzed. Logistic regression was used to analyze the association between the physical activity for a total of at least 60 minutes per day and individual, family, school and sedentary behavior. RESULTS: A total of 22.7% (37 867/166 757) of primary and middle school students aged 9 - 18 had been physically active doing any kind of physical activity for a total of 60 minutes or more per day, the prevalence was higher among male (25.4%, 21 086/83 159) than female (20.1%, 16 781/83 598) students (P < 0.05). In the 9 - 12 age group, the prevalence was higher among urban (37.6%, 5 980/15 912) than rural (32.0%, 4 917/15 375) students (P < 0.05), but in the 16 - 18 age group, the case was opposite. The prevalence of doing physical activity for a total of 60 minutes or more per day among students who liked physical education (23.7%, 11 866/50 073), were willing to participate in the extracurricular sports activities (23.2%, 13 460/57 907), and were willing to participate long running exercise (26.9%, 9 185/34 153) was higher than those who dislike physical education (15.9%, 589/3705), were not willing to participate in the extracurricular sports activities (15.9%, 567/3565), and were not willing to participate long running exercise (12.1%, 2 246/18 493), respectively. The prevalence was higher among students whose parents supported their physical activity (20.4%, 15 148/74 312) than those students without parents' support (17.5%, 1626/9270) (P < 0.05). And the prevalence was higher among students whose parents often took part in the physical activity (22.7%, 12 864/56 769) than those students whose parents did not (14.6%, 3 906/26 780) (P < 0.05). Logistic regression analysis (adjusted sex, age and urban or not) demonstrated that variables associated with physical activity for a total of 60 minutes or more per day were the initiative will on the physical activity and parental physical activity (OR: 1.478, 95%CI: 1.398 - 1.562). The students without adequate physical education class in school were less likely to do physical activity for a total of 60 minutes or more per day than those who with adequate physical education class in school (OR: 0.536, 95%CI: 0.523 - 0.550), and the students in the school with the phenomenon of "crowding out" or "no" physical education were less likely to do physical activity for a total of 60 minutes or more per day than those whose school without these with phenomenon (OR: 0.712, 95%CI: 0.666 - 0.761). The heavy homework burden (OR: 0.926, 95%CI: 0.899 - 0.953) and long homework time (OR: 0.879, 95%CI: 0.853 - 0.906) were reversely related to the physical activity. CONCLUSION: The prevalence of having been physically active for a total of 60 minutes per day in Chinese students is still low. The strong initiative will on the physical activity, parental physical activity, and better school sports atmosphere are good for students to carry out physical activity, and the students with the heavy homework burden and long homework time are less likely to take part in the physical activity.

Correction: Associations of sexually transmitted infections and bacterial vaginosis with abnormal cervical cytology: A cross-sectional survey with 9090 community women in China.

[This corrects the article DOI: 10.1371/journal.pone.0230712.].

Associations of sexually transmitted infections and bacterial vaginosis with abnormal cervical cytology: A cross-sectional survey with 9090 community women in China.

BACKGROUND: Although it is well acknowledged that persistent infection with high-risk human papillomavirus types in genital sites plays a crucial role in the development of squamous cell cervical carcinoma, there is no unanimous consensus on the association between non-HPV sexually transmitted infections and abnormal cervical cytology. METHODS: In the present study, we evaluated cervical cytology status, sexually transmitted infections and bacterial vaginosis status, and collected social-demographic information among recruited participants to explore the association of STIs and bacterial vaginosis with abnormal cervical cytology. RESULTS: 9,090 women's specimens were successfully tested, with a total of 8,733 (96.1%) women had normal cytology and 357 (3.9%) women exhibited abnormal cytology. The prevalence of HPV, Chlamydia trachomatis, Neisseria gonorrhoeae, and bacterial vaginosis was significantly higher in the ≥ASC-US group than the NILM group (P<0.05). Women with Neisseria gonorrhoeae infection (AOR = 5.30, 95% CIs = 1.30-21.51, P = 0.020) or bacterial vaginosis (AOR = 1.94, 95% CIs = 1.08-3.47, P = 0.026) exhibited an increased risk of abnormal cervical cytology after adjusted for carcinogenic HPV-positive status. CONCLUSIONS: Our results demonstrated that Neisseria gonorrhoeae infection in genital sites and/or bacterial vaginosis may independently increase the risk for cervical cytology abnormalities after adjusted for carcinogenic HPV-positive status. Besides, these results improved our understanding of the etiology of abnormal cervical cytology and may be useful for the management of women with ASC-US cytology.

Factors influencing the diagnosis and treatment of chronic prostatitis among urologists in China.

AIM: To identify the factors influencing diagnosis and treatment of chronic prostatitis (CP) among Chinese urologists. METHODS: A sample of 656 urologists from 29 provinces of China were asked to complete a questionnaire that explored attitudes towards CP as well as diagnosis and treatment patterns in the management of CP. Both univariate and multivariate logistic regression analysis schemes were used to determine the factors that influence the diagnosis and treatment of CP. RESULTS: A total of 656 questionnaires were given out. All were returned and 410 of those were included in the final univariate and multivariate analysis. Multivariate logistic regression analysis indicated that belief of bacterial infection in the etiology of CP (odds ratio [OR], 2.544; 95% confidence interval [CI], 1.650-3.923; P < 0.001) was the most significant factor influencing the routine performance of bacterial culture test. Using the same model, the type of hospital (OR, 2.799; 95% CI, 1.719-4.559; P < 0.001) and the routine use of the 4- or the 2-glass test (OR, 3.194; 95% CI, 2.069-4.931; P < 0.001) were determined to be significant factors influencing the use of the National Institutes of Health (NIH) new classification system. According to the same model, belief of bacterial infection in the etiology of CP (OR, 3.415; 95% CI, 2.024-5.762; P < 0.001) and the routine use of bacterial culture test (OR, 2.261; 95% CI, 1.364-3.749; P < 0.01) were important factors influencing the routine prescription of antibiotics. CONCLUSION: Our findings suggest that attitudes towards CP, and the characteristics of individual urologists' practices may influence the diagnosis and treatment of CP among Chinese urologists.

[Effect of health service and its influence factors in flood disaster areas].

OBJECTIVE: To explore the effect of health service and its influential factors in flood disaster areas. METHODS: Fifty-five towns were sampled randomly from Dongting Lake area suffering from flood in 1998. The health service level, effect, and its influence factors were investigated retrospectively. RESULTS: The incidence rate of notifiable infectious diseases was 11.7 per thousand, prevalence rate of chronic disease was 51.2 per thousand, infant mortality rate was 43.1 per thousand, neonatal mortality rate was 10.2 per thousand, and the total mortality rate was 554.3/100,000 in Dongting Lake area. The health investment level was significantly associated with the incidence rate of notifiable infectious diseases, the infant mortality rate, and total mortality rate. Duration of flood and income per capita were important factors for the effect of health investment. CONCLUSION: Increasing health investment and residents' income in the flood disaster area, shortening the duration of flood would play positive role in residents' health in the flood disaster area.

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

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

Association among dietary magnesium, serum magnesium, and diabetes: a cross-sectional study in middle-aged and older adults.

BACKGROUND: A number of studies have reported the association between magnesium (Mg) and diabetes. However, the various conclusions were inconsistent and the data on the Chinese population was limited. The objective of this study was to evaluate the association among dietary Mg, serum Mg, and diabetes in Chinese adults. METHODS: A cross-sectional study that contained 2904 subjects was conducted. Biochemical test results and dietary intakes of subjects were collected for analysis. The adjusted odds ratios (ORs) and the corresponding 95 % confidence intervals (95 % CIs) were used to determine the relationship between Mg status and diabetes by logistic regression. RESULTS: The prevalence of diabetes of the investigated population was 10.1 %. Dietary Mg intake was not significantly correlated with diabetes (P > 0.05). The significant negative association between serum Mg and diabetes existed, and the multivariate adjusted OR was 0.34 (95 % CI 0.24, 0.49) in model 3 for the highest quartile of serum Mg compared with the lowest. The P values for trend were all less than 0.001 for the relationship between serum Mg and diabetes. Dietary Mg intake and serum Mg were not significantly correlated in the diabetes population (P = 0.936). CONCLUSIONS: Dietary Mg was not significantly correlated with diabetes, while serum Mg was inversely correlated with diabetes in the Chinese population. Meanwhile, dietary Mg intake and serum Mg were not significantly correlated in the diabetes population.