Association between Serum Uric Acid and the Early Marker of Kidney Function Decline among Chinese Middle-Aged and Older Population: Evidence from the China Health and Retirement Longitudinal Study.

Objective: To evaluate the association between serum uric acid (SUA) and kidney function decline. Methods: Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older population for analysis. The kidney function decline was defined as an annual estimated glomerular filtration rate (eGFR) decrease by > 3 mL/min per 1.73 m 2. Multivariable logistic regression was applied to determine the association between SUA and kidney function decline. The shape of the association was investigated by restricted cubic splines. Results: A total of 7,346 participants were included, of which 1,004 individuals (13.67%) developed kidney function decline during the follow-up of 4 years. A significant dose-response relation was recorded between SUA and the kidney function decline ( OR 1.14, 95% CI 1.03-1.27), as the risk of kidney function decline increased by 14% per 1 mg/dL increase in SUA. In the subgroup analyses, such a relation was only recorded among women ( OR 1.22, 95% CI 1.03-1.45), those aged < 60 years ( OR 1.22, 95% CI 1.05-1.42), and those without hypertension and without diabetes ( OR 1.22, 95% CI 1.06-1.41). Although the dose-response relation was not observed in men, the high level of SUA was related to kidney function decline ( OR 1.83, 95% CI 1.05-3.17). The restricted cubic spline analysis indicated that SUA > 5 mg/dL was associated with a significantly higher risk of kidney function decline. Conclusion: The SUA level was associated with kidney function decline. An elevation of SUA should therefore be addressed to prevent possible kidney impairment and dysfunction.

[Differences on ethical consciousness issues between the Chinese Journal of Epidemiology and the American Journal of Epidemiology].

To compare the differences on current ethical issues in the areas of epidemiological practice between China and America, to identify the major ethical problems existing in the epidemiological studies in China. Through searching and reviewing papers published on Chinese Journal of Epidemiology and American Journal of Epidemiology from Jan. 2006 to Dec. 2010, we made a comparison on ethical issues involved in the original studies that focusing on human beings. In total, 749 Chinese articles and 1221 American articles were recruited, with the following findings: (1) The proportion with announcements of "Informed consent by the subjects" was 29.24% in Chinese literature and 38.08% in the Americans (χ² = 16.02, P < 0.001). The proportion with "having had approvals from the ethic committees" was 29.24% in Chinese, while 38.08% in American (χ² = 604.40, P < 0.0001). (2) Both in China and America, there had been an increase of ethical issues in the last 5 years. (3) Articles derived from trial studies had better involvement on ethics than those from observational studies. (4) The level on ethical issues in the American Research Institutes exceeded those in China (5) American studies also had showed better ideas on Ethic issues on biological specimens collection and privacy protection, than those in Chinese studies. Among the studies on Chinese Journal of Epidemiology, the proportion of 'informed consent' was higher than in ethical review, but both ethical review and awareness on 'informed consent' had left far behind than the American Journal of Epidemiology. This could be seen at the institution level of the writers, during specimen collection and privacy protection, as well as at the overall level. The results reminded us that the Departments of Technology Management should spend more efforts on the improvement of public education regarding ethics for researchers and to update the process of edition for Journals as well as to reinforce the rules of ethics in epidemiological research.

[Detection rate on un-repaired cleft lip/palate patients in Gansu province in 2008].

OBJECTIVE: To investigate the number and distribution of un-repaired cleft lip/palate patients in Gansu province. METHODS: A census was conducted by staff members of the health system and Population and Family Planning Committee (PFPC) in Gansu province. Standardized - Questionnaires were administered to collect demographic, domestic and diagnosis-related information. RESULTS: In 2008, the total number of un-repaired cleft lip/palate patients was 4675, with a detection rate of 1.84/10 000 in Gansu province. Rates of detection were higher in males (2.11/10 000), young age group (4.86/10 000), rural areas (2.23/10 000), poor counties (2.19/10 000) than in females (1.43/10 000), medium (0.97/10 000)/old age group (0.68/10 000), township areas (0.62/10 000), or richer counties (1.35/10 000). Among all the cities and prefectures of Gansu, Baiyin city (2.7/10 000) had the highest while Jinchang city (0.7/10 000) had the lowest prevalence rates. CONCLUSION: Un-repaired cleft lip/palate had been a disease burden to Gansu province, especially in the rural area and poorer counties.