Betel quid chewing and oral potential malignant disorders and the impact of smoking and drinking: A meta-analysis.

BACKGROUND: Oral potential malignant disorders (OPMDs) are a precancerous condition of oral disease. Several studies have found that betel quid chewing, smoking and alcohol drinking might be the risk factors of OPMDs. But the relationships of them, especially their interaction are still inconclusive. AIM: To evaluate the relationship between betel quid chewing and OPMDs and to explore the interaction of smoking and alcohol drinking on the relationship. METHODS: We searched PubMed, Web of Science, Embase and the Cochrane Library databases with items complete until January 2021 for relevant studies. The research data were extracted according to the inclusion criteria. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the effect size. Subgroup analysis was performed to assess interactions between exposures and OPMDs. Relative excess risk of interaction (RERI) was used to estimate the size of interaction. RESULTS: Nine articles were selected in the final meta-analysis. The results showed that betel quid chewing (pooled OR: 8.70, 95%CI: 5.18-14.61), alcohol consumption (pooled OR: 1.95, 95%CI: 1.5-2.55), and smoking (pooled OR:4.35, 95%CI: 3.06-6.2) could significantly increase the risk of OPMDs compared to individuals without these behaviors. Smoking and alcohol drinking synergistically increased the association between betel quid chewing and OPMDs (pooled OR(BQ+SM):14.38, 95%CI: 7.14-28.95; pooled OR(BQ+DK): 11.12, 95%CI: 8.00-15.45, respectively). The RERI(BQ+SM) and RERI(BQ+DK) were 2.33 and 1.47, respectively. CONCLUSION: The synergistic effects between smoking/drinking and betel quid highlights the importance of focusing on individuals with multiple exposures. Further study should be conducted to confirm these interactions.

Current Status of Schistosomiasis Control and Prospects for Elimination in the Dongting Lake Region of the People's Republic of China.

Schistosomiasis japonica is an ancient parasitic disease that has severely impacted human health causing a substantial disease burden not only to the Chinese people but also residents of other countries such as the Philippines, Indonesia and, before the 1970s, Japan. Since the founding of the new People's Republic of China (P. R. China), effective control strategies have been implemented with the result that the prevalence of schistosomiasis japonica has decreased markedly in the past 70 years. Historically, the Dongting Lake region in Hunan province is recognised as one of the most highly endemic for schistosomiasis in the P.R. China. The area is characterized by vast marshlands outside the lake embankments and, until recently, the presence of large numbers of domestic animals such as bovines, goats and sheep that can act as reservoir hosts for Schistosoma japonicum. Considerable social, economic and environmental changes have expanded the Oncomelania hupensis hupensis intermediate snail host areas in the Dongting lake region increasing the potential for both the emergence of new hot spots for schistosomiasis transmission, and for its re-emergence in areas where infection is currently under control. In this paper, we review the history, the current endemic status of schistosomiasis and the control strategies in operation in the Dongting Lake region. We also explore epidemiological factors contributing to S. japonicum transmission and highlight key research findings from studies undertaken on schistosomiasis mainly in Hunan but also other endemic Chinese provinces over the past 10 years. We also consider the implications of these research findings on current and future approaches that can lead to the sustainable integrated control and final elimination of schistosomiasis from the P. R. China and other countries in the region where this unyielding disease persists.

Novel sex-specific influence of parental factors on small-for-gestational-age newborns.

Since fetal programming is sex-specific, there may also be sex-specific in parental influences on newborn birth weight. We aimed to investigate the influence of parental factors on small-for-gestational-age (SGA) infants of different sexes. Based on a pre-pregnancy cohort, multivariate logistic regression was used. 2275 couples were included for analysis. Significant associations were observed among paternal height, pre-pregnancy body mass index (BMI), and SGA in male infants; among maternal height, pre-pregnancy BMI, and SGA in female infants, and among other maternal factors and SGA in both male and female infants. Such sex specificity may be related to genetic, epigenetic, or hormonal influences between parents and infants. In conclusion, there is a sex specificity in the effect of parental height and pre-pregnancy BMI on SGA. The data suggest that future studies on infants should consider the sex-specific differences between the effects of genetic or environmental factors and infants.

Impact of mTOR gene polymorphisms and gene-tea interaction on susceptibility to tuberculosis.

BACKGROUND: mTOR gene is a key component of the PI3K/Akt/mTOR signaling pathway, and its dysregulation is associated with various diseases. Several studies have demonstrated that tea drinking is a protective factor against tuberculosis (TB). This study was designed to explore five single nucleotide polymorphisms (SNPs) of mTOR in the Han population of China to determine how their interactions with tea drinking affect susceptibility to TB. AIM: To investigate if the polymorphisms of mTOR gene and the gene-tea interaction are associated with susceptibility to TB. METHODS: In this case-control study, 503 patients with TB and 494 healthy controls were enrolled by a stratified sampling method. The cases were newly registered TB patients from the county-level centers for disease control and prevention, and the healthy controls were permanent residents from Xin'ansi Community, Changsha city. Demographic data and environmental exposure information including tea drinking were obtained from the study participants. We genotyped five potentially functional SNP sites (rs2295080, rs2024627, rs1057079, rs12137958, and rs7525957) of mTOR gene and assessed their associations with the risk of TB using logistic regression analysis, and marginal structural linear odds models were used to estimate the gene-environment interactions. RESULTS: The frequencies of four SNPs (rs2295080, rs2024627, rs1057079, and rs7525957) were found to be associated with susceptibility to TB (P < 0.05). Genotypes GT (OR 1.334), GG (OR 2.224), and GT + GG (OR 1.403) at rs2295080; genotypes CT (OR 1.562) and CT + TT (OR 1.578) at rs2024627, genotypes CT (OR 1.597), CC (OR 2.858), and CT + CC (OR 1.682) at rs1057079; and genotypes CT (OR 1.559) and CT + CC (OR 1.568) at rs7525957 of mTOR gene were significantly more prevalent in TB patients than in healthy controls. The relative excess risk of interaction between the four SNPs (rs2295080, rs2024627, rs1057079, and rs7525957) of mTOR genes and tea drinking were found to be -1.5187 (95%CI: -1.9826, -1.0547, P < 0.05), -1.8270 (95%CI: -2.3587, -1.2952, P < 0.05), -2.3246 (95%CI: -2.9417, -1.7076, P < 0.05) and -0.4235 (95%CI: -0.7756, -0.0714, P < 0.05), respectively, which suggest negative interactions. CONCLUSION: The polymorphisms of mTOR (rs2295080, rs2024627, rs1057079, and rs7525957) are associated with susceptibility to TB, and there is a negative interaction between each of the four SNPs and tea drinking.

SOX1 Promoter Hypermethylation as a Potential Biomarker for High-Grade Squamous Intraepithelial Neoplasia Lesion and Cervical Carcinoma: A Meta-Analysis With Trial Sequential Analysis.

Background: DNA methylation has been widely assessed as a potential biomarker for the early detection of cervical cancer (CC). Herein, we assessed the associations of SOX1 promoter hypermethylation with squamous intraepithelial lesion and CC. Methods: Published studies and genome-wide methylation datasets were searched from electronic databases (up to April 2019). The associations of SOX1 hypermethylation with high-grade squamous intraepithelial lesion (HSIL) and CC risks were evaluated by odds ratios (ORs) and 95% confidence intervals (CIs). The summary receiver operator characteristic test was used to assess the diagnostic value of the SOX1 promoter hypermethylation of CC and intraepithelial neoplasia type III or worse (CIN3+). Trial sequential analysis (TSA) was performed to evaluate the stability of results and estimate the required information size (RIS). Results: In this meta-analysis of 17 published studies, the SOX1 methylation rates increased among low-grade SIL (LSIL, 27.27%), HSIL (40.75%), and CC (84.56%) specimens. Compared with control specimens, SOX1 promoter hypermethylation progressively increased the risk of HSIL by 4.20-fold (p < 0.001) and CC by 41.26-fold (p < 0.001). The pooled sensitivity of SOX1 methylation was estimated to be 0.85 (95% CI: 0.81-0.88) in differentiating patients with CC, corresponding to a specificity of 0.72 (95% CI: 0.69-0.75) and an area under the curve (AUC) of 0.93. Furthermore, the pooled sensitivity of SOX1 methylation was estimated to be 0.75 (95% CI: 0.72-0.78) in differentiating patients with CIN3+, corresponding to a specificity of 0.71 (95% CI: 0.69-0.73) and an AUC of 0.84. The pooled results of TCGA and GEO datasets showed that all CpG sites in SOX1 were associated with CC and 16 of 19 CpG sites were associated with HSIL. The results of TSA illustrated that the size was sufficient and significant associations were observed. Conclusion: This meta-analysis indicated that SOX1 promoter hypermethylation might have a potential value in the clinical diagnosis of CC and CIN3+.

Associations of MGMT promoter hypermethylation with squamous intraepithelial lesion and cervical carcinoma: A meta-analysis.

BACKGROUND: In this research, an meta-analysis was performed for assessment of the associations between O6-methyguanine-DNA methyltransferase (MGMT) promoter hypermethylation possessing low-grade intraepithelial lesion (LSIL), high-grade intraepithelial lesion (HSIL), cervical cancer (CC), and clinicopathological characters of CC. METHODS: Literature selection were conducted through searching PubMed, Web of science, EMBASE, China National Knowledge Infrastructure and Wanfang databases (up to November 2018). An assessment of associations between MGMT methylation and LSIL, HSIL, CC risk and clinicopathological characteristics was performed through pooled odds ratios (ORs) with relevant 95% confidence intervals (CIs). Subgroup analyses, meta-regressions and Galbraith plots were conducted to conduct an exploration on the possible sources of heterogeneity. The genome-wide DNA methylation array studies were extracted from Gene Expression Omnibus (GEO) databases for validation of these outcomes. RESULTS: In this meta-analysis of 25 published articles, MGMT hypermethylation gradually elevated the rates among control group (12.16%), LSIL (20.92%), HSIL (36.33%) and CC (41.50%) specimens. MGMT promoter methylation was significant associated with the increased risk of LSIL by 1.74-fold (P<0.001), HSIL by 3.71-fold (P<0.001) and CC by 7.08-fold (P<0.001) compared with control. A significant association between MGMT promoter methylation with FIGO stage was also found (OR = 2.81, 95% CI: 1.79-4.41, p<0.001). The results of GEO datasets showed that 5 CpG sites in MGMT with a great diagnostic value for the screening of cervical cancer. CONCLUSION: The meta-analysis indicated the association between MGMT promoter hypermethylation and squamous intraepithelial lesion and cervical cancer. MGMT methylation detection might have a potential value to be an epigenetic marker for the clinical diagnosis of cervical cancer.

Adiponectin gene polymorphisms and risk of gestational diabetes mellitus: A meta-analysis.

BACKGROUND: Adiponectin (ADIPOQ) is an important factor involved in the regulation of both carbohydrate and lipid metabolism. Polymorphisms in the ADIPOQ gene are known to influence an individual's predisposition to metabolic syndrome and type 2 diabetes. Moreover, women with gestational diabetes mellitus (GDM) are at an increased risk of developing type 2 diabetes. Several studies have been conducted previously to assess the association between ADIPOQ polymorphisms and GDM; however, the results of the association are inconclusive. AIM: To quantitatively evaluate the association between ADIPOQ +45T/G, +276G/T, and -11377C/G polymorphisms and the risk of GDM. METHODS: A systematic search of EMBASE, PubMed, CNKI, Web of Science, and WANFANG DATA was conducted up to October 20, 2018. We calculated merged odds ratios (ORs) with 95% confidence intervals (CIs) using a fixed-effects or random-effects model depending on the between-study heterogeneity to evaluate the association between AIDPOQ +45T/G, +276G/T, and -11377C/G polymorphisms and the risk of GDM. Subgroup analysis was performed by ethnicity. Publication and sensitivity bias analyses were performed to test the robustness of the association. All statistical analyses were conducted using Stata12.0. RESULTS: Nine studies of +45T/G included 1024 GDM cases and 1059 controls, five studies of +276G/T included 590 GDM cases and 595 controls, and five studies of -11377C/G included 722 GDM cases and 791 controls. Pooled ORs indicated that +45T/G increased GDM risk in Asians (allelic model: OR = 1.47, 95%CI: 1.27-1.70, P = 0.000; dominant model: OR = 1.54, 95%CI: 1.27-1.85, P = 0.000; recessive model: OR=2.00, 95%CI: 1.43-2.85, P = 0.000), not in South Americans (allelic model: OR = 1.21, 95%CI: 0.68-2.41, P = 0.510; dominant model: OR = 1.13, 95%CI: 0.59-2.15, P = 0.710; recessive model: OR = 2.18, 95%CI: 0.43-11.07, P = 0.350). There were no significant associations between +276G/T (allelic model: OR = 0.88, 95%CI: 0.74-1.05, P = 0.158; dominant model: OR = 0.91, 95%CI: 0.65-1.26, P = 0.561; recessive model: OR = 0.82, 95%CI: 0.64-1.05, P = 0.118) or -11377C/G (allelic model: OR = 0.96, 95%CI: 0.72-1.26, P = 0.750; dominant model: OR = 1.00, 95%CI: 0.73-1.37, P = 0.980; recessive model: OR = 0.90, 95%CI: 0.61-1.32, P = 0.570) and the risk of GDM. CONCLUSION: Our meta-analysis shows the critical role of the ADIPOQ +45T/G polymorphism in GDM, especially in Asians. Studies focused on delineating ethnicity-specific factors with larger sample sizes are needed.

Maternal serum level of resistin is associated with risk for gestational diabetes mellitus: A meta-analysis.

BACKGROUND: Resistin is most likely involved in the pathogenesis of gestational diabetes mellitus (GDM), but the existing findings are inconsistent. AIM: To review the literature investigating the associations of the risk of GDM with serum level of resistin. METHODS: A systematic literature search was performed using MEDLINE, EMBASE, and Web of Science (all databases). This meta-analysis included eligible studies that: (1) investigated the relationship between the risk of GDM and serum resistin; (2) included GDM cases and controls without GDM; (3) diagnosed GDM according to the oral glucose-tolerance test; (4) were performed in humans; (5) were published as full text articles in English; and (6) provided data with median and quartile range, median and minimum and maximum values, or mean and standard deviation. The pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to estimate the association between the risk of GDM and serum resistin. To analyze the potential influences of need for insulin in GDM patients and gestational age at blood sampling, we performed a subgroup analysis. Meta-regression with restricted maximum likelihood estimation was performed to assess the potentially important covariate exerting substantial impact on between-study heterogeneity. RESULTS: The meta-analysis for the association between serum resistin level and GDM risk included 18 studies (22 comparisons) with 1041 cases and 1292 controls. The total results showed that the risk of GDM was associated with higher serum resistin level (SMD = 0.250, 95%CI: 0.116, 0.384). The "after 28 wk" subgroup, "no need for insulin" subgroup, and "need for insulin" subgroup indicated that higher serum resistin level was related to GDM risk ("after 28 wk" subgroup: SMD = 0.394, 95%CI: 0.108, 0.680; "no need for insulin" subgroup: SMD = 0.177, 95%CI: 0.018, 0.336; "need for insulin" subgroup: SMD = 0.403, 95%CI: 0.119, 0.687). The "before 14 wk" subgroup, "14-28 wk" subgroup, and "no information of need for insulin" subgroup showed a nonsignificant association between serum resistin level and GDM risk ("before 14 wk" subgroup: SMD = 0.087, 95%CI: -0.055, 0.230; "14-28 wk" subgroup: SMD = 0.217, 95%CI: -0.003, 0.436; "no information of need for insulin" subgroup: SMD = 0.356, 95%CI: -0.143, 0.855). The postpartum subgroup included only one study and showed that higher serum resistin level was related to GDM risk (SMD = 0.571, 95%CI: 0.054, 1.087) The meta-regression revealed that no need for insulin in GDM patients, age distribution similar between cases and controls, and ELISA all had a significant impact on between-study heterogeneity. CONCLUSION: This meta-analysis supports that the maternal serum resistin level is associated with GDM risk.

Scoring systems for prediction of mortality in decompensated liver cirrhosis: A meta-analysis of test accuracy.

AIM: To compare the accuracy of the scoring systems Child-Turcotte-Pugh (CTP), Model for End-stage Liver Disease score (MELD), MELD-Na, and MELD to Serum Sodium ratio (MESO) to predict the mortality in decompensated liver cirrhosis. METHODS: The PubMed, Web of Science, Cochrane Library, EMBASE, and Ovid databases were systematically searched from inception to September 2018 for relevant articles, and we evaluated the quality of the included studies. The accuracy of scoring systems was analyzed with Stata 12 and MetaDiSc 1.4. RESULTS: Sixteen studies involving 2337 patients were included. The pooled areas under the summary receiver operating characteristic curves (AUROCs) of CTP, MELD, MELD-Na, and MESO to predict mortality were 0.81, 0.78, 0.85, and 0.86, respectively. Within 3 mo, the AUROCs of CTP, MELD, and MELD-Na in predicting mortality were 0.78, 0.76, and 0.89, respectively. The AUROCs of CTP, MELD, and MELD-Na at 3 mo were 0.86, 0.78, and 0.86, respectively. The AUROCs of CTP, MELD, and MELD-Na at 6 mo were 0.91, 0.83, and 0.90, respectively. The AUROCs of CTP, MELD, and MELD-Na at 12 mo were 0.72, 0.75 and 0.84, respectively. In cirrhotic patients with bleeding, the AUROCs of CTP and MELD were 0.76 and 0.88, respectively. CONCLUSION: MESO has the highest AUROC in all assessed scoring systems. Considering the different time points, MELD-Na has good accuracy in predicting the mortality of decompensated liver cirrhosis. Compared to CTP, MELD is better in predicting variceal bleeding.

Comparative efficacy and safety of oral antidiabetic drugs and insulin in treating gestational diabetes mellitus: An updated PRISMA-compliant network meta-analysis.

BACKGROUND: The safety and efficacy of different drugs in treatment of gestational diabetes mellitus (GDM) patients who could not maintain normal glucose level only through diet and exercise remains to be debated. We performed this network meta-analysis (NAM) to compare and rank different antidiabetic drugs in glucose level control and pregnancy outcomes in GDM patients. METHODS: We searched PubMed, Cochrane Library, Web of Science, and Embase up to December 31, 2016. Randomized controlled trials (RCTs) related to different drugs in the treatment of GDM patients were enrolled. We extracted the relevant information and assessed the risk of bias with the Cochrane risk of bias tool. We did pair-wise meta-analyses using the fixed-effects model or random-effects model and then adopted random-effects NAM combining both direct and indirect evidence within a Bayesian framework, to calculate the odds ratio (OR) or standardized mean difference (SMD) and to draw a surface under the cumulative ranking curve of the neonatal and maternal outcomes of different treatments in GDM patients. RESULTS: Thirty-two randomized controlled trials (RCTs) were included in this NAM, including 6 kinds of treatments (metformin, metformin plus insulin, insulin, glyburide, acarbose, and placebo). The results of the NAM showed that regarding the incidence of macrosomia and LGA, metformin had lower incidence than glyburide (OR, 0.5411 and 0.4177). In terms of the incidence of admission to the NICU, insulin had higher incidence compared with glyburide (OR, 1.844). As for the incidence of neonatal hypoglycemia, metformin had lower incidence than insulin and glyburide (OR, 0.6331 and 0.3898), and insulin was lower than glyburide (OR, 0.6236). For mean birth weight, metformin plus insulin was lower than insulin (SMD, -0.5806), glyburide (SMD, -0.7388), and placebo (SMD, -0.6649). Besides, metformin was observed to have lower birth weight than glyburide (SMD, 0.2591). As for weight gain, metformin and metformin plus insulin were lower than insulin (SMD, -0.9166, -1.53). Ranking results showed that glyburide might be the optimum treatment regarding average glucose control, and metformin is the fastest in glucose control for GDM patients; glyburide have the highest incidence of macrosomia, preeclampsia, hyperbilirubinemia, neonatal hypoglycemia, shortest gestational age at delivery, and lowest mean birth weight; metformin (plus insulin when required) have the lowest incidence of macrosomia, PIH, LGA, RDS, low gestational age at delivery, and low birth weight. Besides, insulin had the highest incidence of NICU admission, acarbose had the lowest risk of neonatal hypoglycemia. CONCLUSION: Our study concluded that metformin is fastest in glucose control, with a more favorable pregnancy outcomes-would be a better option, but its rate of glucose control is the lowest.However, glyburide is the optimumtreatment regarding the rate of glucose control, but withmore adverse outcomes. This NAMbased on 32 RCTs will strongly help to guide further development of management for GDM patients, clinicians should carefully balance the risk-benefit profile of different treatments according to various situations.

Association between killer cell immunoglobulin-like receptor (KIR) polymorphisms and systemic lupus erythematosus (SLE) in populations: A PRISMA-compliant meta-analysis.

BACKGROUND: Recently, a growing number of studies show that the killer cell immunoglobulin-like receptor (KIR) gene polymorphisms may play a role in the systemic lupus erythematosus (SLE) susceptibility. Nonetheless, the results were inconsistent. Thus, a meta-analysis was carried out by integrating multiple research to clarify the association between KIR polymorphisms and SLE susceptibility. METHODS: The Web of Science, Embase (Ovid), PubMed, Elsevier Science Direct, the Chinese Biomedical Database and CNKI, Wanfang databases (last search was updated on May 15, 2016) were systematically searched to select studies on addressing the association between the KIR polymorphisms and susceptibility to SLE in populations. The odds ratio (OR) with 95% confidence interval (95% CI) was calculated. RESULTS: A total of 10 published case-control studies involving 1450 SLE patients and 1758 controls were available for this meta-analysis. Results suggested that KIR2DL1 might be a risk factor for SLE (OR 2DL1 =1.047, 95% CI=1.011-1.083) in all subjects. The KIR2DL3, KIR2DL5 were identified as protective factors for SLE in Asian populations (OR2DL3= 0.215, 95% CI = 0.077-0.598; OR2DL5 = 0.588, 95% CI = 0.393-0.881), but not in Caucasians. CONCLUSIONS: The meta-analysis results suggested that 2DL1 might be a potential risk factor and 2DL3, 2DL5 might be protective factors for SLE in Asians but not in Caucasians.

Metformin use improves survival of diabetic liver cancer patients: systematic review and meta-analysis.

Metformin has garnered considerable interest as a chemo-preventive and chemo-therapeutic agent given the increased risk of liver cancer among diabetic patients. This work was performed to illustrate the association between metformin use and survival of diabetic liver cancer patients. We conducted a comprehensive literature search of PubMed, Web of Science, Embase, BIOSIS Previews, Cochrane Library from inception to 12 May 2016. Meta-analyses were performed using Stata (version 12.0), with hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) as effect measures. Eleven cohort studies involving 3452 liver cancer patients fulfilled the inclusion criteria. Meta-analyses showed that metformin use was associated with better survival (HR = 0.59; 95% CI, 0.42-0.83; p = 0.002) of liver cancer patients, and the beneficial effect persisted (HR = 0.64; 95% CI, 0.42-0.97; p = 0.035) when the population was restricted to diabetic liver cancer patients. After adjusting for age, etiology, index of tumor severity and treatment of liver cancer, the association between metformin use and better survival of liver cancer patients was stable, pooled HR ranged from 0.47 to 0.57. The results indicated that metformin use improved survival of diabetic liver cancer patients. However, the results should be interpreted with caution given the possibility of residual confounding. Further prospective studies are still needed to confirm the prognostic benefit of metformin use.

Maternal exposure to the production of fireworks and reduced rate of new onset hypertension in pregnancy.

BACKGROUND: Carbon monoxide (CO) is one of the main substances contained in fireworks. Previous studies suggested that CO may have protective effect on the development of hypertension of pregnancy. METHOD: The authors conducted a prospective cohort study in Liuyang, Hunan, China between January 2010 and December 2011. Demographic and life-style variables of the participating pregnant women were obtained through structured interview with the women and clinical data were retrieved from antenatal medical records. Density of fireworks factories was defined as the number of fireworks factories per 1000 residents in the township where the mothers resided during pregnancy. Multiple logistic regression analysis was used to analyze the independent association between maternal exposure to the production of fireworks and new onset hypertension in pregnancy. RESULTS: A total of 5976 pregnant women were included in the final analysis. Density of fireworks factories was inversely correlated with incidence of new onset hypertension in pregnancy (Pearson correlation coefficient = -0.29, p < 0.001). Multiple logistic regression analysis showed that, compared with women who resided during pregnancy in a township with 0-0.25 fireworks factories per 1000 residents, the rates of new onset hypertension in pregnancy in women who resided in a township with 0.26-1.00 fireworks factories per 1000 residents (Odds Ratio = 0.66, 95% confidence interval: 0.46, 0.96) and >1.5 fireworks factories per 1000 residents (Odds Ratio = 0.65, 95% confidence interval: 0.44, 0.97) were reduced by more than 30%. CONCLUSION: Maternal exposure to the high density of fireworks factories is associated with reduced risk of developing new onset hypertension in pregnancy.

[Pre-conceptive factors on the birth ponderal index].

OBJECTIVE: To analyze the pre-conceptive factors on birth ponderal index (PI). METHODS: Fourteen towns were selected randomly from the 37 towns of Liuyang county, Hunan province, through cluster sampling in a prospective cohort study. Information was collected on all the women registered at the Maternity and Child Care Departments, and were planning to give birth in the coming year plus willing to receive a blood test and then followed-up until delivery. Single factor analysis would involve chi-square test and correlation analysis, while the multiple-factor analysis would adopt binary logistic regression method. RESULTS: A total of 1368 women were recruited in the cohort and 611 of them had a delivery of one child. Means of birth weight, birth length, and birth PI were (3.26 ± 0.43) kg, (50 ± 0.46) cm and 26.08 ± 3.43, respectively. Data from the multiple stepwise regression analysis showed that income (OR = 6.920, 95%CI: 1.089 - 43.974) and cortisone levels (OR = 5.121, 95%CI: 0.886 - 29.611) were related to low PI, while LDL-C (OR = 3.736, 95%CI: 0.848 - 16.461), waistline (OR = 6.846, 95%CI: 1.441 - 32.532), education (OR = 0.169, 95%CI: 0.029 - 0.995), and insulin (OR = 0.141, 95%CI: 0.016 - 1.277) were related to high PI. CONCLUSION: Birth PI was associated with income, waistline, education, insulin, cortisone, and LDL-C. Before conception, women should go through necessary tests and keep a good physical condition to reduce their neonates of having abnormal PI.

[Changes in blood pressure and related determinants before and during normal pregnancy].

OBJECTIVE: To study the longitudinal changes of blood pressure (BP) and its related determinants before and during normal pregnancy. METHODS: 14 townships were randomly selected by cluster random sampling method from 37 townships in Liuyang city, Hunan province. Subjects are all women at childbearing age in these 14 townships registered from April 2008 to December 2011. When the subjects visited to the local maternity and child-care agencies for pre-marital check, they were face-to-face interviewed and asked to fill out the questionnaire and finish the medical examination. Following-up program was carried out until delivery, with BP and other pregnancy information checked and collected. Analysis on variance of data regarding repeated measurements were used to investigate the changes of BP and related determinants. RESULTS: A total of 611 cases with complete data were recruited, after excluding 41 cases who were diagnosed as pregnancy-induced hypertension. Finally, data on 570 healthy women with singleton pregnancies was analyzed. Systolic blood pressure (SBP) at pre-pregnancy, first trimester, second trimester and third trimester were (109.9 ± 12.9) mm Hg, (100.6 ± 9.6) mm Hg, (102.6 ± 10.1) mm Hg, (107.8 ± 10.9) mm Hg, respectively while the diastolic blood pressure (DBP) of pre-pregnancy, first trimester, second trimester and third trimester were (71.1 ± 9.0) mm Hg, (64.3 ± 6.6) mm Hg, (65.1 ± 6.8) mm Hg, (68.3 ± 8.1) mm Hg, respectively. The pre-pregnancy BP was lower than the three periods after pregnancy. BP of the third trimester was higher than that of the ones at first or second trimesters, with the difference statistically significant. SBP and DBP both indicated that there were statistically significant changes in the four periods and the linear trend test showed statistically significant. Pre-pregnancy BMI, pre-pregnancy waist circumference and annual per capita income were determinants which affecting the changes of BP. Higher pre-pregnancy body mass index (BMI), wider pre-pregnancy waist circumference and higher annual per capita income were associated with higher BP, while annual per capita income mainly affecting the pre-pregnancy BP. CONCLUSION: BP of the three periods after pregnancy were lower than that of pre-pregnancy. BP of the third trimester was higher than both the first and second trimesters'. Pre-pregnancy BMI, pre-pregnancy waist circumference and annual per capita income were determinants which affecting the changes of BP.

[Study on the causes of sexual orientation of gay].

OBJECTIVE: To explore the relevant factors of the causes of sexual orientations of gay. METHOD: From March to June 2013, 350 gays were recruited from one music bar and three bath centers where gays frequently visited in Changsha city, by proportional stratified sampling method. Meanwhile, another 332 males who identify themselves as non-homosexuality were also recruited considering the composition of ages, gender and educational background. Questionnaire survey was conducted to all the subjects, with 300 effective ones reclaimed. The questionnaire included the general demographic information, traits of character, the condition of foster in childhood and information of family members. The differences between the gays and non-homosexuality groups were analyzed to explore the causes of the sexual orientations of gays. RESULTS: There were statistical significant differences between gays and non- homosexuality group on following indexes (χ(2) was 59.63, 5.90, 16.01, 84.99, 161.57, 77.77, 112.32, 190.84, 30.10 respectively, all of P < 0.05) :had a tender father and an impervious mother, were physically weak, not agile, physically inactive, attentive to details, highly conservative, not adventurous, and radical in childhood, were raised as girls before the age of 18, liked to dress as girls before the age of 18, don't liked to play toy knives and toy guns before the age of 18, suffered from sexual abuse before the age of 18 (e.g. forced to expose private parts or forced to have sex) by adults, had read or watched books or films about homosexual and experienced sexual pleasure from that before the age of 18. The rate of gays on these indexes was separately 62.3% (187/300), 57.7% (173/300) , 62.3% (187/300) , 63.0% (189/300), 67.3% (202/300) , 62.7% (189/300), 68.0% (204/300), 65.0% (195/300) and the rate on these indexes of non-homosexuality group was separately 21.3% (64/300), 28.0% (84/300) , 25.0% (75/300) , 12.7% (38/300), 31.3% (94/300), 17.7% (53/300) , 12.7% (38/300), 42.7% (128/300) . The rate of gays on these factors:the youngest boy in family, had the father or twin brothers who were homosexual or self identified as gay was 62.7% (188/300), 56.0% (168/300) and 62.0% (18/29) respectively; and the rate was 40.7% (122/300), 4.0% (12/300) and 20.0% (2/10), respectively among non-homosexuality group. The difference showed statistical significance (χ(2) was 34.52, 193.14, 5.27 respectively, all of P < 0.05). CONCLUSION: The correlative factor of sexual orientation of gays maybe was family relationship, tend and education since childhood, psychological characteristics, sexual experience during puberty.

[Dynamic investigation on the co-infection status of two pathogens in ticks from tourist point in Heilongjiang province].

OBJECTIVE: To monitor the co-infection status of Borrelia burgdorferi sensu lato (B.b.s.l) and spotted fever group Rickettsia (SFGR) in tourist areas of Heilongjiang province. METHODS: Polymerase chain reaction (PCR) was used to detect the 5S-23S rRNA intergenic spacer of B.b.s.l and ompA of SFGR in ticks, dynamically collected from tourist areas of Heilongjiang province in 2010. Amplification products from positive ticks were sequenced, and phylogenetic analysis was conducted by Mega 5.0 software package. RESULTS: 849 ticks were collected from two tourist points, with the dominant ticks in Tiger Mountain and Jingpo Lake were Ixodes persulcatus and Haemaphysalis concinna. Regarding the Ixodes persulcatus from Tiger Mountain, the infection rates of B.b.s.l and SFGR were 26.15% and 10.05%. The infection rate of SFGR was 13.33% in Haemaphysalis concinna and the B.b.s.l was undiscovered in the same ticks from Jingpo Lake. However, the co-infection could only be detected in Ixodes persulcatus of both tourist areas. Surveillance data showed that the major ticks were more likely to be appeared in July at Tiger Mountain and in June at Jingpo Lake. Data from the sequence analysis on B.b.s.l showed that the B.b.s.l in tourist areas could be classified into three different genotypes, other than B. garinii and B. afzelii. We first detected B. valaisiana-like group genotype in northeast of China. Results from the sequence analysis of SFGR positive products showed that the two DNA sequences of newly detected agents were completely the same as Rickettsia sp. HL-93 which was detected in Hulin and Rickettsia sp. H820 found in northeast, China. CONCLUSION: The co-infection of B.b.s.l and SFGR was detected in ticks from the tourist areas of Heilongjiang province, and data from the sequencing of specific fragment showed that various kinds of genotypes existed in this area. However; the rates of co-infections-different according to environment, time and population that contributed to the kinds of and the index of ticks existed in the surveys points, also the infection rate of the ticks was studied.

[Characteristics and the estimated size of men who have sex with men in different venues of one city].

OBJECTIVE: To study the features, safe sex behavior and the size of men who have sex with men (MSM) population in actual and virtual venues in one city. METHODS: We carried out a cross-sectional study in actual and virtual venues, using the Estimated Size of Population from a Single Sample (LMS method) to estimate the size of MSM population. RESULTS: Most MSM in actual venues were 24 - 43 year olds and had received high school education, whereas in virtual venues, the majority of this population were younger than 29 years old and had higher education, including some college students. The awareness of AIDS of the two groups from different venues showed no statistically significant difference, neither the safe sex behaviors. Proportions of the MSM population in actual and virtual venues were 21.22% (16 383, 95%CI: 11 514 - 21 252) and 78.78% (60 830, 95%CI: 57 327 - 64 329), respectively. After adjusting the overlapping part of the MSM from both venues, the total number was between 60 830 and 77 213, constituting a proportion of 5.03% - 6.38% in the sexually active male population (15 - 64 year olds) in this city. CONCLUSION: The size of the MSM population was large but the characteristics were different in the actual or virtual venues. As most MSM preferred going to the virtual venues, intervention program on AIDS-specific strategy in this area, in particular dealing with the Internet, should be strengthened.

[An investigation on the trend and related determinants of cigarette smoking on experimental smokers among undergraduate students in Changsha].

OBJECTIVE: To investigate the trend and related determinants of cigarette smoking on experimental smokers among undergraduate students in Changsha. METHODS: Stratified sampling method was adopted and 3600 undergraduate students from grade 1 to 3 in Changsha city were investigated through a self-administered questionnaire. All the experimental smokers during the last month were selected and divided into two groups based on the present smoking status. χ(2) test and logistic regression analysis were used to compare the differences of cigarette smoking among subpopulations and to explore the determinants. RESULTS: Among the 1550 experimental smokers of undergraduate students, the prevalence of cigarette smoking was 30.8% (95%CI: 28.5 - 33.1). Students from the second-class (OR = 2.367) or the third-class universities (OR = 2.562) were more likely to adopt smoking behavior than those from top universities. Students majored in sports or arts (OR = 2.456) were significantly more inclined to smoke than the liberal arts students. Students whose father were cadres (OR = 1.602) were more likely to become smokers than those whose fathers were workers. Students being males (OR = 7.386), having high monthly expenses (OR = 1.139), with positive attitude to smoking benefits (OR = 1.140) were risk factors for smoking. Number of smoking members in the family (OR = 1.801) was significantly associated with the prevalence of cigarette smoking. Knowledge on diseases caused by smoking (OR = 0.806) was protecting factor to smoking among the experimental smokers. CONCLUSION: Those experimental smokers among undergraduate students might become smokers and the determinants of cigarette smoking behavior would include: ranking of universities, students' major, gender, father's occupation, amount of pocket money, number of smoking members in the family, knowledge about smoking, the attitude to the benefit of smoking.