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Objective:To explore the robust relationship between insomnia and type 2 diabetes mellitus by two-sample Mendelian randomization analysis to overcome confounding factors and reverse causality in observational studies.Methods:We identified strong,independent single nucleotide polymorphisms(SNPs)of insomnia from the most up to date genome wide association studies(GWAS)within European ancestors and applied them as instrumental variable to GWAS of type 2 diabetes mellitus.After excluding SNPs that were significantly associated with smoking,physical activity,alcohol consumption,educational attainment,obesity,or type 2 diabetes mellitus,we assessed the impact of insomnia on type 2 diabetes mellitus using inverse variance weighting(IVW)method.Weighted median and MR-Egger regression analysis were also conducted to test the robustness of the association.We calculated the F statistic of the selected SNPs to test the applicability of instrumental variable and F statistic over than ten indicated that there was little possibility of bias of weak instrumental variables.We further examined the existence of pleiotropy by testing whether the intercept term in MR-Egger regression was significantly different from ze-ro.In addition,the leave-one-out method was used for sensitivity analysis to verify the stability and relia-bility of the results.Results:We selected 248 SNPs independently associated with insomnia at the genome-wide level(P<5 ×10-8)as a preliminary candidate set of instrumental variables.After clum-ping based on the reference panel from 1000 Genome Project and removing the potential pleiotropic SNPs,a total of 167 SNPs associated with insomnia were included as final instrumental variables.The F statistic of this study was 39.74,which was in line with the relevance assumption of Mendelian randomi-zation.IVW method showed insomnia was associated with higher risk of type 2 diabetes mellitus that po-pulation with insomnia were 1.14 times more likely to develop type 2 diabetes mellitus than those without insomnia(95%CI:1.09-1.21,P<0.001).The weighted median estimator(WME)method and MR-Egger regression showed similar causal effect of insomnia on type 2 diabetes mellitus.And MR-Egger re-gression also showed that the effect was less likely to be triggered by pleiotropy.Sensitivity analyses pro-duced directionally similar estimates.Conclusion:Insomnia is a risk factor of type 2 diabetes mellitus,which has positively effects on type 2 diabetes mellitus.Our study provides further rationale for indivi-duals at risk for diabetes to keep healthy lifestyle.
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Oligodontia is the congenital absence of six or more teeth and comprises the more severe forms of tooth agenesis. Many genes have been implicated in the etiology of tooth agenesis, which is highly variable in its clinical presentation. The purpose of this study was to identify associations between genetic mutations and clinical features of oligodontia patients. An online systematic search of papers published from January 1992 to June 2021 identified 381 oligodontia cases meeting the eligibility criteria of causative gene mutation, phenotype description, and radiographic records. Additionally, ten families with oligodontia were recruited and their genetic etiologies were determined by whole-exome sequence analyses. We identified a novel mutation in WNT10A (c.99_105dup) and eight previously reported mutations in WNT10A (c.433 G > A; c.682 T > A; c.318 C > G; c.511.C > T; c.321 C > A), EDAR (c.581 C > T), and LRP6 (c.1003 C > T, c.2747 G > T). Collectively, 20 different causative genes were implicated among those 393 cases with oligodontia. For each causative gene, the mean number of missing teeth per case and the frequency of teeth missing at each position were calculated. Genotype-phenotype correlation analysis indicated that molars agenesis is more likely linked to PAX9 mutations, mandibular first premolar agenesis is least associated with PAX9 mutations. Mandibular incisors and maxillary lateral incisor agenesis are most closely linked to EDA mutations.
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Humanos , Fenótipo , Proteínas WntRESUMO
In order to understand the status of the cultivation of the masters of public health (MPH) in colleges in China and improve the cultivation model, an electronic questionnaire survey were conducted among 22 schools of public health in colleges. The result showed that the size and the enrolment scale of Chinese MPH students were relatively small, and the training objectives were still unclear. There was no obvious difference between the curriculum setting for MPH and academic master degree. The practical skill-oriented courses and emergency response ability of public health practice were insufficient. The cultivation model of MPH should be improved in future.
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To investigate the current status of postgraduates training in public health and preventive medicine in China. In this study, a questionnaire survey was conducted among directors of enrollment and teaching in 22 universities with postgraduate admission qualifications in corresponding disciplines nationwide. In 2016, full-time postgraduates were mainly academic masters. In addition to the graduate entrance examination, the common enrollment mode in colleges was to enroll a high qualified student with recommendations from relevant experts or institutions and an exemption from entrance examination (20/22). The emphasis on training contents between academic and public health master was different. Currently, the scale of public health postgraduate enrollment in public health and preventive medicine in China is stable, and the training program is reasonable, but there is an issue of monotonous model and uneven distribution of enrollment.
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In order to underst and the status of health emergency personnel training development and raising coping measures, electronic questionnaire surveys were conducted among 22 colleges and universities in different region of China. The result showed that colleges universities in China invested less in the training of emergency personnel. It is different and emphasized particularly for the cultivation of emergency professional ability among different types of public health students. Universities and employer hold relative evaluation of students′ emergency professional ability with distinct regional differences.
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Family-based cohort study is a special type of study design,in which biological samples and environmental exposure information of the member in a family are collected and related follow up is conducted.Family-based cohort study can be applied to explore the effect of genetic factors,environmental factors,gene-gene interaction,and gene-environment interaction in the etiology of complex diseases.This paper summarizes the objectives,methods and results,as well as the opportunities and challenges of the family-based cohort study on common chronic non-communicable diseases in rural population in northern China.
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Family-based cohort study is a special type of study design, in which biological samples and environmental exposure information of the member in a family are collected and related follow up is conducted. Family-based cohort study can be applied to explore the effect of genetic factors, environmental factors, gene-gene interaction, and gene-environment interaction in the etiology of complex diseases. This paper summarizes the objectives, methods and results, as well as the opportunities and challenges of the family-based cohort study on common chronic non-communicable diseases in rural population in northern China.
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China/epidemiologia , Doença Crônica/etnologia , Estudos de Coortes , Interação Gene-Ambiente , Doenças não Transmissíveis/etnologia , Projetos de Pesquisa , População RuralRESUMO
Objective To explore the security and its influencing factors on benign airway stenosis treated with interventional of high pressure balloon expansion catheter.Methods Clinial data of 39 cases of inpatients suffered from benign airway stenosis were chosen.17 cases were male,and 22 cases were female.The ages of them ranged from 15 to 83 years old.According to the clinical symptoms,HRCT 3D reconstruction,and the results of bron-choscope,all patients were treated with balloon expansion catheter at different criterions.The balloon catheter with size that slightly smaller than the targeted normal bronchial tube was chosen,expansion for average 1 -4 times,single balloon expansion time ranged from 0.5 to 4 min,the pressures were kept at 3 -6 atmosphere,and the highest pres-sure did not exceed 8 atmospheric pressure.The efficacy and complications were retrospectively analyzed.Results 19 cases were completely effective,14 cases were basically effective,6 cases were completely ineffective,and the total effective rate was 84.6% (33 /39 ),the incidence of complications was 35.8% (14 /39 ),moreover,no deaths occurred.Conclusion High pressure balloon catheter expansion is one of commonly used technology in breathing interventional treatment;it has the characteristics of easy operation,and immediate curative effect,and so on.But if the improper operation,incorrect selection of the case,or inaccurate evaluation of the stenosis during operation,serious complications and unnecessary iatrogenic injury can be occurred.Therefore,it is worthy of attention and further summarizing by breathing interventional physicians.
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Objective To preliminaryly explore the effect and adverse reaction of Marine Injection combined therapy through local spray in benign tracheobronchial stenosis.Methods 19 cases of bronchial tuberculosis were collected in our department.By assessing cough,shortness of breath and other symptoms,chest high -resolution CT (HRCT)of three -dimensional reconstruction,and length were observed by ultrafine bronchial stenosis.According to the pathogeny and types of stenosis,combined multiple intervention were sequentially adopted,and then Marine Injec-tion was sprayed through one -off endoscopic spray tube.All the subjects were divided into the two groups,the higher concentration Marine injection (1 200 mg/mL)group was chosen with the condition of serious inflammation,edema, ulcer and necrosis,obvious local granulation tissue hyperplasia,severe scar stenosis,and the length of stenosis greater than 2 cm or the sectional area of stenosis less than 50% of the normal sectional area,otherwise the low concentration (600 mg/mL)group was chosen.The subjects were reexamined by clinical symptoms,high -resolution CT (HRCT) of three -dimensional reconstruction,and ultrafine bronchoscopy a week after the surgery to dynamically observe the local changes.Depending on the situation,the injection was sprayed once a week,adding up to 2 -4 times.Follow -up visit lasted for 3 months,cough,expectoration or hemoptysis,and dyspnea were observed.Results 11 cases were effective fully,17 cases were effective substantially,7 cases were ineffective,the total effective rate was 80% (28 /35).The overall complication rate was 42.8% (15 /35),no deaths occurred.No complications related to local spra-ying of Marine were seen.Conclusion Local spray of Marine Injection may have preferable effect that inhibits scar formationand prevention airway restenosis.It is worth further study with a high security,precise clinic effect,easy oper-ation and etc.
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Objective:To review our patients who underwent cranio-maxillofacial resection in the recent 10 years and explore the indication of the operation. Methods:From 2003 to 2013, 116 patients underwent cranio-maxillofacial resection in our department for the treatment of tumors involving the skull base. Tumors that involved the skull base were divided into 3 types according to skull base invasions shown in the coronal planes of CT and MRI scans. Type 1 tumor was adjacent to the skull base with free bone (n=45), type 2 tumor involved the skull base with intact dura (n=30), and type 3 tumor involved dura with free brain (n=41). All patients underwent cranio-maxillofacial resection by oral and maxillofacial surgeons and neurosurgeons. The defects after cranio-maxillofacial resection were reconstructed immediately with adjacent local or regional flaps (n=62) and free vascularized flap (n=54) according to different de-fects, respectively. Results:Cranio-maxillofacial resection was successfully performed in all patients. No intraoperative complication was found. The overall success rate of soft tissue flaps and free flaps was 98.3%and 96.4%, respectively. Three patients with intracrani-al infection (n=2) and bleeding in the internal carotid artery were dead postoperatively even though they underwent salvage surgery. The overall rate of complications was 14.7%, and the dead rate was 2.6%. Recurrence or distant metastasis was found in 36 patients dur-ing the follow-up period. Conclusion: For the indication of cranio-maxillofacial resection, the balance between tumor resection and postoperative function, survival rate, and quality of life should always be considered. This technique includes the balance between func-tion and form, survival and quality of life, donor and recipient sites, and primary and secondary functions.
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<p><b>OBJECTIVE</b>To investigate the association between polymorphism of leukotriene A4 hydrolase (LTA4H) gene among ischemic stroke patients and the related subtypes in the discordant sib pairs.</p><p><b>METHODS</b>Families including ischemic stroke patients and their siblings were recruited. Four single nucleotide polymorphisms (SNPs) of LTA4H as rs2072512, rs2540489, rs2540500 and rs6538697 were selected. Generalized estimating equation (GEE) was used to adjust for in-family correlation in the analysis of discordant sib pairs. Conditional logistic regression model and family based association test (FBAT) were both used to test the associations of LTA4H gene with ischemic stroke and its subtypes.</p><p><b>RESULTS</b>In total, data from 356 discordant sib pairs from 234 ischemic stroke patient pedigrees were analyzed. Results of GEE showed that hypertension, diabetes mellitus and hyperlipoidemia were associated with ischemic stroke. According to the association test results, rs2540489 G allele was found to be associated with ischemic stroke, both in the additive model (OR = 0.62, 95% CI: 0.41-0.94) and in the recessive model (OR = 0.48, 95% CI: 0.23-1.02). For two main ischemic stroke subtypes, rs2540489 G allele was found to be associated with large-artery atherosclerosis stroke in the additive model (OR = 0.48, 95% CI: 0.24-0.95) and in the recessive model (OR = 0.25, 95% CI: 0.07-0.93). After adjusting age, sex and other factors, the associations mentioned above, still existed.</p><p><b>CONCLUSION</b>rs2540489 polymorphism in LTA4H gene seemed to be associated with large-artery atherosclerosis stroke.</p>
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Humanos , Alelos , Aterosclerose , Isquemia Encefálica , Genética , Diabetes Mellitus , Epóxido Hidrolases , Genética , Hiperlipidemias , Hipertensão , Modelos Logísticos , Linhagem , Polimorfismo de Nucleotídeo Único , Irmãos , Acidente Vascular Cerebral , GenéticaRESUMO
Objective:To investigate the use of antibacterial agents for emergency patients with acute upper respiratory infections in tertiary hospitals in Beijing .Methods:We used the medical claim data for urban workers in 10 tertiary hospitals in Beijing from Oct .2010 to Sep.2012.Medical records of emer-gency patients with acute upper respiratory tract infections had been selected as the study sample .The proportions of antibacterial prescriptions and categories of antibacterial drugs were described and ana -lyzed.Results:This study included 135 979 visitors (male:42.7%;mean age:43.6 ±16.2 years).The average antibacterial prescription rate was 71.2% (95%CI 71.0%-71.5%), of which the single kind use was 80.0%(95%CI 79.7%-80.2%).Among acute upper respiratory tract infections , the antibacte-rial prescription rate for acute tonsillitis visits was highest (85.1%, 95%CI 84.5%-85.6%), followed by acute laryngitis and bronchitis (81.69%, 95%CI 80.4%-82.8%), acute pharyngitis (81.4%, 95%CI 77.7% -85.0%), acute sinusitis (77.0%, 95%CI 74.6% -79.4%), acute nasopharyngitis (74.3%, 95%CI 73.7%-75.0%), and common cold (67.6%, 95%CI 67.3%-67.9%).Compared with the female group, the antibacterial prescription rate for the male was higher (73.2%, 95%CI 72.8%-73.6%vs.69.7%, 95%CI 69.4%-70.0%).Compared with the <60 years age cases, the anti-bacterial prescription rate for the ≥60 years cases was higher (72.1%, 95%CI 71.8%-72.3% vs. 66 .8%, 95%CI 66 .2%-67 .5%) .In the visitors who used antibacterial drugs , the average percentage of injection use was 50.6%(95%CI 50.3%-50.9%).The top antibacterial drugs in the list of varie-ties were the second generation cephalosporins (28.4%) , followed by the third generation cephalosporins (21.7%), fluoroquinolones (21.0%) and macrolides (17.6%).Conclusion: The antibacterial pre-scription rate for acute upper respiratory tract infections in the general hospitals in Beijing is high , and the second generation cephalosporins , third generation cephalosporins , fluoroquinolones and macrolides take the lead in the total antibacterial drugs .
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Objective To review our patients who underwent reconstruction of the defect after combined cranio-maxillo-facial resection in recent years.Methods From January,2005 to January,2011,88 patients underwent reconstruction of the defect after combined cranio-maxillo-facial resection.Different reconstructive techniques were used according to the defect classifications in dura,skull base bone,and facial tissues.For dural defects,no repair (37 cases),primary closure (25 cases),and dural repair (26 cases) were performed,respectively.Dural repair materials included thigh fascia lata (2 cases),temporalis fascia (2 cases),pericranium (1 case) and artificial dural patch (21 cases).Bone reconstruction of the skull base were performed in 61 patients with titanium mesh (57 cases),free iliac bone graft (1 case),free cranial bone graft (2 cases) and Medpor (1 case),respectively.Limited facial soft and hard tissue defects in 44 patients were reconstructed with temporalis system of flaps (36 cases),sternocleidomastoid myocutaneous flap (6 cases),and pterygoid muscle flap (2 cases),respectively.Extensive facial soft and hard tissue defects in 44 patients were reconstructed with free latissimus dorsi myocutaneous flap (26 cases),free pectoralis major myocutaneous flap (12 cases),free anterolateral thigh perforator flap (5 cases cases) and free anteromedial thigh perforator flap (1 case),respectively.Results The overall success rate of 88 flaps was 100%.Cerebrospinal fluid leak was found in 4 patients,wound infection was found in 2 patients,intracranial infection was found in 2 patients,respectively.Six patients with cerebrospinal fluid leak or wound infection were cured by conservative treatment.Two patients with intracranial infection were dead although they underwent salvage surgery.Overall rate of complications was 9.1%,dead rate was 2.3%.Conclusion Successful reconstruction of the defect after combined cranio-maxillo-facial resection can be achieved by watertight dural repair,bone reconstruction of the skull base and well-vascularized tissue covered.Regional flap and free tissue transfer are both preferred reconstructive technique depending on the anatomic site and the extent of the defect.
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Objective To retrospectively analyze the effect of two kinds of biological agents in volume -re-duced bullae .Methods 11 patients who suffered from bullae were operated under large C-arm locating ,and infused two kinds of biological agents through micro catheter of fibreoptic bronchoscopy .All of them were randomly divided into the two groups .The biological agents in group A were fibrinogen and diluent thrombin , and that of group B was Porcine Fibrin Sealant Kit .In group A,the micro catheter with diameter of micro thread less than 1.2mm was placed in bullae through fibreoptic bronchoscope ,and then the 2mL lidocaine,5 ml fibrinogen,and double of 500u diluent thrombin were inproperorder injected through micro catheter .In group B,the Porcine Fibrin Sealant Kit was injected at the same method,and then the suspension fluid was exacted .The operation time was recorded ,and then the clinical efficacy and incidence rate of complications were compared .Results The operation time of group A was 5-15 minutes, and that of group B was 6-20 minutes.For all the patients ,4 cases were totally effective ,2 cases were significantly effective,and 2 cases were totally non-effective.The total effective rate was 81.82%(9/11).The incidence rates of common complications in group A and B were 52.38%(22/42),58.33%(14/24),respectively,the difference was not significant (χ2 =0.22,P>0.05).Moreover,there were no serious complications in all cases .Conclusion The security and effect of two kinds of biological agents might be well enough ,but in view of less cases ,they were worth to further popularized and applied in clinical practice .
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In this paper is introduced an image guided oral implant system (IGOIS), including the 3D surface-model generation through Marching Cubes algorithm and large-scale triangular mesh simplification, the realization of pre-operative planning module with computer graphics and image processing technology, the non-invasive point-to-point registration with the fabrication of tooth-supported polymer resin templates and ICP algorithm, and the development of the real-time navigation system software by programming in VTK and VC+ +6.0. The experimental test for a patient's rapid prototype model shows that with the support of IGOIS, the precision achieved in the planning phase can be transferred to the patient so that the accuracy of the oral implant surgery under difficult conditions is improved.
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Humanos , Simulação por Computador , Implantação Dentária , Métodos , Implantes Dentários , Imageamento Tridimensional , Métodos , Modelos Biológicos , Cuidados Pré-Operatórios , Métodos , Interpretação de Imagem Radiográfica Assistida por Computador , Métodos , Cirurgia Assistida por Computador , Métodos , Interface Usuário-ComputadorRESUMO
Objective To investigate the association of serum lipid,lipoprotein,apolipoprotein,leptin,cholecystokinin(CCK)and bile lipid with cholesterol gallstone formation.Methods The patients with gallstone were divided into cholesterol(n=99)and non-cholesterol(n=57)gallstone groups by infrared spectometry.And 52 healthy volunteers were served as control group.The concentrations of serum cholesterol,triglyceride,high and low density lipoproteins,apolipoprotein(Apo),leptin and CCK were measured and compared among three groups.The levels of total bile cholesterol,bile acid and lecithin were also detected.Results The concentrations of serum triglyeeride and total cholesterol in two gallstone groups were higher than those in control group(P value all<0.01).The level of Apo-B in cholesterol gallstone group was higher than that in control group(P=0.017).While the concentrations of high density lipoprotein and CCK were significantly lower in two gallstone groups than those in control group(P value all=0.000).Serum leptin was higher in male patients compared to controls(P<0.05).The bile cholesterol saturation index in two gallstone groups was above 1.Conclusions The changes of serum CCK,triglyceride,total cholesterol,high density lipoprotein,Apo-B and leptin may be correlated to the formation of gallbladder gallstone.
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<p><b>OBJECTIVE</b>The relationship between polymorphisms of ALAD and VDR genes and individual susceptibility of lead poisoning was investigated in children highly-exposed to lead.</p><p><b>METHOD</b>Four hundred and sixty-nine children were recruited into this study and the blood lead, ZPP, hemoglobin as well as three physical developmental indexes (head circumference, height and weight) were measured. VDR and ALAD gene polymorphisms were analyzed by the methods of PCR-RFLP.</p><p><b>RESULTS</b>The subjects with ALAD2 allele had higher ZPP level (10.12 micro mol/L vs 12.87 micro mol/L) (P = 0.017). The subjects with B allele has larger head circumference than only with b allele (51.19 cm vs 50.75 cm) (P = 0.028).</p><p><b>CONCLUSIONS</b>It was suggested that the ALAD gene polymorphism modified the relationship between blood lead and ZPP and the VDR gene variants influenced the skull development in children living under lead-polluted environment. The polymorphism of ALAD and VDR genes might serve as the molecular inherited factors modifying the susceptibility of lead poisoning.</p>
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Criança , Feminino , Humanos , Masculino , Alelos , Estatura , Genética , Peso Corporal , Genética , China , Epidemiologia , Poluição Ambiental , Frequência do Gene , Genótipo , Chumbo , Sangue , Intoxicação por Chumbo , Epidemiologia , Genética , Polimorfismo Genético , Sintase do Porfobilinogênio , Genética , Receptores de Calcitriol , GenéticaRESUMO
<p><b>OBJECTIVE</b>In order to minimize lead pollution and to protect the identified individuals with high blood lead level from lead contamination, an epidemiological study was carried on children living around the village and township-owned lead industries in Tianying town.</p><p><b>METHODS</b>Environmental monitoring: lead levels in air, soil, drinking water and crops were measured. Biological monitoring: 959 children aged 5 - 12 years were selected from villages where the lead smelters located near the residential areas and the battery disassembling was done in some families. The control children (207 pupils) were from other villages without lead exposure. Blood lead, ZnPP and teeth lead were determined. Height, weight and head circle of children and IQ scores were measured.</p><p><b>RESULTS</b>The environment was seriously polluted. The average lead concentrations in air and soils were 8.5 times and 10 times of the MACs (national health standard) respectively. Eighty-five per cent the air samples with lead concentrations higher than the national health standard. Local crops and wheat at farmers' home were also contaminated by lead dust, with. Lead content being 24 times higher than the standard. The mean blood lead and ZnPP levels of children lived in the polluted areas were 496 microgram/L and 9.41 microgram/g Hb respectively. The lead exposure caused adverse effects on children's IQ and physical development.</p><p><b>CONCLUSION</b>It is necessary to remove and reduce currently active sources of lead pollution in the community and to increase public awareness of potential health effects of lead exposure.</p>