Do low-serum vitamin E levels increase the risk of Alzheimer disease in older people? Evidence from a meta-analysis of case-control studies.

OBJECTIVE: Whether low-serum vitamin E increases the risk of Alzheimer disease (AD) in older people remains inconclusive. This meta-analysis aims to synthesize evidence-based case-control studies to evaluate the association between serum vitamin E and the risk of AD. METHODS: Potentially relevant studies were selected through PubMed, Embase, Wanfang, Chongqing VIP, and China National Knowledge Infrastructure databases by using the core terms Vitamin E/alpha-tocopherol and Alzheime's disease/senile dementia/AD in the titles, abstracts, and keywords of the articles. The association between serum vitamin E levels and AD was estimated by using the weighted mean difference (WMD) and 95% confidence interval by adopting a random effects model. Heterogeneity was assessed by using Cochran Q test and I2 statistic. Forest plot was used to present the results graphically from meta-analysis. Publication bias was evaluated by using funnel plots and Egger test. RESULTS: We identified 17 studies that met the eligibility criteria. The studies included 2057 subjects with 904 AD patients and 1153 controls. The results indicated that AD patients had a lower concentration of serum vitamin E compared with healthy controls among older people (WMD = -6.811 µmol/L, 95% confidence interval -8.998 to -4.625; Z = -6.105, P < .001). Publication bias was not detected and sensitivity analysis performed by omitting each study, and calculating the pooled WMD again for the remaining studies indicated the results stable. CONCLUSIONS: Alzheimer disease is associated with a low concentration of serum vitamin E in older people. However, necessary prospective cohort studies should be conducted to determine the risk of serum vitamin E for AD in the future.

Prevalence of suicide attempts among Chinese adolescents: A meta-analysis of cross-sectional studies.

OBJECTIVE: According to World Health Organization, for every committed suicide there were 20 suicide attempts at least. In the last decade, despite the increasing awareness on suicide attempts among adolescents in China, there has been no comprehensive system reporting vital statistics. Consequently, the prevalence of suicide attempts reported in some studies ranged variedly. Therefore, the purpose of this study was to provide the first meta-analysis of cross-sectional studies of suicide attempts to fill this gap. METHODS: Two reviewers independently screened potentially relevant cross-sectional studies of suicide attempts through PubMed-Medline, Embase, Wanfang Data, Chongqing VIP and Chinese National Knowledge Infrastructure databases using the core terms 'suicid*'/'suicide attempt*'/'attempted suicide' and 'adolescen*'/'youth'/'child*'/'student*' and 'China'/'Chinese' in the article titles, abstracts and keywords. Chi-square based Q test and I(2) statistic assessed the heterogeneity. Forest plot was used to display results graphically. Potential publication bias was assessed by the funnel plot, Begg's and Egger's test. RESULTS: In total, 43 studies with 200,124 participants met the eligibility criteria. The pooled prevalence of suicide attempts among Chinese adolescents was 2.94% (95% CI: 2.53%-3.41%). Substantial heterogeneity in prevalence estimates was revealed. Subgroup analyses showed that the prevalence for males was 2.50% (95% CI: 2.08%-3.01%), and for females was 3.17% (95% CI: 2.56%-3.91%). CONCLUSIONS: In sum, abstracting across the literatures, the prevalence of suicide attempts among Chinese adolescents was moderate compared with other countries around the world. Necessary measures should be set out prevent them in the future.

The prevalence of suicidal ideation among the elderly in China: a meta-analysis of 11 cross-sectional studies.

OBJECTIVE: This study aimed to estimate the pooled prevalence of suicidal ideation among Chinese elderly aged ≥ 60 years. METHODS: Two reviewers independently searched the potentially relevant studies through electronic database (PubMed-Medline, Embase, Wanfang Data, Chinese National Knowledge Infrastructure and Chongqing VIP) using key terms 'suicid', 'suicidal ideation' combined with 'aged', 'elderly' and 'old people'. All selected studies should meet the eligibility criteria in this study. Chi-square based Q test and I(2) statistic assessed the heterogeneity. Forest plots were used to display results graphically. Potential publication bias was assessed by the funnel plot and Begg's test. Prevalence rate was meta-analysed. RESULTS: In total, 11 studies were included with 11,526 subjects. The prevalence of suicidal ideation among Chinese elderly ranged from 2.2% to 21.5%. The pooled prevalence of all 11 studies was 11.5% (95% CI: 8.3%-14.8%). Subgroup analyses showed the prevalence for males was 11.0%, and for the females was 15.6%. In three subgroups for age, 60-69, 70-79 and ≥ 80, the prevalence was 9.1%, 12.1% and 18.9% respectively. A slightly higher prevalence in rural areas was calculated than in urban (14.7% vs. 11.8%). In mainland China, the prevalence was 12.6%. And in Taiwan and Hongkong, the pooled prevalence was 9.2%. CONCLUSIONS: The prevalence of suicidal ideation was relatively high among elderly in China, and it should attract enough attention.

Visual analysis of global hemorrhagic fever with renal syndrome research from 1980 to 2022: Based on CiteSpace and VOSviewer.

OBJECTIVE: The development and current state of hemorrhagic fever with renal syndrome (HFRS) over the past 40 years are analyzed in this study, along with explored and discovered the hotspots and frontiers in the field, which serve as the foundation for future investigation. METHODS: CiteSpace and VOSviewer analysis software were used to visually analyze the literature data on HFRS from 1980 to 2022, including the annual number of publications, countries and research institutions, authors, co-cited literature and keywords. RESULTS: The number of pertinent papers published in the field of HFRS displayed an overall upward trend from 1980 to 2022. The United States, China, Germany, Sweden, and France are the top 5 countries in terms of publishing volume, with high intermediate centrality mainly concentrated in Europe and the United States. The top 10 co-occurring keywords were hemorrhagic fever, renal syndrome, infection, virus, epidemic, nephropathia epidemical, disease, hantavirus, outbreak, and transmission. According to keyword cluster analysis, there were 4 main research fields. In the HFRS-related study, there were mainly 21 notable keywords and "Korean hemorrhagic fever" had the highest hemorrhagic value (28.87). CONCLUSION: The United States, China, Germany, Sweden and other countries attached great importance to the HFRS-related research. Moreover, the collaboration between authors and institutions in various collaborator clusters should be strengthened. In recent decades, investigations have focused on the study of viral infection and the clinical symptoms and pathophysiology of HFRS. Future research may concentrate on factors affecting host population distribution and density, such as vaccine development and meteorological factors pertaining to virus transmission.

Obesity and depressive symptoms in the elderly: a survey in the rural area of Chizhou, Anhui province.

OBJECTIVE: The aim of the present study is to examine the relationship between obesity and depressive symptoms and to test the "Jolly Fat" hypothesis among older Chinese. METHODS: A total of 736 rural Chinese aged 60 years and older participated in this cross-sectional study. Body mass index (BMI = kg/m(2) ) was calculated from the subjects' measured weight (kg) and height (meter). Depressive symptoms were assessed using the 30-item Geriatric Depression Scale (GDS-30), with a cut-off point of 11. RESULTS: Among 736 total participants, the prevalence of depressive symptoms was 24.1% in men and 27.9% in women. A trend about depressive symptoms decreased with increasing BMI was found in men (χ(2) trend = 5.74, df = 1, p = 0.01). A weak inverse linear trend between obesity and depressive symptoms was observed among subjects. In men, obese group was less likely to suffer from depressive symptoms compared with normal weight group before or after adjustment for confounders, with odds ratios of 0.32 (95% confidence interval (CI): 0.12-0.85) and 0.28 (95% CI: 0.09-0.85), respectively. However, the association between BMI and depressive symptoms in women showed no significant differences. CONCLUSIONS: Our results supported the "Jolly Fat" hypothesis only in rural older Chinese men, but not in women. Gender differences existed in the relationship between obesity and depressive symptoms.

Epidemiology of COVID-19 in Jiangxi, China: A retrospective observational study.

ABSTRACT: To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) in Jiangxi Province, China, from January 21 to April 9, 2020.COVID-19 epidemic information was obtained from the official websites of the Jiangxi Provincial Health Committee, Hubei Provincial Health Committee, and National Health Commission of the People's Republic of China. ArcGIS 10.0 was used to draw a map of the spatial distribution of the cases.On January 21, 2020, the first COVID-19 confirmed case in Jiangxi was reported. By January 27, COVID-19 had spread rapidly to all cities in Jiangxi. The outbreak peaked on February 3, with a daily incidence of 85 cases. The last indigenous case reported on February 27. From January 21 to April 9, a total of 937 confirmed cases of COVID-19 were reported, with a cumulative incidence of 2.02/100,000. Of those, 936 patients (99.89%) were cured, and 1 (0.11%) died due to COVID-19. The COVID-19 epidemic trend in Jiangxi was basically consistent with the national epidemic trend (except Hubei). Throughout the epidemic prevention and control phase, Jiangxi province has taken targeted prevention and control measures based on the severity of the spread of COVID-19.The COVID-19 epidemic in Jiangxi was widespread and developed rapidly. In less than 1 month, the epidemic situation was effectively controlled, and the epidemic situation shifted to a low-level distribution state. All these proved that the COVID-19 prevention and control strategies and measures adopted by Jiangxi Province were right, positive and effective.

HIV infection and risk of COVID-19 mortality: A meta-analysis.

BACKGROUND: This meta-analysis aimed to estimate the association of human immunodeficiency virus (HIV) infection and risk of coronavirus disease 2019 (COVID-19) mortality. METHODS: We systematically retrieved articles published on HIV infection and risk of COVID-19 mortality through PubMed, EMBase, China National Knowledge Infrastructure, WanFang, and Chongqing VIP databases using a predefined search strategy from December 1, 2019 to January 31, 2021. Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Cochran Q test and I2 statistics were quantified to measure heterogeneity. Odds ratio (OR) and 95% confidence intervals (CI) were computed and displayed in the form of forest plots. Subgroup analysis was performed to explore the source of heterogeneity. Funnel plot, Begg test, and Egger test were used to assess potential publication bias. Stata software version 11.0 was used to analyze all the statistical data. RESULTS: We included 10 studies with 18,122,370 COVID-19 patients, of whom 41,113 were with HIV infection and 18,081,257 were without HIV infection. The pooled overall results suggested that people living with HIV infection had a higher risk of mortality from COVID-19 than those without HIV infection (OR = 1.252, 95% CI 1.027-1.524). Subgroup analysis showed that people living with HIV infection had a higher risk of COVID-19 mortality than those without HIV infection in the United States (OR = 1.520, 95% CI 1.252-1.845) and in South Africa (OR = 1.122, 95% CI 1.032-1.220); however, no significant association was found in the United Kingdom (OR = 0.878, 95% CI 0.657-1.174). CONCLUSION: Patients with HIV infection should be the emphasis population to prevent the risk of mortality during the clinical treatment of COVID-19 patients.

No association between abortion and risk of breast cancer among nulliparous women: Evidence from a meta-analysis.

BACKGROUND: Various epidemiological studies have demonstrated the association between abortion and risk of breast cancer among nulliparous women; however, results remain inconclusive. This meta-analysis assessed the association based on previous studies. METHODS: PubMed, EMBase, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang databases were searched for relevant articles until February 2018. In this meta-analysis, fixed-effects models were used to estimate the combined effect size and the corresponding 95% confidence interval (CI). All statistical data were analyzed using STATA 12.0. RESULTS: A total of 14 articles consisting of 6 cohort studies and 8 case-control studies were included in this review. All articles were of high quality, as determined based on the Newcastle Ottawa Scale assessment. The combined risk ratio (RR) indicated no significant association between abortion and breast cancer among nulliparous women (RR = 1.023, 95%CI = 0.938-1.117; Z = 0.51, P = .607). Subgroup analyses revealed no significant associations between risk of breast cancer and induced abortion or between risk of breast cancer and spontaneous abortion (SA) among nulliparous women (RR = 1.008, 95% CI = 0.909-1.118 and RR = 1.062, 95%CI = 0.902-1.250, respectively). Neither 1 nor >2 abortions increased the risk of breast cancer among nulliparous women. Sensitivity analysis showed that our results were reliable and stable. CONCLUSION: Current evidence based on epidemiological studies showed no association between abortion and risk of breast cancer among nulliparous women.

Association of Mycoplasma fermentans and the risk of HIV-1 infection: A meta-analysis.

BACKGROUND: Previous studies have reported the association between Mycoplasma fermentans (M. fermentans) and the risk of human immunodeficiency virus 1 (HIV-1) infection, but the results were inconsistent. The present study aims to systematically review reported studies on M. fermentans and its association with HIV-1 infection, as well as to summarize the findings using a meta-analysis. METHODS: Studies meeting the inclusion criteria in the PubMed, Embase, China National Knowledge Infrastructure, WanFang Data, and Chongqing VIP databases up to March 2019 were identified. Cochran Q and I statistics were used to assess heterogeneity. Additionally, pooled odds ratio (OR) with 95% confidence intervals (CI) were calculated and displayed by Forest plots. Also, the funnel plot, Begg test, and Egger test were used to evaluate potential publication bias. In addition, the source of heterogeneity was investigated by subgroup and sensitivity analyses. RESULTS: A total of 11 studies comprising 1028 HIV-1-positive patients and 1298 controls were ultimately included in this meta-analysis. Our results indicated that M. fermentans could increase the risk of HIV-1 infection among humans (OR = 3.66, 95%CI 1.26-10.64). Subgroup analysis showed that the risk of HIV-1 infection associated with M. fermentans was, based on the geographical distribution, 1.19 (95%CI 0.33-4.33) in Europe, 2.83 (95%CI 0.94-8.52) in United States, 11.92 (95%CI 3.93-36.15) in Asia; based on the source of the sample, 2.97 (95%CI 0.89-9.95) in blood samples, 4.36 (95%CI 1.63-11.68) in urine samples; based on the detection method, 2.80 (95%CI 0.72-10.96) with the polymerase chain reaction method, 5.54 (95%CI 1.21-25.28) with other detection methods; based on the source of controls, 1.91 (95%CI 0.53-6.89) in sexually transmitted diseases individuals, and 8.25 (95%CI 2.16-31.60) in health individuals. CONCLUSION: Our study revealed evidence of the association between M. fermentans and HIV-1 infection. Considering the heterogeneity, further studies are warranted to understand the relationship between M. fermentans and HIV-1 infection.

A systematic review of clinical studies on electrical stimulation therapy for patients with neurogenic bowel dysfunction after spinal cord injury.

BACKGROUND: This study aimed to perform a systematic literature review of the clinical trial evidence on electrical stimulation for the treatment of neurogenic bowel dysfunction (NBD) after spinal cord injury (SCI). METHODS: Systematic electronic searches were carried out in the PubMed/Medline, EMBASE, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure databases, along with the reference lists in the include studies. Studies were eligible for inclusion if they adopted a controlled clinical design based on human population, the patients suffered from spinal cord injury, the main outcomes were the disorders of bowel function and the intervention was electrical stimulation. Also, the language was limited to English and Chinese. RESULTS: Eleven studies were included in this systematic review, comprising transcutaneous electrical stimulation, transrectal bowel stimulation, sacral nerve stimulation, intravesical electrical stimulation, etc. Of the 11 studies, 3 were randomized controlled trials, 8 were controlled before-and-after trials. The quality of the included studies was moderate bias risk. Most studies revealed that the electrical stimulation was beneficial for the patient with NBD after SCI. CONCLUSIONS: Only 11 small clinical studies with 298 participants have evaluated the efficacy of electrical stimulation for NBD after SCI. Although some studies showed electrical stimulation was benefit for the patient with NBD after SCI, there was currently not enough evidence to support the use of electrical stimulation could improve the clinical symptoms of those patients. Thus, well-designed randomized controlled trials with larger patient population are warranted to establish its benefit in clinical practice in the future.

Meta-analysis of computed tomography angiography versus magnetic resonance angiography for intracranial aneurysm.

BACKGROUND: Whether the diagnosis value of computed tomography angiography (CTA) for intracranial aneurysm is in accordance with magnetic resonance angiography (MRA) remains inconclusive. This meta-analysis aims to synthesize relevant studies to compare the diagnostic efficacies of the 2 methods. METHODS: Potentially relevant studies were selected through PubMed, Embase, Wanfang, Chongqing VIP, and China National Knowledge Infrastructure databases by using the core terms "computer tomography angiography" (CTA) and "magnetic resonance angiography" (MRA) and "intracranial aneurysm*" in the titles, abstracts, and keywords of the articles. Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2) was utilized to evaluate the quality. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were count. Summary receiver operating characteristic curves (SROC) and area under the curve (AUC) were used to summarize the overall diagnostic performance. Statistical analyses were performed by Stata version 12.0 and MetaDisc 1.4 software. RESULTS: Ten articles were identified in this current paper. For CTA, the pooled estimates of diagnostic parameters for intracranial aneurysm were as follows: sensitivity, 0.84 (95%CI = 0.81-0.86); specificity, 0.85 (95%CI = 0.79-0.89); PLR, 4.09 (95%CI = 2.45-6.81); NLR, 0.18 (95%CI = 0.11-0.28); DOR, 23.74 (95%CI = 10.49-53.74); AUC, 0.90, respectively. For MRA, the pooled estimates of diagnostic parameters for intracranial aneurysm were as follows: sensitivity, 0.80 (95%CI = 0.77-0.83); specificity, 0.87 (95%CI = 0.82-0.91); PLR, 3.61 (95%CI = 1.72-7.55); NLR; 0.27 (95%CI = 0.21-0.35); DOR, 16.77 (95%CI = 7.38-38.11); AUC, 0.87, respectively. No significant difference was found the AUC value between CTA and MRA for intracranial aneurysm (Z = 0.828, P > .05). CONCLUSION: This comprehensive meta-analysis demonstrated that the diagnosis value of CTA was in accordance with MRA for intracranial aneurysm. However, considering the limitation of sample size, the results should be treated with caution.

Link between risk of colorectal cancer and serum vitamin E levels: A meta-analysis of case-control studies.

BACKGROUND: The effect of low serum vitamin E levels on the risk of colorectal cancer (CRC) remains inconclusive. This meta-analysis aims to synthesize relevant studies to evaluate the association between serum vitamin E and the risk of CRC based on case-control studies. METHODS: Potentially relevant studies were selected by searching PubMed, EMBASE, and China National Knowledge Infrastructure databases according to inclusion and exclusion criteria. The association between serum vitamin E levels and CRC was estimated by the weighted mean difference (WMD) and 95% confidence interval (CI) using a random-effects model. Heterogeneity was evaluated using Q test and I statistic. Subgroup analysis was conducted to explore sources of heterogeneity. Sensitivity analysis was performed to reveal stability and reliability. RESULTS: A total of 10 papers with 11 studies, including 6431 subjects with 520 CRC patients and 5981 controls, were included in this present meta-analysis. The results indicated that compared with healthy controls, patients with CRC showed lower concentrations of serum vitamin E (WMD = -2.994 µmol/L, 95% CI = -4.395 to -1.593). Ethnicity subgroup analysis indicated that the serum vitamin E levels were lower in European (WMD = -1.82 µmol/L, 95% CI = -3.00 to -0.65), but not in Asian. Control-source subgroup analysis revealed that a significant association was observed in subgroup with hospital-based controls (WMD = -3.43 µmol/L, 95% CI = -6.27 to -0.59), but not in those with population-based controls. Sensitivity analysis suggested no significant difference in the pooled estimates, indicating stable results. CONCLUSIONS: CRC is associated with a lower concentration of serum vitamin E. However, necessary prospective cohort studies should be conducted to assess the effect of serum vitamin E on the risk of CRC in the future.

Characterization and factors associated with sleep quality among rural elderly in China.

This article elucidates on sleep quality characterization and its associated factors among the Chinese elderly in the rural areas of Anhui province. We conducted a questionnaire survey on 2700 elderly individuals, from whom we obtained 2416 valid responses. The sleep quality, health-related quality of life (HRQoL), and functional status of the subjects were assessed using the Pittsburgh Sleep Quality Index (PSQI), Short Form-36 (SF-36), and Activities of Daily Living (ADL) scales. Body Mass Index (BMI) was obtained by measuring the height and weight of the subjects. The results showed that 49.7% of the participants slept poorly. Binary logistic regression analysis indicated that chronic disease, advanced age, low quantities of staple food (g), rice as major food, poor Physical Component Summary (PCS), poor Mental Component Summary (MCS), and significant dysfunction of ADL were predictors for poor sleep quality. However, no association was found between BMI and sleep quality. As half of the rural elderly in China were found to suffer from poor sleep quality, comprehensive measures should be undertaken to improve this situation.

[Sleep and quality of life among rural elderly in Anhui province].

OBJECTIVE: The primary purposes of this article were to examine the distributions and correlation between conditions of sleep and the quality of life, so as to explore the risk factors of abnormal sleep among elderly in the rural areas of Anhui province. METHODS: Elderly who aged 60 years or more (n = 1680) were randomly selected from rural areas in Anhui province. Conditions of sleep and quality of life of the subjects were assessed independently, using the pittsburgh sleep quality index (PSQI) scale and SF-36 scale. A generalized logistic model analysis was performed, using sleep-related factors as explanatory variables. RESULTS: The average PSQI score was 7.43 +/- 4.13. Persons whose sleep conditions were graded as well, common or poor were accounted for 29.4%, 24.3%, 46.3%, respectively. Sex and sleep quality were different in terms of quality of life among all the factors(P < 0.05). Men had better quality than women, and poor sleepers had poorer quality of life as compared to the one with better conditions. Factors as being married/living alone/economically independent, having better social function, often eating meat or wheat were significant predictors for having good sleep conditions. However, factors as better education received, living alone, with poor vitality/general health, having chronic diseases (back pain, coronary heart or stomach disease), less meat intake, rice as major foods etc. were predictors for poorer sleeping condition. CONCLUSION: Our data showed that it was unsatisfactory on the quality of sleep among the rural elderly in Anhui province. Conditions on general, health and nutrition should be improved in order to prevent the poor sleep condition.