Trends of substance abuse behavior among adolescents in Guangdong Province, 2007-2016 / 中国学校卫生

Objective@#To analyle prevalence and trend of substance abuse behaviors among adolescents in Guangdong province and to provide theoretical evidence for effective interventions.@*Methods@#Data regarding smoking, drinking, drugs abuse from Adolescents Health Risk Behavior Survey in 2007, 2010, 2013 and 2016 were collected and comparatively analyzed.@*Results@#The incidences of tried smoking(27.37%), current smoking(8.32%), passive smoking(45.52%), current drinking(27.97%) and drug using(0.75%) in 2016 were lower than that in 2007(32.40%, 10.81%, 52.69%, 31.97%, 1.35%), and the average annual decrease rate were 1.89%, 2.95%, 1.64%, 1.50%, 6.75%, respectively(χ2=152.73, 92.50, 313.92, 46.48, 46.64, P<0.01). During the past decate, the incidences of current smoking in rural adolescents(12.02%, 10.64%, 9.99%, 10.10%) were significantly higher than that in urban adolescents(8.88%, 8.52%, 8.17%, 6.56%)(χ2=54.46, 26.62, 25.23, 100.43, P<0.01); the incidences of current drinking in urban adolescents(33.57%, 30.37%, 35.76%, 30.46%) were significantly higher than that in rural adolescents(30.97%, 28.48%, 28.47%, 25.32%)(χ2=16.71, 10.13, 153.47, 81.76, P<0.01); the incidence of current drinking was the highest among college students in each monitoring year(47.71%, 41.76%, 42.36%, 37.77%)(χ2=583.37, 681.25, 610.04, 729.02, P<0.01); the incidence of current smoking was the highest among vocational school students in each monitoring year(16.36%, 17.00%, 14.90%, 16.71%)(χ2=256.45, 515.61, 339.63, 742.52, P<0.01); In addition to the incidence of drug abuse was the highest among college students in 2010(2.02%), vocational school students were the highest in other years(χ2=66.92, 34.38, 23.08, 20.55, P<0.01).@*Conclusion@#Smoking and drug abuse among adolescents in Guangdong showed a declining trend by years, as well as the prevalence of drinking behavior. Strengthened intervention should be targeted on smoking behavior among rural students, drinking behavior among urban students, and smoking behavior and drug abuse among vocational school students.

Increased red cell distribution width in patients with slow coronary flow syndrome

OBJECTIVE: An elevated red cell distribution width has been recognized as a predictor of various cardiovascular diseases. Slow coronary flow syndrome is an important angiographic clinical entity with an unknown etiology. This study aimed to examine the relationship between red cell distribution width and the presence of slow coronary flow syndrome. METHODS: In total, 185 patients with slow coronary flow syndrome and 183 age- and gender-matched subjects with normal coronary flow (controls) were prospectively enrolled in this study. Red cell distribution width and C-reactive protein were measured upon admission, and the results were compared between the patients with slow coronary flow syndrome and normal controls. RESULTS: Red cell distribution width levels were significantly higher in the patients with slow coronary flow syndrome than the normal controls. Moreover, the data showed that the plasma C-reactive protein levels were also higher in the patients with slow coronary flow syndrome than in the normal controls. In addition, a multivariate analysis indicated that C-reactive protein and red cell distribution width were the independent variables most strongly associated with slow coronary flow syndrome. Finally, the red cell distribution width was positively correlated with C-reactive protein and mean thrombosis in the myocardial infarction frame counts of the patients with slow coronary flow syndrome. CONCLUSION: The data demonstrated that red cell distribution width levels are significantly higher and strongly positively correlated with both C-reactive protein and thrombosis in the myocardial infarction frame counts of patients with slow coronary flow syndrome. These findings suggest that red cell distribution width may be a useful marker for patients with slow coronary flow syndrome. .

Revaluation of Clopidogrel: Let the Data Speak for Themselves / 华中科技大学学报（医学）（英德文版）

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.