Role of alcohol-metabolizing enzymes gene polymorphisms and environmental exposure on colorectal cancer: a case-only study / 中华流行病学杂志

<p><b>OBJECTIVE</b>This study was designed to explore the interactions of alcohol dehydrogenase 1B (ADH1B) rs1229984, aldehyde dehydrogenase 2 (ALDH2)(rs671) and cytochrome P4502E1(CYP2E1)rs1329149 with environmental factors and the interactions between genetic factors in the susceptibility of colorectal cancer (CRC). Roles of genetic factors in the development of colorectal cancer were also studied.</p><p><b>METHODS</b>With a case-only study design, 472 colorectal cancer cases were enrolled between 2007 and 2009 in this study. Data on demographic characteristics, histories of environmental exposure and clinico-pathological parameters were obtained from all the participants through written questionnaires. Genotypes were determined by Sequenom MassARRAY system. Unconditional logistic regression analysis was employed to explore the gene-environment interactions and gene-gene interactions. χ(2) test and unconditional logistic regression were used to evaluate the roles of polymorphisms on the risk of metastasis to CRC.</p><p><b>RESULTS</b>Overweighted individuals that carrying at least one of the ADH1B rs1229984 G alleles presented significant increase on the risk to colorectal cancer(OR = 1.720, 95%CI:1.038-2.848,ORadj = 1.785, 95%CI:1.061-3.002). Modest interaction was seen between smoking and ADH1B(rs1229984) only before the adjustment of data, by sex, age and drinking status(OR = 0.597, 95% CI:0.387-0.921, ORadj = 0.922, 95%CI:0.509-1.669). Correlations between polymorphisms and the Dukes stage were not found.</p><p><b>CONCLUSION</b>Overweight presented significant interaction with G allele of ADH1B rs1229984 in the susceptibility of CRC. None of the rs1229984, rs671 and rs1329149 exhibited significant influence on the development of CRC.</p>

The application of integrated surveillance system for symptoms in surveillance of influenza among children / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the integrated application of sales of child-specific over-the-counter (OTC) cold related medications in retail pharmacies and healthcare visits of children for influenza-like illness (ILI) in surveillance and early warning of influenza among children.</p><p><b>METHODS</b>An integrated surveillance system (ISS) was implemented since 2012 in Qianjiang County, a rural area in Hubei Province of China. The daily information from August 1, 2012 to February 28, 2013 of health care visits of children for ILI reported by 80 health facilities and sales of 14 child-specific over-the-counter (OTC) cold related medications reported by 11 pharmacies were extracted from ISS database. Cumulative sums (CUSUM) model was conducted to analyze the degree of fitting and the early warning signal generated; the correlationship was then analyzed further.</p><p><b>RESULTS</b>In 212 days, 983 visits of children for ILI and 12 819 sales by person of child-specific OTC were reported. Conducting CUSUM model, the fitting degree was in the acceptable range, 31 warning signals were generated from ILI data series with 3 peak periods and 14 from OTC data series with 2 peak periods. A similar time trend of two data series was observed with a correlation(r = 0.497, P < 0.05), but without any spatial clustering. And the optimal correlation(r = 0.505, P < 0.05) appeared at a time offset of 4 days preceded by OTC sales.</p><p><b>CONCLUSION</b>The availability of integrated surveillance system for symptoms could be applied for surveillance of influenza among children; while it could explore the possibility of real epidemic in the very early stage.</p>

Study on the risk factors of tuberculosis in four cities and provinces in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the influencing factors on tuberculosis (TB) in four provinces in the eastern and central parts of China.</p><p><b>METHODS</b>From Nov. 2009 to Feb. 2011, three population-based field surveys were conducted among the resident population in several townships/streets in Guangdong, Hunan and Jiangsu provinces and Shanghai municipality to collect TB-related information. 474 sputum smear positive TB patients and 1896 controls were randomly selected from the population under study and each case was matched by province, age and sex using a frequency matching method. Single-variable and multiple non-conditional logistic regression modeling were applied for data analysis, and odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated.</p><p><b>RESULTS</b>Data from Single-variable analysis showed that TB history, history of exposure to TB, DM history, immigrant population and per-capita living space were risk factors for TB, and high level of education was protective factors.</p><p><b>RESULTS</b>from multiple logistic regression showed that the risk factors of TB would include the following items: history of having had TB (OR = 52.356, 95%CI: 18.956 - 144.607), living space over 50 m(2)per-capita (OR = 8.742, 95%CI: 1.107 - 69.064), history of exposure to TB (OR = 6.083, 95%CI: 2.336 - 15.839) and being immigrants (OR = 3.306, 95%CI: 1.907 - 5.734), while having had high degree of education as the protective factor of TB (OR = 0.284, 95%CI: 0.110 - 0.733).</p><p><b>CONCLUSION</b>Control programs targeting those ever having TB patients and contacts to TB patients as well as immigrants should be strengthened.</p>

Depression and associated factors among migrant women of reproductive age in some areas of Wuhan / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand factors as social support, situation of depression and related risk factors among migrant women of reproductive age in some areas of Wuhan.</p><p><b>METHODS</b>Cluster sampling method and face-to-face interview with structured questionnaire were used to investigate 316 migrant women in Wuhan.</p><p><b>RESULTS</b>The overall prevalence rate of depression was 32.3%.</p><p><b>RESULTS</b>from binary logistic regression analysis showed that factors as: under pressure (OR = 4.010, 95%CI: 1.672 - 9.617), having had negative life events (OR = 2.050, 95%CI: 1.170 - 3.591) or tight relations with neighbors (OR = 2.537, 95%CI: 1.053 - 6.113), not quite satisfied (OR = 4.247, 95%CI: 1.521 - 11.855) or satisfied (OR = 2.411, 95%CI: 1.111 - 5.233), on his/her own health status etc., might serve as the possible risk factors for depression. In scores related to social support, and the utilization of such support, there were statistically significant differences seen between the groups with depression and the one without.</p><p><b>CONCLUSION</b>The prevalence of depression among migrant women of reproductive age appeared to be high in some areas on Wuhan. Factors as: under pressure, having had negative life events, tight relations with neighbors, status on satisfaction of one's own health situation as well as related social support, seemed to be the main risk factors for depression in this population.</p>

Application of log-linear model in the case-parent triad study / 中华流行病学杂志

We were introducing a log-linear model for case-parent triad study.Data from a previous study of the association between MTHFR C677T aud cleft lip with or without cleft palate (CL/P) was analyzed,in order to investigate the maternal effect,fetal effect and their interaction,using a series of log-linear models.Our results showed that mothers who were carrying two copies of MTHFR C677T variant alleles appeared to have reduced the risk of CL/P in offspring,comparing to those with homozygous of wild-type allele.With S2=0.43 (95％ CI:0.19-0.95).No significant association was found for fetal genotype and maternal-fetal iuteraction with CL/P.Log-linear model method seemed to be useful in the estimation of maternal effect,fetal effect and maternal-fetal interaction,in the case-parent triad study design.This approach showed specific benefit in studies that related to genetic effects on complex diseases such as pregnancy complications and diseases originated from fetus.

Construction of surveillance and early-warning-index-system on tuberculosis in China / 中华流行病学杂志

Objective To establish the surveillance and warning index system corresponnding with the epidemic characteristics of tuberculosis,in China.Methods Literature review and expert meeting were conducted to formulate the preliminary index system frame.Delphi method was used for screening the index and determining the weight of each index.Results Two-round Delphi consultations were performed.The activity coefficients were 87.0％,90.0％ respectively,with means of authority coefficient as 0.850 ± 0.055 and 0.917 ± 0.017,respectively.Mean scores of the index were 7.063 ± 1.435,8.156 ± 0.611 respectively,with the means of coefficient of variation as 0.352 ±0.161 and 0.170 ± 0.057 respectively.The harmony coefficients were 0.322 (x2=499.472,P＜0.05)and 0.393 (x2=241.126,P＜0.05) respectively.After the two-round consultation,the tuberculosis monitoring and warning index system was developed,including 4 first-class indicators,9 second-class indicators and 48 third- class indicators.Conclusion An index system was established for tuberculosis monitoring and early warning that could provide evidence for tuberculosis prevention and control as well as for the forecasting and warning model of the disease.

The influence of T lymphocyte activation on HIV-1 susceptibility of Han Chinese / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the influence of T lymphocyte activation on HIV-1 susceptibility of Han Chinese.</p><p><b>METHODS</b>In 2008, 37 HIV-1 highly exposed persistently seronegative individuals (ESNs) and 101 healthy controls were screened from Shenzhen. Flow cytometer was used to assay the expression difference of HIV-1 infection related co-receptor, the difference between the two groups were analyzed by Mann-Whitney U statistics methods.</p><p><b>RESULTS</b>T cell HLA-DR(+) CD4 T cells and HLA-DR(+) expression of ESNs (12.64 (5.94 - 21.90), 21.12 (10.74 - 30.21)) were all significantly lower than that of healthy controls (22.52 (7.91 - 58.60), 32.28 (14.72 - 67.82)) (P values all < 0.05). T cell CD45RA-RO(+), CCR5(+)CD4 expression of ESNs (58.68 (49.06 - 72.44), 21.93 (15.84 - 25.89)) were all significantly higher than that of healthy controls (53.17 (42.63 - 63.21), 16.14 (11.94 - 21.98)) (P values all < 0.05). T cell CXCR4(+)CD4 T cells expression of ESNs (93.67 (92.17 - 94.96)) was significantly lower than that of healthy controls (95.16 (92.99 - 96.77)) (P values all < 0.05). Healthy controls and ESNs could be divided into low expression group and high expression group according to HLA-DR(+)CD8 T cells bimodal distribution. A total of 89.2% (33/37) ESNs fell into HLA-DR + CD8 low expression group, and 58.4% (59/101) of the healthy controls located in low expression group (P < 0.05).</p><p><b>CONCLUSION</b>To Han Chinese, the low activation status of T lymphocyte has significant correlation with HIV-1 low susceptibility.</p>

The application of artificial neural networks to predict individual risk of essential hypertension / 中华流行病学杂志

Objective To establish models to predict individual risk of essential hypertension and to evaluate and explore new forecasting methods. Methods To select data of 3054 community residents from a epidemiological survey and divided them into 4 : 1 (2438 cases and 616 cases) ratio in accordance with the balance of age and sex to filter variables, and to establish, test and evaluate the prediction models. Using artificial neural network (ANN) and logistic regression analysis to establish models while applying ROC to evaluate the prediction models. Results Forecast results of the models applying to the test set proved that ANN had lower specificity but better veracity and sensitivity than logistic regression.In particular, the Youden's index of the ANN2 came up to 0. 8399 which was distinctly higher than the other two models.When the area was under the ROC curve of logistic regression, the ANN1 and ANN2 models equaled to 0. 732±0. 026,0. 900±0. 014 and 0. 918±0. 013 respectively, which proved that the ANN model was better in the prediction about individual health risk of essential hypertension. Conclusion Our results showed that ANN method seemed better than logistic regression in terms of predicting the individual risk from hypertension thus supplied a new method to solve the forecast of individual risk.

Study on the prognostic factors of colorectal cancer and on suggested model for prediction / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the factors related to the prognosis of colorectal cancer (CRC) and to establish a prognostic model for evaluating the prognosis of the patients with CRC.</p><p><b>METHODS</b>370 cases with CRC were selected in the study and clinical/pathological factors were collected and patients were followed. Kaplan-Meier method was used to calculate survival rate. Log-rank test and proportional-hazards regression model (Cox model) were used for univariate and multivariate analysis. Log cumulative hazards function plot was used to test Cox model proportional-hazards assumption (PH assumption). Prognostic index (P1) was calculated based on the results of multivariate analysis.</p><p><b>RESULTS</b>(1) One-year, three-year and five-year survival rates were 90.5%, 78.3% and 76.5% respectively. (2) Lymphatic metastasis, Duckes classification and therapeutic measure were independent prognostic factors of CRC and all passed PH assumption. (3) Patients with different PI were classified into 3 groups and there were significant differences noticed in survival rates (P < 0.001). (4) Individual survival rate was evaluated based on the prognostic Cox model and PI.</p><p><b>CONCLUSION</b>Lymphatic metastasis, Duckes classification and therapeutic measure were independent prognostic factors of CRC. To test PH assumption of the factors, selection of Cox model was essential. Cox model and PI seemed to be available in predicting the long term survivrate of patients with CRC.</p>

Evaluation on the highly active anti-retroviral therapy in 181 AIDS patients / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the clinical effect under highly active anti-retroviral therapy (HAART) in AIDS patients and for improving the curative effect and prognosis.</p><p><b>METHODS</b>Epidemiological method was used from five aspects to describe the post-treatment clinical symptoms of 181 AIDS patients in Suizhou, and to evaluate the change of virus load and immune function of 79 AIDS patients. Data was doubly recorded by Epi Data and database was set up by SPSS 13.0 for analysis.</p><p><b>RESULTS</b>The effective powers of anomal-fever, cough, diarrhoea, lymphadenectasis, weight drop, erythra, mycotic infection were 81.39%, 85.00%, 84.62%, 81.89%, 82.86%, 66.07% and 45.45% respectively. CD4+ T lymphocyte count rose obviously after treatment, with an averag of 276 x 10(6) cells/ml (65 x 10(6)-824 x 10(6) cells/ml), an 129 x 10(6) cells/ml increase in three months and was 294 x 10(6) cells/ml (102 x 10(6)-750 x 10(6) cells/ml) in six months. The count change of CD4+ T lymphocyte between 3 months and 6 months did not show sigificant difference. The number of deaths among drug withdrawals was 14, with a case fatality rate as 29.79%; while the number of deaths among non-drug withdrawals was 3, with the case fatality rate as 2.24%.</p><p><b>CONCLUSION</b>Results through this study showed that HAART could obviously improve the clinical symptom of AIDS patients, and to increase the number of virus load. Improving the compliance could also reduce the case fatality rate.</p>

The relationship between the potential years of life lost of lung cancer and air pollution in Wuhan / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the present situations of lung cancer in Wuhan and to explore the relationship between the potential years of life lost of lung cancer and air pollution, especially vehicle emissions.</p><p><b>METHODS</b>Data gathered between 1986 and 1995 in Wuhan city, including air pollution and tobacco production and data on lung cancer between 1991 and 2000 were collected extensively. Simple Correlation and Grey Relational Analysis were used to analyze the relationship of them.</p><p><b>RESULTS</b>There was a ascending tendency in variance of oxides of nitrogen (NOx). The degree of grey incidence (DGI) between the concentration of air pollutants and the male's or female's potential years of life lost of lung cancer (PYLL) were calculated respectively. In males, the values of DGI were 0.6702, 0.7071, 0.6199 on sulfur dioxide (SO2), NOx, total suspensions (TSP) respectively. In females,the values of DGI were 0.6188, 0.8555, 0.5842 according to the same order as listed above. Significant positive correlation was found between the concentration of NOx and with lung cancer in both males and females by spearman correlation test (rmale = 0.63523, P = 0.0484; rfemale = 0.76396, P = 0.0101).</p><p><b>CONCLUSION</b>With the fast growing speed of the quantity of vehicles, pollution of vehicle emission-caused air pollution posed an important risk factor for lung cancer, despite the fact that tobacco smoking still played the leading role.</p>

A case-control study on congenital heart diseases with methylenetetrahydrofolate reductase gene, cystathionine beta-synthase gene, and environmental factors / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore congenital heart diseases (CHD) in their offsprings in association with parental methylenetetrahydrofolate reductase (MTHFR) gene C677T, cystathionine beta-synthase (CBS) gene T833C, and environmental factors.</p><p><b>METHODS</b>A 1:1 case-control study was carried out to investigate 115 pairs of case and controlled children and their parents, and the parents' MTHFR gene 677 C-->T mutation and CBS gene 833 T-->C mutation were also identified. The possible risk factors were analysed by simple and multiple factors logistic regression methods.</p><p><b>RESULTS</b>Results revealed that 5 factors were related to the occurrence of CHD in the offsprings: maternal exposures to pesticides in the early stage of pregnancy (OR = 8.62), suffering from diseases during pregnancy (OR = 2.069), catching cold in the early stage of pregnancy (OR = 4.125), under depressed or nervous condition during pregnancy (OR = 4.653), maternal MTHFR 677TT genotype (OR = 3.872).</p><p><b>CONCLUSION</b>These results suggested that maternal MTHFR 677TT genotype was one of the risks to the occurrence of CHD in offspring but parents' CBS gene 833 T-->C mutation did not get involved in CHD. In addition, the occurrence of CHD was related to maternal exposures to pesticides, catching a cold, suffering from diseases, depressed or under nervous condition in the early stage of pregnancy or during pregnancy.</p>

Study on the relations between serum insulin-like growth factor-1, insulin-like growth factor binding protein-3 and colorectal cancer: a meta-analysis / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between circulating levels of insulin-like growth factor-1 (IGF-1), IGF-binding protein-3 (IGFBP-3) and colorectal cancer.</p><p><b>METHODS</b>A meta-analysis of 6 epidemiological studies on insulin-like growth factors and risk of colorectal cancer were performed.</p><p><b>RESULTS</b>The pooled odds ratio (OR) of IGF-1 and IGFBP-3 were 1.56 (95% CI: 1.14-2.13) and 0.78 (95% CI: 0.43-1.44) respectively. According to the results from different measurements (enzyme-linked immunoabsorbent assay and immunoradiometric assay), the pooled OR were 1.92 and 1.23 for IGF-1, 0.46 and 1.44 for IGFBP-3 respectively.</p><p><b>CONCLUSION</b>High serum levels of IGF-1 were independent risk factors of colorectal cancer but the OR of IGFBP-3 was not statistically significant. The heterogeneity between studies on IGFBP-3 and colorectal cancer was caused by different measurements used, but there was still a need to conduct simultaneous large size study under 2 different measurements for further conclusion.</p>