Minimally invasive percutaneous plate internal fixation through anterolateral single incision for the treatment of open distal tibiofibula fractures / 中国骨伤

OBJECTIVE@#To investigate therapeutic effect of minimally invasive percutaneous plate internal fixation (MIPPO) through a single incision in treating open distal tibiofibula fractures.@*METHODS@#From March 2015 to February 2019, 10 patients with open distal tibiofibula fractures were treated with MIPPO technique through single anterolateral incision, including 8 males and 2 females, aged from 31 to 68 years old. According to Gustilo classification, 6 patients were typeⅠ, 3 patients were typeⅡand 1 patient was type ⅢA. Operative time, intraoperative blood loss and fracture healing were observed, Mazur ankle joint scoring was used to evaluate clinical effect.@*RESULTS@#All patients were followed up from 9 to 24 months. Operative time ranged from 85 to 120 min, intraoperative blood loss ranged from 80 to 200 ml, fracture healing time ranged from 18 to 30 weeks. Nine patients with Gustilo typeⅠandⅡachieved satisfactory healing wound, original wound of 1 patient with Gustilo type ⅢA was poor, and healed by skin flap transplantation at stageⅡ. No steel exposed and infection occurred. According to Mazur ankle scoring at the final following-up, total score was from 61 to 97, and 8 patients got excellent result, 1 good and 1 poor.@*CONCLUSION@#MIPPO technique through anterolateral single incision for the treatment of open distal tibiofibula fractures could protect original medial wound in opertaion, avoid plate exposed through anterolateral extensor tendon to cover internal fixation, and MIPPO technique could protect fracture end blood flow to improve fracture healing rate, and it is a kind of choice.

Multiple Biomarkers Improved Prediction for the Risk of Type 2 Diabetes Mellitus in Singapore Chinese Men and Women

Background@#Multiple biomarkers have performed well in predicting type 2 diabetes mellitus (T2DM) risk in Western populations. However, evidence is scarce among Asian populations. @*Methods@#Plasma triglyceride-to-high density lipoprotein (TG-to-HDL) ratio, alanine transaminase (ALT), high-sensitivity Creactive protein (hs-CRP), ferritin, adiponectin, fetuin-A, and retinol-binding protein 4 were measured in 485 T2DM cases and 485 age-and-sex matched controls nested within the prospective Singapore Chinese Health Study cohort. Participants were free of T2DM at blood collection (1999 to 2004), and T2DM cases were identified at the subsequent follow-up interviews (2006 to 2010). A weighted biomarker score was created based on the strengths of associations between these biomarkers and T2DM risks. The predictive utility of the biomarker score was assessed by the area under receiver operating characteristics curve (AUC). @*Results@#The biomarker score that comprised of four biomarkers (TG-to-HDL ratio, ALT, ferritin, and adiponectin) was positively associated with T2DM risk (P trend <0.001). Compared to the lowest quartile of the score, the odds ratio was 12.0 (95% confidence interval [CI], 5.43 to 26.6) for those in the highest quartile. Adding the biomarker score to a base model that included smoking, history of hypertension, body mass index, and levels of random glucose and insulin improved AUC significantly from 0.81 (95% CI, 0.78 to 0.83) to 0.83 (95% CI, 0.81 to 0.86; P=0.002). When substituting the random glucose levels with glycosylated hemoglobin in the base model, adding the biomarker score improved AUC from 0.85 (95% CI, 0.83 to 0.88) to 0.86 (95% CI, 0.84 to 0.89; P=0.032). @*Conclusion@#A composite score of blood biomarkers improved T2DM risk prediction among Chinese.

Sugar-sweetened beverages consumption in midlife and risk of late-life cognitive impairment in Chinese adults / 中华流行病学杂志

To evaluate whether midlife consumption of sugar-sweetened beverages (SSBs), including juices and soft drinks, were associated with late-life cognitive impairment in Chinese adults. Follow up was conducted for participants from Singapore Chinese Health Study, a population-based prospective cohort, for 16-23 (mean 20) years. The information about their SSBs consumption were collected at baseline survey from 1993 to 1998 by using a validated food frequency questionnaire and their cognition status were evaluated by using a Singapore-modified Mini-Mental State Examination Scale in the 3(rd) follow-up visit during 2014- 2016. Multivariable logistic regression models were used to estimate the and 95s. A total of 16 948 participants were included in the analysis and 2 443 of them were identified as cognitive impairment using education-specific cutoffs. Sex, age, ancestral home, education level, physical activity level, total diet fiber intake level, BMI, alcohol drinking were significantly associated with cognitive impairment (0.05). Compared with those who never or hardly ever drank soft drinks, no significant differences in cognitive impairment risk were observed for those who drank soft drinks 2 or more times a week (=0.91, 95: 0.77-1.08), those who drank 1 time a week (=1.00, 95:0.82-1.23) and those who drank 1-3 times a month (=0.94, 95: 0.80-1.09) (trend =0.306). Compared with those who never or hardly ever drank juices, no significant differences in cognitive impairment risk were observed for those who drank juices 2 or more times a week (=1.03, 95:0.88-1.20), those who drank 1 time a week (=0.96, 95: 0.82-1.12) and those who drank 1-3 times a month (=0.94, 95: 0.82-1.08) (trend =0.930). No significant interactions were found with age, sex, and BMI status. SSBs consumption in midlife was not significantly associated with risk of late-life cognitive impairment in Singaporean Chinese adults with relatively low consumption levels. Further researches are needed to verify the results.

Plasma Fetuin-A Levels and Risk of Type 2 Diabetes Mellitus in A Chinese Population: A Nested Case-Control Study

BACKGROUND: Fetuin-A is a hepatokine that involved in the pathogenesis of insulin resistance. Previous epidemiological studies have found a positive association between blood fetuin-A and type 2 diabetes mellitus (T2DM) risk among Caucasians and African Americans. We aimed to investigate the prospective relationship between fetuin-A and T2DM in an Asian population for the first time. METHODS: A nested case-control study was established within a prospective cohort of Chinese living in Singapore. At blood collection (1999 to 2004), all participants were free of diagnosed T2DM and aged 50 to 79 years. At subsequent follow-up (2006 to 2010), 558 people reported to have T2DM and were classified as incident cases, and 558 controls were randomly chosen from the participants who did not develop T2DM to match with cases on age, sex, dialect group, and date of blood collection. Plasma fetuin-A levels were measured retrospectively in cases and controls using samples collected at baseline. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI). Restricted cubic spline analysis was used to examine a potential non-linear association between fetuin-A levels and T2DM risk. RESULTS: Compared with those in the lowest fetuin-A quintile, participants in the highest quintile had a two-fold increased risk of developing T2DM (OR, 2.06; 95% CI, 1.21 to 3.51). A non-linear association was observed (P nonlinearity=0.005), where the association between fetuin-A levels and T2DM risk plateaued at plasma concentrations around 830 µg/mL. CONCLUSION: There is a positive association between plasma fetuin-A levels and risk of developing T2DM in this Chinese population.

Total fluid intake, urination frequency and risk of bladder cancer: a population-based case-control study in urban Shanghai / 中华流行病学杂志

Objective To evaluate the association between total fluid intake and the time of urination per day and the risk of bladder cancer. Methods A population-based case-control study was conducted in urban Shanghai, China, during January 1996 to December 1998. The study included 608 incident cases of bladder cancer and 607 age- and sex-matched controls. Unconditional logistic regression models were used to estimate the odds ratios(ORs)and their corresponding 95%confidence intervals(95%CIs)for bladder cancer associated with frequency of urination, after adjusted for age, gender, smoking status, history of occupation with high risk, history of bladder infections, body mass index and other confounding factors. The level of statistical significance was set at 0.05(two-sided). Results No significant trend was observed for the association between total fluid intake, time of nighttime urination and the risk of bladder cancer. Increasing time of urination during daytime was associated with decreased risk of bladder cancer(P for trend=0.014). ORs(95%CIs)for subjects who voided 4 times, 5 times and 6 or more times per day[0.72(0.49-1.05),0.60(0.41-0.87)and 0.62(0.43-0.90), respectively], when compared with those with less than 4times per day after adjustment of confounding factors. Data showed that smokers and nonsmokers who voided at least 6 times per day had the ORs of 0.72(95%CI: 0.45-1.15)and 0.46(95%CI:0.25-0.87)when compared to their counterparts who voided 3 times or less per day during the daytime. Subjects who urinated at least 6 times per day and consumed more than 1500 ml of total fluid per day experienced a significant 57% reduction in risk compared to subjects who urinated 3 times or less and consumed less than 750 ml of total daily fluid intake. Conclusion Increased urination frequency and total fluid intake, especially among those who never smoked might be associated with a reduced risk of bladder cancer.

Cigarette smoking and primary liver cancer risk: a nested case-control study in Shanghai / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the association between cigarette smoking and risk of primary liver cancer (PLC) among middle-aged and elderly men in urban Shanghai.</p><p><b>METHODS</b>A nested case-control study was conducted based on a cohort of 18,244 men who were 45-64 years of age in 1986-1989 and had no history of cancer at recruitment in Shanghai. As of 31 Dec 2000, a total of 213 incident cases of PLC were identified. 1094 matched controls were randomly selected among the cohort subjects who were free of cancer and alive at the time of cancer diagnosis of the index case. The matching criteria were date of birth (within 2 years), date of biospsy specimen collection (within 1 month), and neighborhood of residence at recruitment. Conditional logistic regression models were used to estimate adjusted odds ratios (ORs) and their corresponding 95% confidence intervals (CIs).</p><p><b>RESULTS</b>After controlling for potential confounders, cigarette smoking (ever vs. never) was associated with risk of PLC (OR = 1.91; 95% CI: 1.28-2.86). Risk of PLC increased with increasing number of cigarettes smoked per day, as well as duration of cigarette smoking, pack-years of cigarettes consumed over lifetime and earlier age started smoking. The ORs were 2.16 (95% CI = 1.37-3.40), 2.14 (95% CI = 1.18-3.87), 2.12 (95% CI = 1.21-3.74) and 2.57 (95% CI = 1.50-4.40) for men who smoked 20 cigarettes or more daily, smoked for 40 or more years, consumed more than 37 pack-years of cigarettes, and began smoking before 20 years of age, respectively.</p><p><b>CONCLUSION</b>This study confirms that cigarette smoking is an independent risk factor for primary liver cancer among males in Shanghai.</p>

A prospective cohort study on body mass index and mortality among middle-aged and elderly men in urban Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the association between body mass index (BMI) and mortality as well as the effect of age on it among middle-aged and elderly men in urban area of Shanghai.</p><p><b>METHODS</b>A total of 18,244 male subjects aged 45-64 years resided in urban area of Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and were actively followed under annual visits. 'Cox proportional hazards model' was used to estimate the relative risks (RR).</p><p><b>RESULTS</b>By the end of the follow-up process in 2002, a total number of 235,762 person-years was accumulated in the cohort, with an average of 12.9 years per subject. A total number of 3365 deaths including 1381 from cancer and 1165 from cardio- and cerebro-vascular diseases (CVD), was identified during the follow-up period. Compared with those under normal BMI (BMI 18.5-23.9), the RRs of death for all causes of death among groups at low BMI (BMI < 18.5), overweight (BMI 24-27.9) and obesity (BMI > or = 28) were 1.20, 1.12 and 1.61, respectively, among non-smokers after adjustment for age, alcohol consumption and level of education. After excluding the numbers observed during the first 5 years of follow-up, the corresponding RRs became 1.01, 1.12, and 1.75, respectively. The risk of deaths from colon cancer or CVD increased along with the increase of BMI, while the risk of non-cancer and non-CVD deaths, mostly deaths from infectious diseases, increased significantly in the group of low BMI. Among those aged > or = 55 years at baseline survey, the risk for all causes of death increased more significantly with those having obesity. However, among those who were younger than 55 years of age, no significant correlation between BMI and overall mortality was noticed.</p><p><b>CONCLUSION</b>A positive relationship between obesity and total mortality was observed in the middle-aged and elderly men in urban Shanghai. The association was more obvious among the elderly while the risk of deaths from colon cancer or CVD rose along with the increase of BMI. The risk of death from infectious disease increased significantly in the group with low BMI.</p>

Cigarette smoking and cancer mortality: a prospective cohort study in urban males in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the association between cigarette smoking and cancer mortality in urban men in Shanghai and its impact when smoking habit changed during the follow-up period.</p><p><b>METHODS</b>A total of 18 244 male residents aged 45 to 64 years in urban Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and was actively followed up on annual visits. Cox proportional hazards model was used to estimate relative risks (RR).</p><p><b>RESULTS</b>By the end of follow-up program in 2002, 235 762 person-years, averaged 12.9 years per subject in the cohort was reached. 3365 deaths including 1381 cancer deaths were registered during the follow-up period. The mortality rates for cancers of lung, stomach, liver, pancreas, esophagus, head and neck etc. increased significantly among smokers. Compared with data of nonsmokers at the baseline survey, the adjusted RR was 1.49 for all-causes mortality among current smokers at the baseline survey. After excluding subjects who changed their smoking habit during the follow-up period, the RR became 1.78 compared with lifelong-nonsmokers. The corresponding RRs rose from 2.05 to 2.58 for all cancer deaths and from 6.40 to 8.77 for lung cancer deaths. The age-adjusted all-causes and cancer death rates among current smokers at the baseline survey were 1695.6 and 782.0 per 100 000 person-years, respectively. After exclusion of those with smoking habit changed during the follow-up period, the rates among persistent smokers were 2353.7 and 1144.6 per 100 000 person-years, respectively.</p><p><b>CONCLUSION</b>Cigarette smoking is an important predictor for risk of all-causes of death as well as for cancer deaths. The change of smoking habit during the follow-up period could result in underestimating the deleterious effect of cigarette smoking on health.</p>