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Objective@#To explore the association of arsenic with unexplained recurrent spontaneous abortion (URSA).@*Methods@#A case-control study was conducted to select URSA patients who were admitted to the Beijing Maternal and Child Health Care Hospital affiliated to Capital Medical University from April to October 2018 as a case group. Women who had a normal pregnancy in the Family Planning Department of the hospital but volunteered to have an abortion were selected as a control group. The case and control group were paired in a 1: 1 ratio. The inclusion criteria of the case group were patients with newly diagnosed recurrent spontaneous abortion who had clinically confirmed more than 2 spontaneous abortions and had 20 weeks prior to pregnancy, excluding patients with recurrent spontaneous abortion caused by abnormal blood coagulation (anti-phospholipid antibody positive), abnormal physiological anatomy (B-ultrasound), abnormal immune factors (anti-nuclear antibody positive, anti-cardiolipin antibody, etc.), genetic chromosomal abnormalities (karyotype analysis) and pathogenic microbial infection. The control group was matched according to the age of the case group (±3 years old) and the gestational age (±2 weeks) to exclude adverse pregnancy outcomes such as stillbirth, congenital malformation, premature delivery and low birth weight infants. A total of 192 subjects were included. Questionnaires were used to collect information of all subjects, and 12 ml of peripheral venous blood was collected to detect blood arsenic levels. Blood arsenic levels were divided into low concentration group (<1.00 μg/L), medium concentration group (1.00-1.50 μg/L) and high concentration group (>1.50 μg/L). The multivariate conditional logistic regression was performed to analyze the relationship between blood arsenic exposure and URSA and explore the influencing factors of blood Arsenic.@*Results@#The geometric mean values of blood arsenic level in the cases group and control group were 1.68 (1.50-1.86) μg/L and 1.26 (1.17-1.37) μg/L, respectively. The blood arsenic level in the case group was significantly higher than that in the control group (P<0.05). The results of multivariate conditional logistic regression analysis showed that after adjusting for tobacco exposure during pregnancy, pre-pregnancy body mass index and the effects of residential decoration in past five years, the risk of URSA was higher in the high-concentration group compared with the low-concentration group (OR=2.56, 95%CI:1.06-6.24).@*Conclusion@#Blood arsenic may increase the risk of URSA in women of childbearing age.
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The size of the non-sampling error is directly related to the accuracy and reliability of the sampling survey result. This paper studied the non-sampling errors generated during the sampling process of the China National Human Biomonitoring Program(CNBP), mainly including the sampling frame error, non-response error and measurement error. The program reduced the influence of the non-sampling error on the quality of the survey effectively by scientifically designing the sampling scheme and questionnaire, strengthening investigator trainings and standardizing the data review, which could be used to provide reference for the control of non-sampling errors in public health monitoring projects in China.
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Objective To explore the sampling method in China National Human Biomonitoring Program (HBP) and the related errors,so as to calculate and evaluate the study design in sampling.Methods The sampling method of HBP is of multistage nature.Taking the results of sampling method from Guizhou province as an example,results related to sampling error and variation coefficient were calculated,using the multistage unequal probability sampling error method.Results The HBP covered 152 monitoring sites in 31 provinces (autonomous regions and municipalities) and with 21 888 residents selected.The replacement rates at various stages were 5.26％,6.35％ and 40.6％ respectively.The sampling error in Guizhou province was 3 207 594,and the coefficient of variation was 0.097.Conclusions According to the multi-stage unequal probability sampling method,the sampling coefficient variability appeared small with high precision,in Guizhou province.However,this method did not consider the weight adjustment of non-sampling errors such as population missing rate and response rate.Methods related to the calculation on multi-stage sampling error among large-scale public health monitoring projects need to be further studied.
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Heavy metal is one of pollutants existed widely in the environment,its relationship with cardiovascular disease has attracted more and more attention.In this review,the concentrations of heavy metals,including lead,cadium and asenic,in the body from several national surveillance networks and the epidemiological studies on the effects of the exposure of three heavy metals on cardiovascular system were summarized.It is suggested to strengthen nationwide surveillance for body concentrations of heavy metals in general population in order to provide baseline data for quantitative evaluation of the risk of heavy metal exposure on cardiovascular disease.
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Objective To explore the sampling method in China National Human Biomonitoring Program (HBP) and the related errors,so as to calculate and evaluate the study design in sampling.Methods The sampling method of HBP is of multistage nature.Taking the results of sampling method from Guizhou province as an example,results related to sampling error and variation coefficient were calculated,using the multistage unequal probability sampling error method.Results The HBP covered 152 monitoring sites in 31 provinces (autonomous regions and municipalities) and with 21 888 residents selected.The replacement rates at various stages were 5.26％,6.35％ and 40.6％ respectively.The sampling error in Guizhou province was 3 207 594,and the coefficient of variation was 0.097.Conclusions According to the multi-stage unequal probability sampling method,the sampling coefficient variability appeared small with high precision,in Guizhou province.However,this method did not consider the weight adjustment of non-sampling errors such as population missing rate and response rate.Methods related to the calculation on multi-stage sampling error among large-scale public health monitoring projects need to be further studied.
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Heavy metal is one of pollutants existed widely in the environment,its relationship with cardiovascular disease has attracted more and more attention.In this review,the concentrations of heavy metals,including lead,cadium and asenic,in the body from several national surveillance networks and the epidemiological studies on the effects of the exposure of three heavy metals on cardiovascular system were summarized.It is suggested to strengthen nationwide surveillance for body concentrations of heavy metals in general population in order to provide baseline data for quantitative evaluation of the risk of heavy metal exposure on cardiovascular disease.
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Objective To evaluate the protective effect of ACEI drugs on radiation pneumonitis,and to compare ACEI with ARB,statin, steroid, and NSAID on the treatment of radiation induced lung injury through the network Meta-analysis. Methods A computer-based online search of PubMed, EMbase, Cochrane Library, as well as CNKI, CBM, VIP, Wanfang database was conduce. The NOS score was used to evaluate the quality of studies,and the results were analyzed by stata14. 0 software. Results ACEI drugs showed desired effect on the treatment of radiation pneumonia,which can effectively reduce the incidence of radiation-induced lung injury,but can not prolong the survival time of the patients.The protective effects of statins and non-steroid anti-inflammatory drugs are second only to those of ACEI.Meta-analysis results were proved to be stable and credible by the sensitive-analysis.The therapeutic effect of ACEI on radiation induced lung injury is not affected by sex and age of patients. Conclusion ACEI drugs have an optimum protective effect on radiation induced lung injury.
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Objective To evaluate the efficacy of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) in the treatment of idiopathic pulmonary fibrosis through the method of system evaluation. Methods A computer-based online search of Pubmed, Embase, Cochrane Library, CNKI, CBM and Wanfang were used for database retrieval. Revman 5.0 was used to assess the bias of the included studies. The Stata 14.0 was used to evaluate the extraction indexes of efficacy, p (O2), p (CO2), DLco, FEV1 and VC. GRADE score was used to evaluate the level of evidence. Results A total of 17 articles (related with 1381 patients) were included in this study, including 14 studies using ARB and 3 studies using ACEI. Compared with the control group ACEI and ARB drugs showed advantages in the treatment of pulmonary fibrosis (RR=1.34, 95%CI:1.24-1.44, Z=7.81, P<0.001). Auxiliary index analysis showed that the test groups were treated with enalapril (SMD=0.72, 95%CI:0.21-1.22, Z=2.77, P=0.006), telmisartan (SMD=3.86, 95%CI:2.44-5.27, Z=5.35, P<0.001), valsartan (SMD=1.94, 95%CI:1.33-2.55, Z=6.27, P<0.001) and captopril (SMD=0.60, 95%CI:0.11-1.09, Z=2.41, P=0.016), the p(O2) levels were significantly improved in patients ≥65 years old (SMD=0.76, 95%CI:0.52-1.00, Z=6.18, P<0.001) and patients < 65 years old (SMD=3.97, 95%CI:2.61-5.32, Z=5.73, P<0.001), and disease duration≥5 years (SMD=1.39, 95%CI:0.45-2.33, Z=2.89, P=0.004) and disease duration<5 years (SMD=3.26, 95%CI:2.06-4.46, Z=5.34, P<0.001) compared with those of control group (SMD=2.95, 95%CI:1.95-3.94, Z=5.82, P<0.001). The curative effect of telmisartan was better than that of other drug groups (P < 0.001), and which was much better for patients under 65 years old (P<0.001). There was no significant difference in the disease duration between two groups (P=0.307). The p (CO2) levels were significantly improved in patients treated with telmisartan [SMD=-12.94,95%CI:(-14.01)-(-11.86),Z=23.51,P<0.001), valsartan [SMD=-1.95,95%CI:(-2.56)-(-1.34),Z=6.29,P<0.001] compared with those of control group [SMD=-11.13,95%CI:(-17.03)-(-5.24),Z=3.70,P<0.001]. The effect of telmisartan was better than that of valsartan (P<0.001). In addition, values of DLco (SMD=0.64, 95%CI:0.45-0.83, Z=6.72, P<0.001), FEV1 (SMD=1.19, 95%CI:0.52-1.86, Z=3.47, P<0.001) and VC (SMD=0.51, 95%CI:0.16-0.85, Z=2.85, P=0.004) were improved in test group compare with those of control group. And the GRADE scores of relevant indexes were low quality to moderate quality. Conclusion ACEI and ARB can improve the efficacy, the p (O2) and p (CO2) in the treatment of pulmonary fibrosis. Patients with age<65 years old and treated with telmisartan have the best curative effect, and which is not related to the disease duration.
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Objective To investigate the effect and the mechanism of different G-CSF-priming protocols on leukemia cell lines (HL-60 and U937) in vitro and provide the clinical guidance to clinical treatment of acute leukemia.Methods The leukemia cell lines HL-60 and U937 were used as model to detect the effects of three drugs alone and combined two drugs (HA) or three drugs (HAG) respectively.Cell viability and cell growth inhibition were performed by cell count kit-8 (CCK-8) assay.Apoptotic marker AnnexinV/PI,cell membrane surface antigen CD11b,cell cycle,mitochondrial membrane potential (JC-1) and Caspase-3 were determined by flow cytometry.Results After using of HAG for 48 h,HL-60 and U937 cells counts were decreased significantly and the apoptotic marker Annexin V was significantly increased. To compare the single drug group with two drug combination group,the result was significantly different (P ＜0.05),and the apoptosis of U937 cells was higher than HL-60 cell line.CD11b expression among the three groups did not change (P ＞ 0.05).Using of CAG and MAG,the mitochondrial nembrane potential of HL-60 and U937cells was increased,the three-drug combination group was significantly higher than single-drug group and control group (P ＜0.05); Caspase-3 was activated,the fluorescence intensities of Caspase-3 of the three-drug combination group and single drug group were significantly higher (P ＜0.05) comparing with the control group.Conclusion HAG regimen could induce leukemia cells to apoptosis through the reduction of mitochondrial membrane potential and the activation of Caspase-3 to induce apoptosis of leukemia cells.