Effects of Prenatal Multiple Micronutrient Supplementation on Miscarriage in Developing Countries: A Meta-analysis of Randomized Controlled Trials.

Objectives: The potential adverse impact of prenatal multiple micronutrient supplementation (MMN) versus iron-folic acid (IFA) on perinatal mortality is concerned. It has been speculated that MMN might survive frail fetuses to late pregnancy or early infancy, resulting in an increase in perinatal death. If the speculation holds true, MMN would prevent miscarriages. We aimed to assess the speculation. Methods: Pubmed, Embase, Web of Knowledge, and Cochrane Library were searched. Primary outcome was miscarriages. Secondary outcomes were stillbirths, perinatal deaths, and infant deaths; death events combined with miscarriages. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were estimated with fixed- or random-effect model, depending on heterogeneity tests. Pre-specified stratified and sensitivity analyses were planned to assess whether results varied by maternal baseline or trial characteristics. Results: In total, 15 trials were identified. MMN versus IFA significantly reduced miscarriage risk (RR 0.91, 95% CI 0.83-1.00). MMN significantly reduced infant death risk within 90 days (RR 0.86, 95% CI 0.78-0.95); this reduction remained when miscarriage and stillbirth were included (RR 0.88, 95% CI 0.82-0.94). MMN insignificantly increased perinatal death risk (RR 1.08, 95% CI 0.93-1.25), but the increased risk vanished when miscarriages were included (RR 0.99, 95% CI 0.89-1.10). No difference for other death events between groups was observed, irrespective of whether miscarriages were accounted for. Conclusions: MMN versus IFA supplementation prevented miscarriages and infant deaths within 90 days. The modestly increased perinatal mortality risk is a fallacy due to the survival bias resulting from protective effect on miscarriages.

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>

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>

Effects of CD147 on the production of matrix metalloproteinase-9 by fibroblasts and the invasion of melanoma cells / 中南大学学报(医学版)

OBJECTIVE@#To investigate a possible role of CD147 in the production of matrix metalloproteinase-9 (MMP-9) by fibroblasts and the invasion of melanoma cells.@*METHODS@#We cocultured CD147-expression melanoma cells with fibroblasts and examined the MMP-9 expression of fibroblasts by zymography and the invasion of melanoma cells by transwell invasion assay.@*RESULTS@#MMP-9 expression was enhanced in conditioned media, while cocultured with melanoma cells in a dose-dependent manner, and CD147 antibody inhibited the production of MMP-9 in the fibroblasts. When fibroblasts were cultured at the bottom of the lower compartment of transwell invasion model, the number of melanoma cells that invaded significantly increased. Addition of anti-CD147 antibody to the upper compartment transwell invasion model resulted in the significant inhibition of the melanoma cell invasion in reconstituted basement membrane.@*CONCLUSION@#CD147 expressed in melanoma cells plays an important role in the melanoma cell invasion by stimulating the production of MMP-9 by fibroblasts.