Ethnic Differences in Preterm Birth Risks for Pregnant Women with Thyroid Dysfunction or Autoimmunity: A Meta-analysis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Abnormal maternal thyroid function is associated with preterm birth. However, this association stays dubious in relevant individual studies for ethnic difference reasons and lack of direct supporting data. This study aimed to evaluate the relationship between preterm birth and thyroid dysfunction or autoimmunity based on ethnic differences.</p><p><b>METHODS</b>Relevant studies were identified through searches of MEDLINE, Excerpta Medica, Wan Fang, China Biological Medicine disc, and China National Knowledge Infrastructure from inception to June 15, 2016. Original articles in which an incidence or prevalence of thyroid dysfunction or autoimmunity before second trimester of pregnancy could be extracted were included.</p><p><b>RESULTS</b>Thirty-two unique studies were included for the final meta-analysis. Patients involved were divided into two groups: Group 1 (G1) and Group 2 (G2) comprising of Asian and Caucasian populations, respectively. Positive thyroid antibodies were associated with the occurrence of preterm birth in both G1 [odds ratio (OR): 3.62, 95% confidence interval (CI): 2.83-4.65] and G2 (OR: 1.35, 95% CI: 1.17-1.56); hypothyroidism, only in G2 (OR: 1.20, CI: 1.09-1.33); and subclinical hypothyroidism or hypothyroxinemia, in neither group.</p><p><b>CONCLUSION</b>Thyroid autoimmunity may be a more favorable factor leading to preterm birth among pregnant women of different ethnicities, compared with thyroid dysfunction.</p>

Role of PERK/eIF2α/CHOP Endoplasmic Reticulum Stress Pathway in Oxidized Low-density Lipoprotein Mediated Induction of Endothelial Apoptosis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>PERK/eIF2α/CHOP is a major signaling pathway mediating endoplasmic reticulum (ER) stress related with atherosclerosis. Oxidized LDL (ox-LDL) also induces endothelial apoptosis and plays a vital role in the initiation and progression of atherosclerosis. The present study was conducted to explore the regulatory effect of ox-LDL on PERK/eIF2α/CHOP signaling pathway in vascular endothelial cells.</p><p><b>METHODS</b>The effects of ox-LDL on PERK and p-eIF2α protein expression of primary human umbilical vein endothelial cells (HUVECs) were investigated by Western blot analysis. PERK gene silencing and selective eIF2α phosphatase inhibitor, salubrinal were used to inhibit the process of ox-LDL induced endothelial cell apoptosis, caspase-3 activity, and CHOP mRNA level.</p><p><b>RESULTS</b>Ox-LDL treatment significantly increased the expression of PERK, PERK-mediated inactivation of eIF2α phosphorylation, and the expression of CHOP, as well as the caspase-3 activity and apoptosis. The effects of ox-LDL were markedly decreased by knocking down PERK with stable transduction of lentiviral shRNA or by selective eIF2α phosphatase inhibitor, salubrinal.</p><p><b>CONCLUSION</b>This study provides the first evidence that ox-LDL induces apoptosis in vascular endothelial cells mediated largely via the PERK/eIF2α/CHOP ER-stress pathway. It adds new insights into the molecular mechanisms underlying the pathogenesis and progression of atherosclerosis.</p>

Incidence and associated factors for single and recurrent falls among the elderly in an urban community of Beijing / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the incidence of falls and recurrent falls, and explore associated factors for single and recurrent falls among urban community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district, Beijing in 2009. Data regarding the incidence of fall and recurrent falls in the previous year, as well as associated factors were collected from the elderly through face-to-face interviews.</p><p><b>RESULTS</b>The incidence of falls and recurrent falls was 17.8% and 6.1%, respectively, and it increased with age (χ2for trend=21.06, 19.20, P=0.001, 0.002). Binary logistic stepwise regression analysis showed that age (OR=2.20), living alone (OR=4.67) and gait disturbance (OR=1.27) were risk factors, while housing with elevators (OR=0.35), appropriate width/height of stair steps (OR=0.78), sufficient lighting for stairway (OR=0.45) and regular exercise (OR=0.12) could lower the risk for single fall; factors such as low monthly family income (OR=1.39), poor vision (OR=1.83), low physical ability (OR=4.47), abnormal static balance (OR=2.48), and fear of falls(OR=2.23) were risk factors, while appropriate width/height of stair steps (OR=0.49) and easiness of access to daily supplies (OR=0.41) were protective factors for recurrent falls.</p><p><b>CONCLUSION</b>The incidence of falls in community-dwelling elderly people in Beijing is common, and falls and their related injuries have been associated with both intrinsic and extrinsic factors.</p>

A prospective study on recurrent falls and related factors in elderly from the urban communities in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the incidence and risk factors for recurrent falls in community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district,Beijing in 2009. Data on recurrent falls within the past 12 months were collected through face-to-face interview, with both single factor analysis and logistic regression analysis used to explore the related factors on recurrent falls in the elderly.</p><p><b>RESULTS</b>The incidence of recurrent falls among 472 older adults was 6.1% (29) within the past 12 months. Results from logistic regression analysis showed that factors as higher family monthly income(OR = 1.39, 95% CI:0.67-2.16), afraid of being fallen(OR = 2.23, 95% CI:1.47-3.85)and abnormal static balance(OR = 2.48, 95% CI:1.84-4.05)were risk factors, while bench height in the surrounding environment(OR = 0.49, 95% CI:0.21-1.12)and easiness of access to daily supplies (OR = 0.41, 95%CI:0.14-1.16)were protective factors for recurrent falls.</p><p><b>CONCLUSION</b>The incidence of recurrent falls among the elderly from the communities in Beijing was high. Since falls could be caused by various factors, intervention should be targeting on risk factors in a multi-dimensional way.</p>

Consequence and risk factors of falls-related injuries in community-dwelling elderly in Beijing / 中华流行病学杂志

Objective To investigate the incidence of falls during the past year,as well as the consequence of falls so as to explore the risk factors for fall-related injuries in the community-dwelling elderly in Beijing.Methods A cross-sectional study was conducted in a community in Beijing.A total of 1512 persons aged 60 years and over were selected using stratified cluster sampling method.Information related to all kinds of falls was collected with a standardized structured questionnaire through face-to-face interview.Binary logistic regression was used to explore the related factors for consequence of any falls,especially falls-related injuries in the elderly.Results 272 older adults had one falling episode at the baseline study,with the incidence rate of fall and the frequency of falls as 18.0％ (272/1512) and 379 times respectively.Among the 1512 interviewees,8.7％ (131) suffered from injuries as a result of falls.Out of the total 379 times of falls,143 resulted in injuries.Most common injuries appeared to be soft tissue related (84 times,58.7％) and epidermal abrasion (57 times,39.9％),followed by fracture (20 times,14.0％) and open wound (9 times,6.3％).The most common injured areas were lower limbs (67 times,46.9％),followed by upper limbs (39 times,27.3％),head (27 times,18.9％),face (19 times,13.3％),hip (11 times,2.9％),waist/abdomen (10 times,2.6％),chest (6 times,1.6％),vertebral column (5 times,1.3％) and neck (3 times,0.8％).Data from logistic regression analysis showed that being female (OR=2.09),with proper bench height (OR =1.94),being alcoholic (OR =3.10),being able to walk more than 400 meters (OR =2.11),fear of falls (OR=3.30) etc.were risk factors,while enough handrails provided in surrounding areas (OR =0.41) showed as the protective factor for falls-related injuries in the elderly.Conclusion The incidence rates of falls and falls-related injuries among elderly community-dwellers in urban areas of Beijing were considered to be high.Falls and its related injuries were caused by varied factors,suggesting the intervention strategies should be targeted to the related factors as well as focusing on primary prevention.

Elevated platelet activating factor level in ischemia-related arrhythmia and its electrophysiological effect on myocardium / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The mechanism through which platelet activating factor (PAF) induces cardiac electrical activity and arrhythmia is not well understood and previous studies have suggested a potential involvement of ion channels in its action. The present study was aimed to clarify the role of PAF in fatal arrhythmias following acute myocardia infarction (AMI) and the underlying mechanism.</p><p><b>METHODS</b>(1) Blood PAF levels were measured among 72 AMI patients at the time of diagnosis with AMI and 48 h later, and their electrocardiogram (ECG) was recorded continuously. (2) Ischemia simulation and surface electrocardiogram were conducted in 20 pigs and their PAF levels were measured. (3) PAF perfusion and standard microelectrode recording were performed on guinea pig papillary muscles.</p><p><b>RESULTS</b>In both humans and pigs, elevated PAF levels were detected in AMI and simulated ischemia, respectively, and even higher PAF levels were found when fatal arrhythmias occurred. In guinea pig myocardium, PAF induced a shortening of action potential duration at 90% level of repolarization (APD90)under non-ischemic conditions and a more pronounced shortening under early simulated ischemic conditions.</p><p><b>CONCLUSION</b>AMI and ischemia are associated with increased PAF levels in humans and pigs, which are further raised when fatal arrhythmia follows. The effects of PAF on the myocardium may be mediated by multiple ion channels.</p>

Study on severity, status of awareness and therapy regarding urinary incontinence in elderly people from rural areas in Jixian county,Tianjin / 中华流行病学杂志

Objective To understand the prevalence of urinary incontinence(UI)and its severity in rural elderly people,as well as to investigate the awareness on UI in the elderly and health-care service seeking behavior.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin.A total of 743 people aged 60 years and over were selected under cluster sampling method.All the information was collected with a standardized structured questionnaire by face-to-face interview.Prevalence,severity,the awareness on UI in the elderly and their utilization of health-care service for its diagnosis and treatment were analyzed.Results Prevalence of UI was 33.38% among people aged 60 years and over in two townships of Jixian,higher in females than in males(43.15% vs.22.75%,χ~2=34.70,P＜0.0001).The prevalence rates of UI in 60-age group,65-age group,70-age group,75-age group,80-age group,85-95 age group were 28.64%,32.12%,34.08%,35.45%,47.76%,30.00%,respectively,and increased with age (for trend χ~2=219,P=0.029).Stress urinary incontinence(SUI)and urge urinary incontinence(UUI)were mild,while mixed urinary incontinence(MUI)were mainly moderate.The differences of severity of SUI,UUI,MUI between men and women did not show statistical significance(all P＞0.05).In 743 elderly people,more than half of the respondents had never heard of UI(50.20%,373/743)and only 170(22.88%)elderly people considered UI as a disease.630(84.79%)and 665(89.50%)elderly people in our research group did not know that such condition was curable and preventable.In 248 elderly people with UI,only 12(4.84%)of them ever seeking community health-care services in the health-care centers or hospitals.For the ones who did visit the centers,the purpose was only to seek for drug treatment.Conclusion Prevalence of UI appeared to be high among the elderly people in rural areas of Jixian county.Most of the elderly people were lack of knowledge about UI that hindered them from seeking for diagnosis and treatment in the clinics,plus the treatment program for UI was not standardized.Knowledge on UI and health care seeking behavior should be popularized and strengthened among elderly people living in the rural areas.

Prevalence and related factors of falls among the elderly in an urban community of Beijing / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To understand the prevalence, consequences and risk factors of falls among urban community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in Longtan Community, Beijing. A total of 1512 individuals aged 60 years or over were selected by stratified cluster sampling. Data regarding the frequency of falls in the previous year, as well as circumstances, consequence and related factors of falls were collected from the elderly through face-to-face interviews with questionnaires in their home.</p><p><b>RESULTS</b>The prevalence of falls was 18.0% on the average among 1512 participants, higher in women (20.1%) than in men (14.9%) (P = 0.006), and increased with age (chi2(for trend) = 10.37, P = 0.001). The total rate of falls-induced injuries among the fallers was 37.7%. Falls usually resulted in soft-tissues bruises (58.7%), fear of repeated episodes of falls (58.8%), loss of independence and confidence in movement (35.7%) and even in hip fracture. In addition to the burden of medical care, falls also generated a big economic burden. Occurrence of falls was significantly associated with both intrinsic and extrinsic factors. The related factors of falls in the elderly included age > or = 60-70 years, femininity, less physical activities, fear of future falls, living alone, severely impaired vision, health problem-impacted activities of daily living, chronic diseases (diabetes, hypertension, postural hypotension, stroke sequela, cataract, arthritis, dementia and depression), medications (psychoactive, anti-diabetic), gait imbalance, high bed and faintly-lighted stairway.</p><p><b>CONCLUSION</b>The prevalence of falls among urban community-dwelling elderly in Beijing is closely associated with significant associated with intrinsic and extrinsic factors. Efforts to prevent falls in the elderly should be made at community level.</p>

Study on the prevalence of urinary incontinence and its related factors among elderly in rural areas,Jixian county,Tianjin / 中华流行病学杂志

Objective To understand the prevalence of urinary incontinence(UI) and its related factors so as to develop a three-tier program for prevention of the disease.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin,during July to November 2007.A total of 743 people aged 60 years and over were selected under cluster sampling,and all information were collected with a standardized structured questionnaire by face-to-face interview.All the data were analyzed with multivariate logistic regression method to explore the related factors for UI in the elderly.Results The overall prevalence of UI was 33.38 percent among people aged 60 years and over in two townships.Risk factors flor UI in men would include older age (OR=1.39).occupation(OR=5.00),awareness of UI(OR=1.91),having in chronic respiratory diseases(OR=2.23),prostate(OR=11.47),neurological(OR=11.76),or motor systems (OR=2.48).while protective factors would include high educational level(taking primary school or below as control group),OR for the junior middle school group appeared to be 0.35,for senior middle school group it was 0.77.and ofundergraduate group it was 0.53.Risk factors for UI in women would include older age(OR=1.31),constipation(OR=1.46),awareness of UI(OR=1.94),increased bodv nlass index(when normal weight group served as control group,OR in the overweight group was 1.03 and in the obesity group OR was 1.54),suffering from chronic respiratory diseases(OR=4.84).diabetes mellitus(OR=2.36),or motor system diseases(OR=1.37),more gravidity(OR=1.03),more parity(OR=1.02),suffering from perinea laceration(OR=1.72) and wound infection during delivery(OR=1.65),while protective factors would include physical exercises(OR=0.64).Conclusion Prevalence of UI was higher among the elderly people in rural areas of Jixian county,Tianjin.UI in the elderly might have been influenced by various factors which suggesting the intervention strategy should be targeted at those related factors as well as focusing on primary prevention.

To assess the demands of community-based health care service among 717 elderly / 中华流行病学杂志

<p><b>UNLABELLED</b>OBJECTIVE To understand the demands and influencing factors on the community-based health care service (CHS) among the elderly and to provide evidence of implementing health service for them</p><p><b>METHODS</b>Cluster sampling method was used on 717 persons aged 60 and above in Yanjiao Developing Area. A survey was carried out, using questionnaire and focus group discussion approaches.</p><p><b>RESULTS</b>Data showed that a two-week prevalence of diseases was 56.3% while the overall prevalence of chronic diseases was 92.1% with 70.0% of them suffering from more than two kinds of chronic diseases. The rates of ADL and IADL loss were 1.8% and 7.0% respectively with 37.0% of them sought medical consultation in the past two weeks. Major reason affecting the use of health service was low income. 57.7% of the elderly expressed their willingness of accepting CHS with the strongest demands as regular physical check-up, health education and consultation, specialized care services, home care service while major reasons hindering the acceptance of CHS could be referred to self-perception on good stamina and lack of awareness to CHS.</p><p><b>CONCLUSION</b>The demands of CHS in the elderly were greater than those in general population that called for CHS programs to be acceptable and relevant to meet the different needs.</p>

Evaluation on the effectiveness for self-management of hypertensive patients in a community / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the acceptability of self-management project for patients with hypertension and the short term result, and provide the evidence of preventing and controlling hypertension using chronic disease self-management.</p><p><b>METHODS</b>Voluntary patients with hypertension were grouped into the control and experimental groups after matching age, sex, education levels and the number of chronic diseases between the two groups. Data collected through questionnaire after intervention were compared with the baseline data through analysis of covariance and chi(2) test.</p><p><b>RESULTS</b>Rate of awareness for the diagnostic criteria of hypertension, risk factors and associated diseases increased by 56.4%, 50.4% and 37.6% respectively, and the rate of high salt diet intake, body mass index and the times of visiting doctors decreased by 27.1%, 0.8 kg/m(2) and 2.7 times on average in experimental group, as compared with control group. The health status (energy, fatigue, shortness of breathe, pain) improved (P < 0.05). In the similar comparison, the rate in which the hypertensive patients took antihypertensive medicine increased by 20%, and the scores of cognitive symptoms management and of patient communication with physician increased by 3.9 and 1.1 points respectively. The rate of compliance to medication increased by 21.5% compared with themselves.</p><p><b>CONCLUSION</b>The awareness rate of hypertensive patients on knowledge and on unhealthy life style improved after implementing the self-management program. Their emotion, healthy behavior, health status and symptoms related to hypertension improved. Data showed that it was effective for hypertensive patients to use chronic diseases self-management.</p>