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Objective:To analyze the relationship between plasma uranium concentration and renal injury.Methods:A case-control study was conducted in Hunan province, involving 102 renal injury cases and 102 matched controls. The association between plasma uranium concentration and renal injury was analyzed using conditional logistic regression models, and the dose-response relationship was analyzed through restricted cubic spline regression. The linear regression model and Spearman correlation were used to analyze the association between plasma uranium concentration and renal injury indicators.Results:The median of plasma uranium concentration was 8.94 ng/L in all subjects and 10.19 ng/L in the case group. The plasma uranium may be a risk factor for renal injury, with a dose-response relationship between the both representing nonlinear association ( χ2=5.15, P<0.05). The risk of renal injury was 4.21 times higher in the group exposed to highest uranium concentration than that in the group exposed to lowest uranium concentration. Plasma uranium concentration was closely related to glomerular filtration rate, serum creatinine and β 2-microglobulin ( r=0.211, -0.142, 0.195, P<0.05). Conclusions:The plasma uranium concentration is significantly associated with the renal injury, which may provide epidemiology evidence for the prevention of renal injury.
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Objective To investigate the risk of fatal stroke mortality associated with short-term exposure to air pollution， and to determine the susceptible population. Methods In this study， daily stroke mortalities of adults between 2012 and 2014 in Songjiang District， Shanghai were collected. Time-stratified case-crossover approach was used to assess the association between daily concentrations of air pollutants and fatal stroke mortalities. Results This study included 514 patients who died from acute strokes. The average concentrations during the study period were 77.45 μg·m-3 for PM2.5， 21.22 μg·m-3 for SO2， and 57.59 μg·m-3 for NO2. The fatal stroke mortality of adults under the age of 65 was found to be significantly associated with NO2. At the time of a Lag of 2 d and 03 d， a significantly higher risk of fatal stroke mortality in relation to NO2 exposure was observed， and the OR values of ischemic stroke mortality for people were 3.86 （1.53-9.75） and 5.83 （1.40-24.34） respectively. People over the age of 65 were more sensitive to increased PM2.5 concentrations， at the time of a Lag of 03 d， fatal strokes increased by 28% when PM2.5 levels increased. A significantly higher risk of fatal stroke mortality in relation to increase of NO2 concentration was observed among people who were overweight or obese. Conclusion A significantly higher risk of fatal stroke mortality is associated with the increase of PM2.5 and NO2. The results also suggest that the susceptible population should take additional precautions to avoid or reduce the risk of fatal strokes.
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Objective To develop plantar force model of patellofemoral pain (PFP), so as to provide theoretical references for the assessment of PFP rehabilitation. Methods The case-control study was conducted, and a total of 126 patients with PFP and 126 healthy controls matched by gender and age were enrolled in the study. The participants were tested for plantar force and pressure during level walking, and twelve plantar regions were divided and recorded. Whether the participants suffered PFP was analyzed as dependent variable, meanwhile the peak force and peak pressure in 12 plantar regions of participants at selected speed during level walking were analyzed as independent variables. Conditional logistic regression (CLR) equations of peak force and peak pressure with PFP were established, respectively. The receiver-operating characteristic (ROC) curve of the corresponding equations was derived, and the area under ROC curve was calculated to analyzed the validity of different equations on PFP assessment. Results The CLC equation of peak force in 12 plantar regions of the participants with FFP was constructed, and only peak force of lateral heel was in the equation. The CLC equation of peak pressure in each plantar region included medial heel, midfoot, 1st and 2nd metatarsals. Meanwhile, the area under ROC curve of the pressure equation was larger than that of the force equation. Conclusions Peak force and pressure at different plantar regions can be used to assess PFP during level walking, and peak pressure is more effective for assessment.
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【Objective】 To analyze the status and influencing factors of blood donation among medical college on going students, so as toassist in implementing targeted measures to expand and stabilize the group of college blood donors. 【Methods】 The cross-sectional survey method was used to carry out the field questionnaire survey. 【Results】 128 people participated in blood donation, and the blood donation rate was 16%. Gender, the knowledge and intention towards blood donation, and behavior of peers were the influencing factors revealed by the logistic regression analysis (P<0.05). In addition, the publicity and service provided by blood stations were also important factors. 【Conclusion】 The publicity of voluntary blood donation should be improved in colleges to raise the donation intention of college students.Service provided by blood centers should also be improved to ease donation fear, so as to expand the college donor population.
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OBJECTIVE： To establish antibiotics use rationality evaluation model in type Ⅰ incision surgery patients， and to provide reference for prescription review of clinical pharmacists. METHODS： Totally 432 inpatients underwent type Ⅰ surgical incision in a hospital from Jan. 1st- Dec. 31st， 2017 were selected as the research objects. The information of diagnosis and treatment including age， nosocomial infection， the number of kinds of antibiotics used were extracted. Based on the results of clinical pharmacists’ comments on the antibiotics use rationality in patients’ prevention and treatment， non-conditional Logistic regression and support vector machine （SVM） in machine learning method were used to convert clinical pharmacists’ comments into objective index that can be recognized by the machine learning model， using categories of antibiotics （preventive or therapeutic use） as dependent variables and the patient’s diagnosis and treatment information as independent variables. Classification and identification model was established for antibiotics use rationality in type Ⅰ incision surgery patients. Using sensitivity， specificity and Youden index as indexes， established mode was validated on the other 61 samples of type Ⅰ incision surgery patients. The rationality of antibiotics prescriptions in type Ⅰ incision surgery patients before （by manual review， Jan.-Dec. 2017） and after （Jan.-Oct. 2018） using the model were collected， and the effects of the model were evaluated. RESULTS： The sensitivity， specificity and Youden index of non-conditional Logistic regression model were 65.63％， 75.00％ and 40.63％， respectively. Main parameters of the model established by SVM included gamma 0.01， cost 10， sensitivity 92.19％， specificity 87.50％， Youden index 79.69％. The model established by SVM was better than non-conditional Logistic regression. SVM was used to validate established mode， and sensitivity， specificity and Youden index were 100％， 88.57％ and 88.57％， respectively. Compared with before using the model， the evaluation ratio increased from 69.44％ to 100％， the rate of prophylactic use of antibiotics decreased from 23.84％ to 16.43％， the rate of rational drug type selection increased from 37.86％ to 54.39％， and treatment course shortened from 5.01 days to 3.26 days after using the model. CONCLUSIONS： Established antibiotics use rationality evaluation model in typeⅠincision surgery patients by SVM in machine learning method fully covers all the patients， promotes rational use of antibiotics in typeⅠincision surgery patients， and provides a new idea for pharmacist prescription comment.
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Objective To investigate the risk factors of color-ectal cancer and to provide scientific basis for prevention of colorectai canc-er. Methods A 1:1 matched case-control study was carried out in Dalian including 200 cases with colorectal cancer and 200 controls. We analyzedthe data with the univariate analysis and mutivariate conditional logistic re-gressiou,theu calculated the Odds Ratio and the 95% confidence. Results Conditional logistic regression showed that history of constipation, family history of other tumor,intake much bloat food ten yeats ago and easily an-gry were the risk factors of colorectal cancer, and intake much fresh vegeta-bles ten years ago was the protective factors of colorectal cancer. One way analysis showed that following factors were the risk factors of coloroctal cancer:there were pollution factor around home 10 years ago, belly CT test,sleep over twelve o'clock at night,family history of coloroctal cancer, history of pries, appendicitis and the operation history of appendicitis, intake much fry and bake food,seashell and animal liver before ten years ago,of-ten feel strew, don't like to communicate with others,pessimism,don't harmonization with colleague. And iutaking much chicken meat, bean prod-ucts,garlic ten years ago,doing exercise and the frequency of exercise,high income were the protective factors of colorectal cancer. Conclusion Coloroctal cancer was the result of many factors. But the incidence of that in Dalian city was related to history of constipation, family history of other tumor, easily angry, intake less fresh vegetables and intake much bloat food ten years ago.
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Objective To investigate the factors of Alzheimer’s Disease (AD). Methods A 1:1 matched case-control study was conducted. The study included 129 patients of clinically diagnosed AD and 129 controls selected from Nanchang and Jiujiang areas. The data were analyzed by the conditional logistic regression. Results The results showed the unsociable personality (OR=2.486,95%CI=1.075～6.638),the history of great negative life events (OR=4.125,95%CI=1.706～12.249),using cookers made of aluminum (OR=2.454,95%CI=1.277～5.268) were identified as risk factors for AD. The good family income state (OR=0.324,95%CI=0.106～0.828) and frequently physical exercises (OR=0.258,95%CI=0.104～0.520) were protective factors for AD. Conclusion Alzheimer’s Disease seems to be related to the income state,frequency of physical exercises,personality,big negative life events,using cookers made of Aluminum.
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Objective To explore the controlling level of fasting blood glucose(FBG) and glucosylated hemoglobin(GH) in order to stop occurrence of nephropathy in diabetic mellitus.Methods Data was collected by retrospective study,analyzed by non-conditional Logistic regression.Then the controlling levels of blood glucose and glucosylated hemoglobin were studied by regression equation.Results It was regarded that under 6.8 mmol/L of FBG and 5.9% of GH,diabetic nephropathy can be prevented;while under 6.0 mmol/L of FBG and 5.3% of GH,the onset of diabetic nephropathy was strictly controlled.Conclusion it is more important to control strictly on the threshold of fasting blood glucose and glucosylated hemoglobin for prevention of diabetic nephropathy.
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OBJECTIVES: To evaluate the hypothesis that air pollution could increase emergency room visits for respiratory diseases, and if so, to quantify the strength of association between those. METHODS: We compiled daily records of hospital emergency room visits for respiratory diseases in Seoul, from November 1. 1995 to October 31. 1996, by using medical utilization data of unscheduled visits. In addition, air quality and weather data for the same period was collected. And a case-crossover design was applied by adopting conditional logistic regression analysis to determine the relationship between air pollutants and emergency room visits for respiratory diseases. In particular, the control periods were chosen by a bidirectional paired matching technique 7, 14, and 21days before and after the case periods. RESULTS: Only ozone was associated with the increased number of emergency room visits for respiratory diseases. The relative risk according to a 30ppb increase of ozone concentration (24hr mean, lagged 1day) was 1.91 (95% confidence interval = 1.78-2.05). CONCLUSION: There was a statistically significant association between the ambient ozone and daily emergency room visits for respiratory diseases.
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Contaminantes Atmosféricos , Contaminación del Aire , Servicio de Urgencia en Hospital , Modelos Logísticos , Ozono , Seúl , Tiempo (Meteorología)RESUMEN
Objective: To discuss the risk factors of suicide with psychological autopsy method. Methods: 66 complete suicides from Jinzhou and Zhuanghe of Dalian , LiaoNing province, which were individually matched with control population. Results: Three main risk factors of suicide remained in the final conditional logistic regression model. They were social support (OR = 0.66, 95%CI = 0.48 - 0.91 ), depression (OR=1.18, 95%CI=1.03-1.35) and neurosis (OR=2594.59,95%CI=6.29-1069550) . Conclusion: The combined effect of multiple factors increases the risk of suicide but not the unique effect of single factor. The suicide preventive efforts should focus on individuals exposed to multiple risk factors.
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Objective To investigate risk factors for the development of advanced schistosomiasis. Methods The case\|control study was designed with a match of 1∶1 and 1∶2. Healthy persons and chronic schistosomiasis patients were used as control. Each group was composed of 213 cases. Items investigated included: history of schistosomiasis and treatment, exposure to the contaminated water, social\|economical condition and nutritional status, other concomitant diseases. Cellular and humoral immunity, HBVMs and ABO blood groups were also detected. Statistical analysis was performed by 1∶1 and 1∶2 matched single and stepwise conditional logistic regression analysis with SAS software. Results By stepwise conditional logistic regression analysis, it was revealed that number of schistosomiasis examination(OR=1^168-1^311), interval from first infection to last treatment(OR=1^142), interval from first infection to this investigation (OR=1^089), \{HBsAg\++\}(OR=4^683-10^759), \{HBcAb\++\} (OR=2^873), \{HBsAg\++\}+\{HBeAb\++\}+\{HBcAb\++\}(OR=7^64) were risk factors of developing advanced schistosomiasis. The average living space and cellular immunity were lower in advanced schistosomiasis patients than others. No association was found between advanced schistosomiasis and ABO blood groups. Conclusion The development of advanced schistosomiasis is associated with repeated infections, and delayed or incomplete treatment. Combined infection with hepatitis B, poor socio\|economic conditions and impaired cellular immunity may increase the pathogenetic risk of schistosomiasis.
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By application of the conditional Logistic regression model, the factors influencing iron deficiency anemia in preschool children from 3 to under 7 years old have been analysed. To estimate the mode parameters, Newton-Raphson iterative method has been used. By 81 matched groups of 1:4 paired case-control and among seventeen hazard factors, five significant factors contained in the model are as follows: eating less meat, fewer vegetables and fruits, having a poor appetite and cooking with aluminium utensils.