Associations between glycated hemoglobin and glucose indicators in adults in areas at different altitude in China / 中华流行病学杂志

Objective: To explore the associations of glycated hemoglobin (HbA1c) with FPG and oral glucose tolerance test 2-hour (OGTT-2 h) in areas at different altitude in China. Methods: Subjects who participated in 2018-2019 China Chronic Disease and Risk Factor Surveillance and had no prior type 2 diabetes diagnosis were included. Subsequently, they were categorized into three groups based on altitude of living area (<2 000, 2 000- and ≥3 000 m). With adjustment for intracluster correlation, multivariable linear regression analysis was performed to evaluate the associations of HbA1c with FPG and OGTT-2 h in the context of HbA1c was normal (<5.7%) or abnormal (≥5.7%). Furthermore, the shape of relationships between HbA1c and glucose indicators was examined using restricted cubic spline. Finally, receiver operating characteristic curve was used to evaluate the diagnostic performance of HbA1c for diabetes. Results: A total of 157 277 subjects were included in the analysis. While FPG and OGTT-2 h levels gradually decreased with increase of altitude, HbA1c level was similar among the three groups. When HbA1c was <5.7%, its association with FPG and OGTT-2 h was weak and no obvious difference was observed among the three groups. When HbA1c was ≥5.7%, the FPG and OGTT-2 h increased by 15.45% (95%CI:14.71%- 16.18%) and 24.54% (95%CI:23.18%-25.91%) respectively per one standard deviation increase in HbA1c in group in area at altitude <2 000 m. However, the FPG and OGTT-2 h increased by 13.08% (95%CI:10.46%-15.76%) and 21.72% (95%CI:16.39%-27.31%), respectively, in group in area at altitude 2 000- m, and increased by 11.41% (95%CI:9.32%-13.53%) and 20.03% (95%CI:15.38%- 24.86%), respectively, in group of altitude ≥3 000 m. The restricted cubic spline indicated that the curve showing the association of HbA1c with FPG and OGTT-2 h was flat when HbA1c was <5.7%, but showed a positive linear relationship when HbA1c was ≥5.7%. The area under curve for detecting diabetes was 0.808 (95%CI:0.803-0.812) in group of altitude <2 000 m and 0.728 (95%CI:0.660-0.796, P=0.022) in group of altitude ≥3 000 m. The relevant optimal cutoff value of HbA1c was 5.7%, with a sensitivity of 65.4% and a specificity of 83.0%, and 6.0%, with a sensitivity of 48.3% and a specificity of 93.7%, respectively. Conclusions: When HbA1c was ≥5.7%, the association between HbA1c and glucose indicators became weaker as the increase of altitude. In the area at altitude ≥3 000 m, it may not be appropriate to use HbA1c in the diagnosis of diabetes.

Geographic Variations in the Prevalence, Awareness, Treatment, and Control of Dyslipidemia among Chinese Adults in 2018-2019: A Cross-sectional Study / 生物医学与环境科学（英文）

OBJECTIVE@#To investigate the spatial patterns of the prevalence, awareness, treatment, and control rates of dyslipidemia at the provincial level in China.@*METHODS@#A national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in mainland China in 2018-2019, using a multi-stage, stratified, cluster-randomized sampling design. Subjects, as households, were selected, followed by a home visit to collect information. Both descriptive and linear regression procedures were applied in the analyses.@*RESULTS@#The overall prevalence of dyslipidemia was 35.6%, and wide geographic variations of prevalence, treatment, and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1 ± 13.8 years. The highest-lowest difference regarding the provincial level prevalence rates were 19.7% vs. 2.1% for high low-density lipoprotein cholesterol, 16.7% vs. 2.5% for high total cholesterol, 35.9% vs. 5.4% for high triglycerides, and 31.4% vs. 10.5% for low high-density lipoprotein cholesterol. The treatment rate of dyslipidemia was correlated with the socio-demographic index ( P < 0.001), urbanization rate ( P = 0.01), and affordable basic technologies and essential medicines ( P < 0.001).@*CONCLUSION@#Prevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence, treatment, and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.

Correlation between HBV-DNA levels, SOAT1 expression and differentiation of hepatocellular carcinoma / 中国热带医学

@#Abstract: Objective　To investigate the correlation between HBV-DNA level, sterol O-acyltransferase (SOAT1) expression and tumor differentiation of hepatocellular carcinoma. Methods　The clinical and HBV-DNA level data from 58 cases of HBV-associated hepatocellular carcinoma were collected, and the cancer tissues and their paired paracancerous tissues were collected to detect SOAT1 expression by immunohistochemistry and evaluate tumor differentiation. Correlation was statistically analyzed using chi-square tests. Results　The high-level rate of HBV-DNA in the SOAT1 high expression group was 81.1% (30/37) compared to 19.1% (4/21) of the SOAT1 low expression group, with statistical significance, and there was also a correlation between SOAT1 expression and HBV-DNA levels (χ2=21.253,P<0.05). In the low differentiation hepatocellular carcinoma group, the rate of HBV-DNA high levels was 71.1% (27/38), while it was 35.0% (7/20) in the well-moderate differentiation group, with statistical significance. There was also a significant correlation between HBV-DNA levels and tumor differentiation degree (χ2=7.021,P<0.05). The overall positive rate of SOAT1 expression in all collected cases was 63.8% (37/58), with no expression (0/58) detected in all paired paracancerous tissues, with statistical significance (P<0.05). Furthermore, the expression level of SOAT1 protein in cancer tissues was correlated with the degree of tumor differentiation (χ2=19.889,P<0.05). SOAT1 was generally highly expressed in the low differentiated case group, with a positive rate of 84.2% (32/38), while SOAT1 was generally low expression or no expression in HCC samples with a higher degree of differentiation, with only a few samples exhibiting high expression, with a high expression rate of 25.0% (5/20). Conclusions　There is a correlation between HBV-DNA levels and hepatocellular carcinoma differentiation degree, with higher levels of HBV-DNA detected in low differentiation tumors. Additionally, the expression level of SOAT1 is also related to the degree of differentiation of hepatocellular carcinoma, and the expression level of SOAT1 in low differentiated carcinoma is also higher. Furthermore, there is a positive correlation between HBV-DNA levels and SOAT1 expression levels, and SOAT1 is a key enzyme involved in cellular lipid metabolism. These findings suggest that HBV infection may affect the function and level of SOAT1, which may interfere with hepatocyte lipid metabolism and participate in tumor genesis and evolution.

Cardiovascular health status of Chinese adults based on "Life's Essential 8" score / 中华流行病学杂志

Objective: To assess the cardiovascular health status of adults in China by using the "Life's Essential 8" score, and provide reference for the development and improvement of cardiovascular disease prevention and control policies and measures. Methods: Chronic Disease and Nutrition Surveillance was conducted in 298 counties/districts in 2015 in 31 provinces (autonomous regions, municipalities) across China, multi-stage stratified cluster random sampling was used to select 45 households in each village or neighborhood, and 20 households were further selected to conduct dietary surveys. In this study, a total of 70 093 adults aged ≥20 years who completed the dietary survey and had complete information were included, their cardiovascular health status were assessed by using the "Life's Essential 8" score, a cardiovascular health scoring standard released by the American Heart Association in 2022. All results were adjusted using complex design-based sampling weights to achieve a better estimate of the population. Results: In 2015, the overall cardiovascular health score of Chinese adults aged ≥20 years was 73.3±12.6, the score was significantly higher in women (77.9±11.6) than in men (68.7±11.8), and higher in urban area (74.5±12.8) than in rural area (71.9±12.2), the differences were significant (P<0.001). It was estimated that about 0.25% (95%CI: 0.16%-0.33%) of adults in China had cardiovascular health score of 100, and 33.0% (95%CI: 31.6%-34.3%), 63.2% (95%CI: 62.1%-64.3%), and 3.9% (95%CI: 3.5%-4.2%) of adults had high, moderate and low cardiovascular health scores, respectively. The proportion of those with high cardiovascular health scores was relatively low in men, those with low education level, those with low income, those living in rural areas, and those living in southwest China (P<0.001). Of the eight factors, diet had the lowest mean score (46.0, 95%CI: 44.7-47.3), followed by blood pressure (59.4, 95%CI: 58.2-60.6) and tobacco exposure (61.4, 95%CI: 60.6-62.2). Conclusions: The cardiovascular health status of two-thirds of adult population in China needs to be improved. Diet, tobacco exposure, and blood pressure are the factors affecting the cardiovascular health of Chinese population, to which close attention needs to be paid, and men, rural residents, and those with lower socioeconomic status are key groups in cardiovascular health promotion.

Analysis on trend of health examination rate and influencing factors in adults in China, 2010-2018 / 中华流行病学杂志

Objective: To understand the health examination rate and its changing trend in adults in China from 2010 to 2018, identify the main factors affecting the health examination rate and provide data support for decision making of health intervention. Methods: Data from China Chronic Disease and Risk Factor Surveillance in 2010, 2013, 2015 and 2018 were used. After complex weighting of the data, the rates of health examination, its changing trends and reasons for receiving health examination in adults were analyzed. Average annual percent change (AAPC) was used to describe the changing trend. Anderson model was used as the analysis framework. Multivariate logistic regression model was used to identify the influencing factors for the health examination rate. Results: From 2010 to 2018, the health examination rate in adults increased from 28.2% (95%CI: 24.8%-31.6%) to 41.0% (95%CI: 38.9%-43.1%, P for trend <0.001), the AAPC was 5.47%, the annual average increase was more obvious in those with lower education level and lower income level and in those living in rural area and in western China. In 2018, people received health examination mainly due to providing without charge by community (36.7%) and working unit (28.5%). The results of multivariate analysis showed that being women, age ≥45 years, education level of junior high school or above, living in urban areas, medical insurance, annual income ≥24 000 RMB, suffering from multiple chronic diseases, non-smoking, drinking, adequate physical activity were positive factors for receiving health examination. Conclusion: The rate of health examination in adults increased in China during 2010-2018, and the main reason for receiving health examination is free of charge.

Hypertension Prevalence, Awareness, Treatment, and Control and Their Associated Socioeconomic Factors in China: A Spatial Analysis of A National Representative Survey / 生物医学与环境科学（英文）

Objective@#We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China.@*Methods@#A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015-2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators.@*Results@#Overall, it was estimated that 29.20% of the participants were hypertensive nationwide, among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment, and 7.81% had controlled their condition. Per capita gross domestic product (GDP) was associated with hypertension prevalence (coefficient: -2.95, 95% @*Conclusion@#Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.

Association of homocysteine with ankylosing spondylitis: a systematic review and meta-analysis

Abstract Background: Hyperhomocysteinemia is associated with autoimmune diseases such as ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA). Current findings regarding plasma/serum homocysteine (HCY) levels in AS patients are inconsistent. This study aims to systematically evaluate the association between circulating HCY levels and AS. Methods: Online electronic databases (PubMed, Web of Science, Embase, ScienceDirect, China National Knowledge Infrastructure (CNKI), and Wanfang data) were used to retrieve all relevant articles published up to May 7, 2020. The pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated using the random-effect model, Stata16 software. Results: Nine articles containing 778 AS patients and 522 controls were included in this meta-analysis. No significant differences in HCY levels were found between AS and control groups (pooled SMD = 0.46, 95% CI = − 0.30 to 1.23, P = 0.23). However, subgroup analysis suggested that HCY levels were significantly higher (P < 0.05) in the AS group treated with methotrexate (MTX) compared with the control group. In contrast, HCY levels were significantly (P < 0.05) lower in the AS group receiving anti-TNF-α treatment compared with the control group. No significant differences were detected between HCY levels and disease activity scores (Bath AS disease activity index, BASDAI), and methylenetetrahydrofolate reductase (MTHFR) C677T genotype. Conclusion: This meta-analysis indicates that HCY levels are similar between AS and controls, and do not correlate with disease activity. However, different medical treatments cause fluctuations of circulating HCY levels in AS patients. Further and larger-scale studies are needed to confirm these findings. Trial registration: This study was registered at international prospective register of systematic reviews (PROSPERO), registration number: CRD42020184426.(AU)

Underestimation of weight status among overweight and obese adults in China in 2013 / 中华疾病控制杂志

Objective The aim is to understand the underestimation of body weight status and its associated factors among overweight and obese adults in China. Methods Nationally representative data were collected in 2013 by the China Chronic Disease and Risk Factor Surveillance which used a multistage stratified cluster sampling method. A total of 87 552 overweight and obese adults aged ≥18 years old were included. Demographic characteristics, weight perception and disease status were obtained from in-person interviews. Height, weight and blood pressure were measured through physical examination. Venous blood samples were obtained and assayed for fasting plasma glucose, 2-hour oral glucose tolerance test, total cholesterol, triglycerides, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Complex sampling was weighted and multiple logistic regression models were used for analyzing. Results Among overweight and obese adults, 74.7% (95% CI: 73.3%-76.1%) underestimated their weight status. The mild underestimation rate was 60.7% (59.6%-61.7%) while the severe was 14.0% (13.1%-14.9%). The aged, low education level, low annual income, rural area and obesity were risk factors for both weight status underestimation and severe underestimation (all P<0.05). Awareness of having hypertension and dyslipidemia were protective factors (all P<0.05). Conclusions Most overweight and obese adults in China underestimated their own weight status, which was affected by age, education and income level, awareness of having chronic diseases and other factors. Targeted interventions should be carried out for different characteristic groups.

Vegetable and Fruit Consumption among Chinese Adults and Associated Factors: A Nationally Representative Study of 170,847 Adults / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study examined vegetable and fruit (VF) consumption rate and its associated factors among Chinese adults.</p><p><b>METHODS</b>Nationally representative data from the 2013 China Chronic Disease Surveillance survey were used. Dietary intake data, including VF consumption during the last 12 months, were collected. All analyses were weighted to obtain nationally representative estimates. Associations between VF consumption and other factors (e.g., meal frequency and physical activity) were examined through logistic regression analysis.</p><p><b>RESULTS</b>The average fruit consumption was 102.3 g/day (95% CI: 97.0-107.6) and the average vegetable consumption was 350.6 g/day (95% CI: 339.3-361.8). Over half (53.2%, 95% CI: 50.9-55.4) of Chinese adults met the VF consumption of 400 g/day recommended by the World Health Organization (WHO). Rural residents had a higher prevalence of low VF consumption rate than urban residents [49.20% (95% CI: 46.2%-52.2%) vs. 44.0% (95% CI: 41.7%-46.3%) P < 0.01]. Old age (OR = 1.01, 95% CI: 1.00-1.01), low educational level, low income, minority ethnicity (OR = 1.41, 95% CI: 1.15-1.74), underweight (OR = 1.17, 95% CI: 1.03-1.33), single marital status (OR = 1.20, 95% CI: 1.08-1.33), low health literacy, irregular breakfast (OR = 1.20, 95% CI: 1.04-1.38) or lunch (OR = 1.58, 95% CI: 1.26-1.99) habits, and no leisure-time physical activity were associated with low VF consumption.</p><p><b>CONCLUSION</b>Only half of Chinese adults met the VF consumption recommended by the WHO. Low socio-economic status, irregular diet, and poor health literacy were likely associated with low VF consumption. National efforts and programs are needed to promote VF consumption.</p>

Prediction of 10-year Atherosclerotic Cardiovascular Disease Risk among Adults Aged 40-79 Years in China: a Nationally Representative Survey / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To establish the distribution of 10-year atherosclerotic cardiovascular disease (ASCVD) risk among Chinese adults.</p><p><b>METHODS</b>We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations (PCEs) to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants (representing 520,158,652 Chinese adults) aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease (ICVD) risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases (Chinese model).</p><p><b>RESULTS</b>Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million (47.4%) and 107 million (20.6%) adults had ⋝ 7.5% and > 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk > 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs.</p><p><b>CONCLUSION</b>Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.</p>

Survey on current status of cognitive function among Chinese elderly people / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the current status and distribution features of cognitive function among the elderly population of China.</p><p><b>METHODS</b>A total of 18 137 subjects aged over 60 years old from 2010 Chronic Non-communicable Disease & Risk Factor Surveillance in China were selected in this study. Questionnaire was used to collect the information about gender, age and health status. The Mini-Mental State Examination (MMSE) was adopted as an instrument to measure the cognitive function of adult who had self-reported memory decline. After performing complex weighted analysis, the current status of cognitive function and the prevalence of cognitive disorder were compared by different genders, age groups, urban/rural and education levels.</p><p><b>RESULTS</b>Among the 18 086 subjects, the median of MMSE sore was 23. The score was higher in males (25) than in females (22) and it was higher in urban (25) than in rural area (22). The cognitive function declined with age increasing. The group of people aging 60-64 years old had the highest score (26), and the group of people aging ≥ 80 years old had the lowest score (19). The MMSE score rose up with education level increasing, the group of people with education level above middle school had the highest score (28) and the group of illiterate people had the lowest score (20). The prevalence of overall cognitive disorder was 10.12% (95%CI: 8.22%-12.02%). The female prevalence (12.45%, 95%CI:9.95%-14.94%) was higher than male prevalence (7.68%, 95%CI:5.94%-9.43%). The group of people aged 60-64 years old had the lowest prevalence (4.69%, 95%CI:3.40%-5.98%), and the people aged ≥ 80 years old had the highest prevalence (22.43%, 95%CI:17.80%-27.05%). The prevalence increased with age increasing (χ(2) = 320.02, P < 0.01). The prevalence of cognitive disorder in illiterate group was 14.6% (95%CI:12.01%-17.23%), and it was separately 6.92% (95%CI: 5.21%-8.64%) and 3.99% (95%CI: 2.58%-5.40%) in group of people with education background of primary school and middle school. The prevalence decreased with education levels increasing (χ(2) = 156.49, P < 0.01). Married or cohabiting elderly people had the lowest prevalence (8.51%, 95%CI: 6.58%-10.43%), lower than single ones (9.32%, 95%CI: 4.00%-14.64%) and divorced ones (14.89%, 95%CI: 12.37%-17.50%). The prevalence of cognitive disorder among rural population (12.16%, 95%CI: 9.51%-14.82%) was higher than it among urban population (5.93%, 95%CI: 4.78%-7.07%). The prevalence in central area (13.57%, 95%CI: 8.55%-18.58%) was higher than that in east (7.96%, 95%CI: 6.17%-9.74%) and west region (9.50%, 95%CI: 7.62%-11.38%) of China. The difference was statistically significant (χ(2) = 54.55, 29.76, 8.81 respectively, P < 0.05).</p><p><b>CONCLUSION</b>The prevalence of cognitive disorder among the elderly people over 60 years old was age-related and varied by different gender, marriage status, educational status and the regional distribution.</p>

Prevalence and characteristic of overweight and obesity among adults in China, 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the prevalence and characteristics of overweight and obesity among Chinese adults aged 18 and above, in year 2010.</p><p><b>METHODS</b>A total of 98 271 adults aged 18 and above, who were sampled from 162 surveillance points of 31 provinces of China mainland, were enrolled in the study. Weight and height of each subject were measured, and then body mass index (BMI) was calculated. Overweight was defined as 24 kg/m² ≤ BMI < 28 kg/m², while obesity was defined as BMI ≥ 28 kg/m². After complex weighting, the prevalence of overweight and obesity among total population and specified rates among different populations by gender and districts and age were calculated.</p><p><b>RESULTS</b>Prevalence rate of overweight among Chinese adults was 30.6%, separately at 31.5% and 29.7% among males and females (χ² = 16.05, P < 0.01); 27.1%, 37.2% and 32.3% in groups of population aged 18 - 44, 45 - 59 and over 60 year-old, respectively (χ² = 482.00, P < 0.01); separately at 33.9% and 29.1% in urban and rural areas (χ² = 21.14, P < 0.01); 32.0%, 31.1% and 28.0% in eastern, central and western regions, respectively (χ² = 8.72, P < 0.05). Prevalence rate of obesity among Chinese adults was 12.0%, separately at 11.9% and 12.1% among males and females (χ² = 0.33, P > 0.05); and 10.6%, 14.7% and 12.6% in groups of populations aged 18 - 44, 45 - 59 and over 60 year-old, respectively (χ² = 111.25, P < 0.01); separately at 14.2% and 11.0% in urban and rural areas (χ² = 12.11, P < 0.01); and 13.5%, 11.9% and 9.9% in eastern, central and western regions, respectively (χ² = 10.05, P < 0.01). The total prevalence rate of overweight and obesity among Chinese adults was 42.6%. It appeared that the total prevalence rate of overweight and obesity among urban populations (48.1%) were higher than rural populations (40.1%) (χ² = 20.37, P < 0.01); while the total rate showed a gradual decreasing trend from eastern (45.5%) to central (43.0%) and western (37.9%) regions (χ ²= 10.46, P < 0.01).</p><p><b>CONCLUSION</b>The prevalence of overweight and obesity were comparatively high among Chinese adults aged 18 and above in year 2010, and significant differences could be found among gender, age, urban or rural areas and eastern, central or western districts.</p>

Study on hepatitis C virus genotypes in Yantai district, Shandong province / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To understand the hepatitis C virus (HCV) genotype distribution in Yantai district of Shandong province, and to explore whether the HCV genotypes was relevant to the injure of liver through the index of liver function.</p><p><b>METHODS</b>Using specific PCR primers to amplify the HCV RNA 5' UTR/NS5B,then PCR products were sequenced by genetic analyzer. The genotypes were identified by alignment to the GenBank reference sequences and construction the phylogenetic tree of 5' UTR.</p><p><b>RESULTS</b>Among 9 unpaid blood donors we detected two kinds of genotypes of 1b and 3a, respectively, 8 cases (88.9%) and 1 case (11.1%). Among 33 cases of hepatitis C patients we detected the 1b, 2a and 6a the three kinds of genotypes, respectively, 22 (66.7%), 10 (30.3%) and 1 (3.03%) cases. Subtype 1b is the advantage of popular genotype in HCV carriers from Yantai district, and the distribution of 1b was no significant difference in the different population (chi2 = 0.796, P = 0.373); The difference of indicator of liver damage in the different genotypes of subjects were significant (P < 0.05), the mean of ALT, AST of 2a-subtype carriers was significantly higher than the 1b-subtype population.</p><p><b>CONCLUSIONS</b>The genetic diversity of HCV in Shandong Yantai district was presented. The main genotypes were 1b-subtype, and 3a and 6a-subtype was detected firstly. The genotype of HCV were relevant to the liver damage indicators, 2a-subtype hepatitis C virus infection in the liver cells may play an important role in the disease process.</p>

Study on HLA nucleotide sequence matching in epitope positions among recipient-donor pairs for allogenic hematopoietic stem-cell transplantation / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the human leukocyte antigens(HLA)-A, -B, -Cw, -DRB1 and DQB1 nucleotide sequences between patients waiting for allogenic hematopoietic stem-cell transplantation (HSCT) and donors in Chinese population, and to establish strategy for maximizing optimal donor selection.</p><p><b>METHODS</b>HLA high-resolution typing in a total of 537 recipient-donor pairs was determined by sequence based typing (SBT) method. The nucleotide BLAST tool was used to compare the nucleotide sequences among recipient-donor pairs.</p><p><b>RESULTS</b>Only 16.20% (88/537) of recipient-donor pairs were found to fully match for nucleotide sequences of all HLA-A,-B,-Cw, -DRB1 and -DQB1 loci. Mismatch rate in single locus were 8.38% in HLA-A, 0.74% in HLA-B, 12.29% in HLA-C, 2.42% in HLA-DRB1, and 2.79% in HLA-DQB1, respectively. Mismatch rate in two or multiple HLA loci was 42.65%. Nonpermissive allele mismatch combinations (A 02:01-A 02:06, A 02:06-A 02:07, Cw 03:04-Cw 15:02, Cw 03:03-Cw 04:01, Cw 03:04-Cw 14:02, Cw 03:03-Cw 08:01, DRB1 04:03:01-DRB1 04:05) were detected in single mismatch HLA locus of recipient-donor pairs, mismatches of B 07:05:01-B 07:06, Cw 07:01:01-Cw 07:06 combinations outside of epitope positions were detected in two recipient-donor pairs.</p><p><b>CONCLUSION</b>Our data suggested that attention should be paid in comparing nucleotide sequences between recipient and donor, and in distinguishing nucleotide sequence mismatches within and outside of the epitope positions. These results could serve as guidelines for donor selection.</p>

Disease burden of chronic obstructive pulmonary diseases in west rural areas of China, 2004 - 2005 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the death burden of chronic obstructive pulmonary diseases (COPD) in west rural areas of China in 2004 - 2005.</p><p><b>METHODS</b>The data from 2004 - 2005 the Third National Mortality Retrospective Sampling Survey were used in the study. A total of 28 621 276 person years were investigated in west rural areas, which covered 12 provinces, and consisted of 42 surveillance districts. Based on the data of death cause and population, mortality of COPD, years of potential life lost(YPLL) rate, working YPLL (WYPLL) rate, YPLL rate due to COPD/YPLL rate due to all deaths in west rural areas were calculated and compared with other rural areas. Standardized death rate, standardized YPLL (SYPLL) rate, standardized working YPLL (SWYPLL) rate were calculated from census data in 2000 as standard population and 2004 - 2005 national life expectancy as standard life expectancy.</p><p><b>RESULTS</b>The elder has the higher crude death rate and YPLL rate of COPD in survey districts of west rural areas. And the crude death rate of COPD and YPLL rate were different in different genders. The YPLL rate was 15.47‰ in male and 15.73‰ in female. The crude death rate, YPLL rate, WYPLL rate, the ratio of YPLL rate due to COPD/YPLL rate due to all deaths in survey districts of west rural areas were: 109.53/100 000, 15.76‰, 2.82‰, 11.23%, which were high. While crude death rate, YPLL rate, WYPLL rate, the ratio of YPLL rate due to COPD/YPLL rate due to all deaths in the poorest survey districts of west rural areas were: 122.04/100 000, 27.47‰, 4.26‰, 13.44%, which were higher than other stratifications of west rural areas.</p><p><b>CONCLUSION</b>The death burden of COPD in west rural areas in 2004 - 2005 was the heaviest one in China which experienced the feature that the poorer the rural regions, the heavier the death burden.</p>

Detection and analysis of gene polymorphism in hepatitis B virus C region / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the variations of gene C in hepatitis B viruses between hepatitis B patients and healthy carriers, and provide experimental evidences for analysis of virus gene mutations acting on the virus material science and response of the body to the virus.</p><p><b>METHODS</b>The virus DNA load in hepatitis B patients and healthy blood donors was investigated by real-time polymerase chain reaction (PCR). Gene sequence analysis was taken to detect gene polymorphism, and all the success samples were compaired with standard strain by DNAstar.</p><p><b>RESULTS</b>(1)G Compared with standard strain, C region in all samples had mutations, there were 31 mutations in at least 2 samples (3 mutations in gene PreC and 28 mutations in gene C), including 9 missense mutations, 1 chain termination mutation and 21 synonymous mutation. Mutations nt 1827 c-->a and nt 2221 c-->t existed in all the samples, and most samples had 6 synonymous mutations. Four hepatitis B patients had mutation nt1896 g-->a, and another 4 patients had 2 mutations, namely, S87G and I97F (or 197L) in HBcAg CTL recognition episome. (2) The success ratio of amplification and sequencing of HBV DNA was closely associated with its copy numbers. In the present study, copy numbers of HBV DNA which were successfully amplified and sequenced were almost more than 40 193/ml.</p><p><b>CONCLUSIONS</b>HBV genome were easily affected by nucleotide mutations, 2 residues had mutations in gene of C region, which is firstly reported, suggesting these mutations may be geographical restricted. Mutations in gene of C region may either change the structure and function of HBeAg and HBcAg, which may further induce the escape of immune clearance for HBV or influence the detection of HBsAg or HBeAg, which may creat new problems for the prevention, diagnosis and treatment of hepatitis B.</p>

Chimeric Ad5F35 adenoviral vector-mediated expression of mutant IκBα induces apoptosis of leukemia cells / 中国实验血液学杂志

Constitutive activation of nuclear transcription factor-κB (NF-κB) exists in a variety of leukemia, and induction of apoptosis through blocking NF-κB activation may be an alternative strategy for leukemia treatment. The aim of this study was to investigate the inducing effect of modified adenovirus 5-based adenovirus vector (i.e. chimeric Ad5F35 Vec)-mediated expression of mutant IκBα (IκBαDN) on apoptosis of HL-60 cells. The recombinant Ad5F35-IκBαDN Vec carrying IκBαDN cDNA which deleted the first 1-70 amino acids coding sequences at 5' terminal of human IκBα was transfected into HL-60 cells. The apoptosis, NF-κB DNA binding activity, the expressions of IκBα, cIAP-2 and xIAP in HL-60 cells were detected by DNA binding assay, flow cytometry, real-time quantitative polymerase chain reaction and Western blot respectively. The results showed that apoptosis rates were 22.53 ± 2.999%, 6.08 ± 2.464% and 4.86 ± 1.366% for Ad5F35-IκBαDN Vec-infected or blank vector of Ad5F35-EGFP Vec-transfected and untransfected HL-60 cells respectively, which showed a significant difference between Ad5F35-IκBαDN Vec-transfected and untransfected cells (p < 0.001) and between Ad5F35-IκBαDN Vec-transfected and Ad5F35-EGFP Vec-transfected cells (p < 0.001, p < 0.002), while NF-κB DNA binding activity was decreased, the truncated IκBα was expressed, and IκBα mRNA expression was up-regulated, but the expression of cIAP-2 and xIAP mRNA was down-regulated after transduction for 48 hours. It is concluded that the chimeric Ad5F35 Vec can effectively mediate the expression of IκBαDN cDNA in HL-60 cells, leading to the inhibition of NF-κB DNA binding activity and inducing apoptosis of HL-60 cells.

Effect of food drying methods on fluoride content in maize and pepper in coal-burning type of fluorosis regions / 中国地方病学杂志

Objective To explore the effect of different processing and drying methods of corn and hot pepper on fluorine content in coal-burning type of the endemic fluorosis areas, and to screen food processing and drying methods which meet the quality requirements of grain drying and able to effectively reduce the total fluoride intake of local population. Methods Farmers of endemic fluorosis area in Bijie, Guizhou province were divided into 3 groups: sun-baked drying group, stove drying group with air-tight cover and stove drying group with no cover, 10 households in each group. Corn and fresh hot pepper and samples dried for 2 weeks, or 1, 3, 6-month were collected, and water and fluoride content were detected, and the total daily fluoride intake were calculated in accordance with the "Determination of Water in Food" (GB/T 5009.3-2003) and "Determination of Fluorine in Foods"(GB/T 5009.18-2003). Results Fluoride content in fresh corn and dried for 2 weeks, or 1, 3, 6-month [of sunbaked drying group: (1.40 ± 0.16), (1.56 ± 0.14), (2.15 ± 0.47), (2.70 ± 0.64), (4.06 ± 1.75)mg/kg, stove drying group with air-tight cover: (1.41 ± 0.16), (2.39 ± 0.56), (4.60 ± 0.97), (8.46 ± 5.55), (11.36 ± 3.60)mg/kg,stove drying group with no cover: (1.40 ± 0.13), (4.69 ± 3.97), (4.47 ± 2.77), (9.65 ± 6.47), (26.12 ± 14.52)mg/kg] and pepper[sun-baked drying group: (5.41 ± 1.61), (16.60 ± 7.62), (32.60 ± 7.88), (50.26 ± 17.60),(240.20 ± 272.49)mg/kg, stove drying group with air-tight cover: (754 ± 2.95), (3238 ± 11.50), (119.18 ± 156.45),(224.00 ± 196.58), (495.70 ± 417.29)mg/kg, stove drying group with no cover: (4.82 ± 1.25), (44.30 ± 13.48),(122.89 ± 66.43), (334.23 ± 166.05), (531.01 ± 397.40)mg/kg] increased with elongation of drying time, and the group difference was significant(F = 44.77, 128.71, 126.87, 41.61, 53.63, 170.63, all P ＜ 0.05), with the largest rate of increase in stove drying group with no cover, and the lowest in sun-baked drying group;fluoride was significantly lower (t = 7.93,63.07,5.36,11.98,55.76,7.45, all P ＜ 0.05) after sample washing;total fluoride intake per person per day was 2.57 mg in local adult when ate washed and sun-baked corn, peppers, the total fluoride intake were 5.92, 8.14 mg when ate the food processed by other two drying methods and washed corn, peppers,respectively. Conclusions In the coal-burning type of fluorosis endemic area, should take appropriate health education measures, and instruct local residents to use sun bake their edible corn and pepper for human consumption, and cultivate a habit of washing corn and pepper before cooking, which can reduce the population total fluoride intake, and control endemic fluorosis.

Polymorphisms of Epstein-Barr virus BHRF1 gene, a homologue of bcl-2 / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>EBV BamHI fragment H rightward open reading frame 1 (BHRF1), the Epstein-Barr virus (EBV) early gene, is structurally and functionally homologous to the oncogene bcl-2 and may play an important role in the development of EBV-associated tumors. To characterize the polymorphisms of BHRF1 in EBV-associated tumors, we analyzed the sequences of BHRF1 in isolates from nasopharyngeal carcinoma (NPC) and EBV-associated gastric carcinoma (EBVaGC) biopsies as well as throat washing (TW) samples from healthy donors.</p><p><b>METHODS</b>BHRF1 DNA sequences were analyzed by polymerase chain reaction (PCR) and sequencing for 39 NPC samples, 40 EBVaGC samples, and 53 EBV-positive TW samples from healthy donors. The variants of BHRF1 gene were classified according to the signature changes. The EBV types 1 and 2 at nuclear antigen (EBNA) 3C locus were determined by PCR.</p><p><b>RESULTS</b>Compared with EBV standard cell line B95-8, all isolates carried a silent mutation at amino acid (AA) 80 (nucleotide 54616 T→C), the AA88 L→V mutation was found in most isolates, and the AA79 V→L mutation in a few isolates. Other mutations were sporadically distributed. Based on the mutations at AA88 and AA79, 3 distinct variants of BHRF1 genes, designated as 79V88V, 79L88L, and 79V88L, were identified. The 79V88V was the most common variant. The distribution of the BHRF1 variants among the NPC, EBVaGC, and TW samples was not significant. The corresponding regions of bcl-2 homologues were conserved in all isolates except for 3 samples. The distribution of BHRF1 variants in type 1 and type 2 strains was significant different (P < 0.001, contingency coefficient was 0.554).</p><p><b>CONCLUSIONS</b>The 79V88V is the dominant variant in NPC, EBVaGC, and TW samples from healthy donors and preferential linkages between BHRF1 and EBNA3C variants exist. Conserved BHRF1 in Bcl-2 homologous domains is helpful to remain the important role of BHRF1.</p>

The mortality trends of infectious diseases, maternal and perinatal diseases, and nutritional deficiencies in China, 1973-2005 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the mortality and the constitution of total deaths of infectious disease, maternal and perinatal diseases, nutritional deficiencies and their trends in China, 1973-2005.</p><p><b>METHODS</b>The following data collected from three national retrospective sampling surveys of death causes were used: 1973-1975 nation-wide cancer mortality survey for person years of approximately 2 513 949 310; 1990-1992 nation-wide cancer mortality survey for person years of approximately 335 213 493; 2004 - 2005 the 3rd national retrospective sampling survey of death cause for person years of approximately 142 660 482 by three age groups (0-, 15- and 60-). Based on the data, the crude death rates of ages, genders and diseases were calculated. The standardized death rates were calculated using the population census data of 2000.</p><p><b>RESULTS</b>The total number of deaths caused by infectious diseases, maternal and perinatal diseases, and nutritional deficiencies were 4 913 521, 284 811 and 47 161 in 1973-1975, 1990-1992 and 2004-2005, respectively; the crude death rates were 195.45, 84.96, 33.06 per 100 000, and the standardized death rates were 158.71, 70.76, 27.98 per 100 000. Total number of deaths caused by the above diseases in urban and rural areas were 11 752 and 35 409 during 2004 - 2005, respectively; the crude death rates were 24.69 and 37.35 per 100 000, and the standardized death rates were 19.62 and 32.12 per 100 000. There were 26 176 deaths due to the above diseases in male and 20 985 in female; the crude death rates were 35.87 and 30.11 per 100 000; the standardized death rates were 35.23 and 26.65 per 100 000. The number of deaths reported in different regions were 13 286, 13 922 and 19 953 in eastern, central and western areas respectively; the crude death rates were 25.28, 27.97 and 49.48 deaths per 100 000; the standardized death rates were 21.33, 28.10 and 45.98 per 100 000. The top three causes of death were pneumonia, tuberculosis and virus hepatitis, and the case numbers were 14 265, 8537 and 5771, respectively. The death rates were 10.00, 5.98 and 4.05 per 100 000, the standardized death rates were 8.88, 5.46 and 3.74 per 100 000. The percentage of total deaths (868 484 cases) of infectious diseases, maternal and perinatal diseases, and nutritional deficiencies was 5.43%, which was decreased 80.52% from 1973 - 1975 (27.87%, 4 913 521/17 629 350).</p><p><b>CONCLUSIONS</b>The mortality of infectious diseases, maternal and perinatal diseases, and nutritional deficiencies were generally consistent with long-term decreasing trends observed, the mortality in urban area was greater than that in rural area, the rate in male was greater than that in female, the rate in western region was greater than that in central and eastern regions.</p>