ObjectivesTo compare different formula calculated dosages with the actual doses of warfarin from patients in Beijing Hospital so as to investigate suitable warfarin dosing models for Chinese patients.MethodsOne hundred and three Chinese patients with long-term prescription of warfarin were randomly selected from Beijing Hospital from July 2012 to May 2013. The CYP2C9 and VKROC1 genotypes and basic statistical information were collected. SPSS 18.0 software was used to compare the differences between different formula calculated dosages and the actual dosages of warfarin.ResultsFive genotypes were found in 103 patients, including: CYP2C9 AA genotype + VKORC1 AA genotype (n=72, 69.9%), CYP2C9 AA genotype + VKORC1 AG genotype (n=17, 16.5%), CYP2C9 AC genotype + VKORC1 AA genotype (n=10, 9.7%), CYP2C9 AC genotype + VKORC1 AG genotype (n=3, 2.9%) and CYP2C9 AA genotype + VKORC1 GG genotype (n=1, 1%). Compared with the actual dosages of warfarin, the degree of coincidence was highest for dosages calculated by Jeffrey’s formula.Conclusions Using Jeffrey’s formula to calculate warfarin dosages may be more suitable for Chinese patients with using long-term warfarin. Due to limited sample size, prospective and large sample size studies are required to verify the above conclusion.
ObjectiveTo analyze the clinical characteristics of thrombo embolism (TE) in Chinese hypertrophic cardiomyopathy (HCM) patients. MethodsThis study retrospectively analyzed HCM patients admitted to West China Hospital of Sichuan University. The endpoints were defined as a composite of TE events, including ischemic stroke, transient ischemic attack, and peripheral arterial embolization. ResultsA total of 537 HCM patients were included with a median follow-up of 4.2 years. Forty-two patients reached the TE endpoint and the incidence was 1.9%. The annual incidence of TE was approximately 1.1% and 6.6% for HCM patients without/with atrial fibrillation, respectively. The recurrence rate of TE was high (approximately 26.2%). The mean age was 66.4±13.7 years for the first TE, and the incidence of TE was significantly increased at age ≥70 years. ConclusionThe incidence of TE is high in HCM patients, especially in those with atrial fibrillation, and the recurrence rate of TE is also high.
Objective We investigated and analyzed past and ongoing welfare programs related to health equity, and the relevant policies, documents, and interventions measures for improving China’s migrant worker population’s accessibility and utilization of tuberculosis (TB) control services in TB control programs. Then we evaluated their impactin order to provide evidence and suggestions for the further TB prevention and treatment. Methods We retrieved published documents about TB prevention and treatment of the migrant worker population dating from 1998 to 2008 from MEDLINE, PubMed, CNKI, CBMdisc CDDB, and VIP electronically. Simultaneously, a series of interviews was conducted with patients who used the programs. Results Totally, 58 documents were retrieved. Of these documents 13 passed eligibility criteria: eight have been published, five have not been published, and only one of them is RCT with B degree for quality of evidence. Secondary document research has suggested that the intervention measures that have been adopted concerning TB in China, including health promotion, providing incentive, patient tracking and supervision management. Although tuberculosis cure rates have improved, the scene interviews show that the majority of TB and suspected cases of patients don’t have enough knowledge on TB prevention and free treatment policies. It is often difficult to track the migrant population. TB detection and treatment still need to be enhanced. Conclusions There it is lack of high-quality documents about good intervention design, so it is difficult to make a objective and fair evaluation to the effects of intervention on the migrant population. In the future, we should carry out large-scale, multicenter, high-quality RCTs specifically for TB controlin the migrant population in order to provide evidencefor making a scientific and feasible intervention project.
The management of middle-aged and youth hypertension has become a challenge in clinical practice. The hypertension group of the Chinese Society of Cardiology published the expert consensus on the management of hypertension in young and middle-aged Chinese population in 2019. This paper interprets the key contents of the consensus and provides references for management of young and middle-aged hypertension.
ObjectiveTo systematically review the implementation status, effectiveness and existing problems of nutrition improvement measures for vulnerable populations in rural areas of China. MethodsAll studies about the implementation status, effectiveness and existing problems of nutrition improvement measures for vulnerable populations in rural areas of China were electronically searched in VIP, CNKI, WanFang Data and CBM from inception to January 1st, 2014. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies, and then performed qualitative analysis in terms of implementation effectiveness and situation. ResultsA total of 79 studies were finally included. The results of qualitative analysis showed that:the earliest study was published in 1990; 38.0% of these studies were carried out in the southwest and northwest areas of China; 31.6% of these studies were financially supported, and most funds were provided by some international institutions; 90.0% of these research subjects focused on infants and children (under the age of 10); a variety of nutrition improvement measures had been taken, and 55.7% of these interventions measures were nutrition education which could be implemented easily; the implementation duration of 38.0% of these measures lasted less than half a year; 32.9% of these studies adopted the blood test to evaluate the outcomes of nutrition measures; all of the studies showed that nutrition levels of vulnerable populations in rural areas of China had been obviously improved by these measures. ConclusionThe nutrition improvement measures for vulnerable populations in rural areas of China have been implemented relatively earlier focusing on populations in West China where was less developed. However, an imbalance exists in the attention to target populations, especially to the elderly. Face to face nutrition education is most frequently taken; however, it could not directly reflect the changing of nutritional status. In addition, implementation duration is fairly short which indicates that more fund supports are needed from the government or institutions.
Objective To systematically evaluate the correlation between endometriosis (EM) in Chinese women and Xba I polymorphism in intron-1 of estrogen receptor α (ER-α) gene. Methods Such databases as PubMed, MEDLINE, The Cochrane Library (Issue 3, 2012), VIP, CBM, WanFang Data and CNKI were searched to collect case-control studies about the correlation between EM and Xba I polymorphism in intron-1 of ER-α gene. The retrieval time was from 1980 to 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data and assessed the quality, and then the meta-analysis was conducted by using RevMan 5.0 and Stata 12.0 software. Results A total of 7 studies involving 676 EM patients and 688 healthy volunteers were included. The results of meta-analyses showed that Chinese women with X/X genotype had similar risk of EM compared to those with x/x genotype (OR=0.95, 95%CI 0.58 to 1.54, P=0.82) or X/x genotype (OR=0.73, 95%CI 0.44 to 1.20, P=0.22). The allele X also showed similar risk of EM compared to the allele x (OR=1.11, 95%CI 0.93 to 1.33, P=0.25). Conclusion At present, it has not yet been found that the incidence of EM in Chinese women is related to the Xba I polymorphism in intron-1 of ER-α gene as well as the allele X. For the quantity and quality limitation of the included studies, this conclusion has to be proved by more studies.
ObjectiveTo study the effectiveness and safety of glucosamine for osteoarthritis (OA) in Asian population. MethodDatabases of PubMed, Embase, CNKI, VIP and Wanfang were searched from the time of establishment till May 2014 and controlled trials of glucosamine compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) were included. Quality evaluation and Meta-analysis by using RevMan 5.1 were performed. ResultsA total of 17 studies including 2 251 cases were included. The efficiency rate in the glucosamine group was higher than that in the NSAIDs group[OR=3.03, 95% CI (1.78, 5.18), P<0.000 1]. The efficiency rate in the glucosamine combined NSAIDs group was higher than that in the NSAIDs group[OR=4.30,95%CI (1.84,10.06),P=0.000 8]. The safety analysis showed that the adverse event rate in the glucosamine group was lower than that in the NSAIDs group[OR=0.23,95%CI (0.14,0.37),P<0.000 01], while the difference between the glucosamine combined NSAIDs group and the NSAIDs group was not statistically significant[OR=0.84, 95%CI (0.50, 1.41), P=0.50]. ConclusionsCompared with NSAIDs, glucosamine is better and safer for OA treatment in Asian population.
Twenty patients with chronic lymphedema had been treated by microwave heating. T-lympocyte subpopulation and HLA-DR phenotype of peripheral blood in patientswith lymphedema were examined by using dual colour flow cytometry before and after treatment. We found that CD4 (T helpe/inducer) in chronic lymphedema decreased significantly (Plt;0.01), HLA-DR increased significantly (P lt;0.05). After the microwave treatment, the CD4, CD4/CD8 ratio increased significantly; HLA-DR, HLA-DR+CD+8 lymphocyte reduced. It was clear that microwave could regulate the immunological disorder of lymphedema patients.
Subpopulation treatment effect pattern plot (STEPP) method is a method for examining the relationship between treatment effects and continuous covariates and is characterized by dividing the study population into multiple overlapping subpopulations to be analyzed based on continuous covariate values. STEPP method has a different purpose than traditional subgroup analyses, and STEPP has a clear advantage in exploring the relationship between treatment effects and continuous covariates. In this study, the concepts, advantages, and subpopulation delineation methods of the STEPP method are introduced, and the specific operation process and result interpretation methods of STEPP method analysis using the STEPP package in R language are presented with examples.
ObjectiveThis study aims to analyze the trends in Parkinson’s disease incidence rates among the elderly population in China from 1990 to 2021 and to forecast incidence growth over the next 20 years, providing. MethodsJoinpoint regression and age-period-cohort models were employed to analyze temporal trends in Parkinson’s disease incidence, and the Nordpred model was used to predict case numbers and incidence rates among the elderly in China from 2022 to 2044. ResultsFindings indicated a significant increase in Parkinson’s disease incidence among China’s elderly population from 1990 to 2021, with crude and age-standardized incidence rates rising from 95.37 per 100 000 and 111.05 per 100 000 to 170.52 per 100 000 and 183.91 per 100 000, respectively. Predictions suggested that by 2044, the number of cases will rise to approximately 878 264, with the age-standardized incidence rate reaching 223.4 per 100 000, and men showing significantly higher incidence rates than women. The rapid increase in both cases and incidence rates indicated that Parkinson’s disease will continue to impose a heavy disease burden on China’s elderly population. ConclusionThe burden of Parkinson’s disease in China’s elderly population has grown significantly and is expected to worsen. To address the rising incidence rates effectively, it is recommended to enhance early screening and health education for high-risk groups, improve diagnostic and treatment protocols, and prioritize resource allocation to Parkinson’s disease prevention and care services to reduce future public health burdens.