Objective To investigate the risk factors of infantile urolithiasis resulted from taking milk powder with melamine. Methods The clinical data of infant and young children who took free-screening for melamine associated urolithiasis in the Lanzhou University Second Hospital from September 14th, 2008 to January 6th, 2009 were collected, while the infants without urolithiasis in the same number as those with urolithiasis were also randomly collected into the control group. Then both univariate and multivariate analyses were performed with a logistic regression model to assess the independent risk factors for urolithiasis. Results Of the screened children, 647 children were included in the urolithiasis group and 647 were in the control group. There were 678 boys and 616 girls with an average age of 19.27 months. The results of logistic regression analysis showed that, the children fed with Sanlu powdered infant milk formula which contained a high level of melamine were more likely to suffer from urolithiasis than those took other melamine-contaminated formula (OR=6.09, Plt;0.01); boys were more than girls (OR=1.39, Plt;0.01), and children fed with formula alone were more than those fed with both formula and breast milk (OR=1.61, Plt;0.01). The risk of urolithiasis decreased gradually with age, and the OR value of children in age of smaller than 6 months, 6 to 12 months, 12 to 24 months were 5.23 (Plt;0.01), 2.73 (Plt;0.01), and 1.60 (Plt;0.01), respectively. The risk of urolithiasis increased gradually with the time lengthening of taking melamine-contaminated formula, and the OR value of children who had took melamine-contaminated formula for 3 to 6 months, 6 to 12 months and more than or equal to 12 months were 2.10 (Plt;0.01), 2.81 (Plt;0.01), and 4.75 (Plt;0.01), respectively. Conclusion It shows that feeding with high melamine infant formula (Sanlu powdered infant milk formula), artificial feeding and male children are the risk factors of infantile urolithiasis. Additionally, the risk of urolithiasis decreases with age and increases with time of formula feeding
Objective To explore the correlation between overweight, obesity and incidence of type 2 diabetes mellitus (T2DM). Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CNKI, VIP, CBM and WanFang Data were searched from inception to May, 2012 to collect the cohort studies on the correlation between overweight, obesity and incidence of T2DM. The studies were screened according to the inclusion and exclusion criteria by two researchers independently, the quality was evaluated, the data were extracted, and then meta-analysis was performed using RevMan 5.1 and Stata 11.0 software. Results A total of 8 studies involving 101 864 participants were included. The results of meta-analysis showed that, compared with the normal weight population, the onset risk of T2DM was obviously higher in the overweight (RR=2.59, 95%CI 2.11 to 3.19, Plt;0.000 01), and obese (RR=6.28, 95%CI 4.99 to 7.91, Plt;0.000 01) populations. In the subgroup analysis, the onset risk of T2DM was higher in the western obese population (RR=6.91, 95%CI 5.59 to 8.56) than the eastern obese population (RR=4.19, 95%CI 2.93 to 5.99). Based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the quality of the included studies on T2DM developed by overweight and obesity was low and medium respectively. Conclusion Overweight and obesity can increase the onset risk of T2DM which is higher in the female and western obese populations than the male and eastern obese populations respectively.
Objective To investigate the association between MDM2 gene promoter SNP 309 polymorphism and leukemia susceptibility. Methods Such databases as Ovid, EBSCO, PubMed, CNKI, CBM, VIP and WanFang Data were searched to collect the case-control studies published from January 1990 to June 2012. According to the inclusion and exclusion criteria, the studies were screened, the data were extracted, and the methodological quality of the included studies was evaluated. Then meta-analysis was conducted using RevMan 5.0 and Stata 10.0 software, the pooled odds ratio (ORs) with 95% confidence interval (CI) were calculated, and the sensitivity and publication bias were evaluated at the same time. Results A total of 9 studies within 8 articles were included, which involved 1 821 cases and 5 642 controls. The results of meta-analysis showed that, the susceptibility of leukemia was increased in the G allele carriers compared with the T allele carriers (OR=1.26, 95%CI 1.08 to 1.46, P=0.003), and the leukemia risk was higher in the GG genotype populations compared with the TT genotype populations (OR=1.46, 95%CI 1.02 to 2.10, P=0.04). Among Asians with recessive models, the leukemia risk was higher in the homozygous GG genotype compared with both the heterozygous GT genotype and the homozygous TT genotype (OR=2.00, 95%CI 1.37 to 2.92, P=0.000 3). There was no obvious publication bias. Conclusion MDM2 gene promoter SNP 309 polymorphism is associated with the susceptibility of leukemia, and the G allele is likely to be the risk factor for leukemia.
Objective To investigate the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features. Methods Such databases as PubMed, EMbase, VIP, WanFang Data and CBM were searched from their inception to February 28th, 2013 to collect case-control studies about the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features, and the relevant references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 6 case-control studies were included, which included 405 cases in the gastric cancer group and 185 cases in the normal gastric mucosa group. The results of meta-analysis showed that, RUNX3 expression was lower in the gastric cancer group than the normal gastric mucosa group, with a significant difference (OR=0.07, 95%CI 0.04 to 0.12, Plt;0.000 01); it was also lower in the subgroup of gastric cancer accompanied with lymph node metastasis than that without lymph node metastasis (OR=0.37, 95%CI 0.23 to 0.61, Plt;0.000 1); but it was higher in the subgroup of gastric cancer that had infiltrated into serosa than that had not, with a significant difference (OR=3.92, 95%CI 2.29 to 6.71, Plt;0.000 01); and it was also higher in the subgroup of well differentiated gastric cancer that the moderately and poorly differentiated, with a significant difference (OR=0.36, 95%CI 0.22 to 0.58, Plt;0.000 1). Conclusion RUNX3 expression is notably correlated to gastric cancer and its clinically pathologic features. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.
Objective To assess the value of vascular endothelial growth factor (VEGF) expression in the prognosis of esophageal cancer. Methods PubMed and EMbase were searched for collecting retrospective cohort studies on the correlation between VEGF expression and prognosis of esophageal cancer, and relevant articles were also retrieved from inception to June, 2012. Two reviewers independently screened the literature, extracted the data, and evaluated the quality. Then the meta-analysis was performed by using RevMan5.0 software, and the publication bias of literature was evaluated by means of Begg’s funnel plot and Egger’s method. Results Finally 10 cohort studies involving 811 patients were included. The meta-analysis showed that, patients with high level of VEGF had poor overall survival (HR=1.55, 95%CI 1.25 to 1.91). The results of subgroup analyses including VEGF subtype, critical value of VEGF and source of patient showed that: a) there was no correlation between patient’s prognosis and high level of VEGF-C; b) The high level of VEGF subtype in cancer tissue indicated a higher risk of death when the critical value was 10%, while it was not related to the prognosis when the critical value was 30%; and c) The high level of VEGF in cancer tissue was more valuable to predict the prognosis of esophageal cancer for Chinese patients rather than non-Chinese patients. Conclusion The level of VEGF’s expression in cancer tissue is valuable to predict the prognosis of esophageal cancer.
Objective To provide baseline date for further research by retrospectively investigating the disease constitution of over-60-year old patients in the West China Hospital of Sichuan University in 2011. Methods The information of over-60-year old outpatients was extracted from HIS and their diagnoses were classified by ICD-10. The data of single disease among top 3 categories of diseases were rearranged and analyzed by Excel software. Results The total of over-60-year old outpatients was 895 123 person-time in 2011, accounting for 19.65%, including 716 826 person-time in specialist outpatient clinics. The specialist diagnoses of 683 491 person-time could be classified by ICD-10, accounting for 95.35% of specialist outpatients. The top 12 diseases were neoplasm, circulatory, digestive, factors influencing health status and contacting with health services, respiratory, musculoskeletal system and connective tissues, nervous, eyes, symptoms/signs and abnormal clinical and laboratory findings, non-classified, mental and behavioral disorders, endocrine, and genitourinary system diseases, and the cumulative constituent ratio was 92.96%. The main pathogenic sites of neoplasm were bronchus and lung (21.98%), esophagus (8.66%), stomach (8.10%), rectum (7.37%), prostate (5.86%), and liver and intrahepatic bile ducts (5.55%), with a cumulative constituent ratio of 57.72%. The main disease burden in circulatory system was hypertension (39.50%), chronic ischaemic heart disease (11.17%), and cerebral infarction (9.70%), and the cumulative constituent ratio was 60.38%. While the main disease burden in digestive system was gastritis and duodenitis (24.98%), other diseases of digestive system (9.26%), and other diseases of liver (8.90%), and the cumulative constituent ratio was 43.13%. There were more female than male among the over-60-year old outpatients (50.67% vs. 49.33%), and male was higher than female only in the incidence of neoplasm, respiratory, factors influencing health status and contacting with health services, and genitourinary system diseases. The disease constitution ratio of 60-69 years old patients was 58.21%. The top 3 neoplasm were the malignant tumors in digestive (38.20%), respiratory and intrathoracic organs (24.70%), and lymphoid, haematopoietic and related tissue (11.97%), with a cumulative constituent ratio of 74.87%. Conclusion The top 3 disease burden of over-60-year old outpatients in West China Hospital were neoplasm, circulatory and digestive diseases, which reflects the trend and law of treatment demands of old patients. It needs to deeply analyze the frequency and flow pattern of patients, and to provide evidence for preventing and treating geriatric diseases.
Objective To investigate the correlation between MDM2 SNP309 and gastric cancer (GC) risk in Eastern Asian population. Methods Two reviewers independently searched MEDLINE, EMbase and CBM (from January 1st, 1990 to October 23rd, 2012) for case-control studies on the correlation between MDM2 SNP309 and GC risk in Eastern Asian population. Two reviewers independently screen literature, extracted the data, and assessed the methodological quality. Then meta-analysis was performed using RevMan 5.0 software. Results 5 case-control studies were finally included involving 1 621 GC cases and 2 639 controls. The pooled results showed that the variant homozygote (309GG genotype) was significantly associated with an increased risk of GC as compared to wild-type homozygote (309TT genotype: OR=1.54, 95% CI 1.04 to 2.29, P=0.02). Nevertheless, no association was found in comparison of variant heterozygote (309TG genotype) between wild-homozygote (309TT genotype: OR=1.03, 95% CI 0.75 to 1.42, P=0.006). A significantly increased risk of GC was observed for the recessive model (GG vs. TT/TG: OR=1.49, 95% CI 1.20 to 1.84, P=0.07). While in the dominant model (GG/TG vs. TT), non-significant association was observed (OR=1.18, 95% CI 0.84 to 1.65, P=0.001). Conclusion The MDM2 309GG may be significantly associated with an increased risk of GC among Eastern Asians.
Objective To study and analyze both merits and demerits of 4 famous foreign evidence-based medicine databases, so as to provide references for the development of Chinese evidence-based medicine databases. Methods By means of document analysis and web search, the databases including UpToDate, MD Consult, Clinical Evidence and DynaMed were comprehensively analyzed from the following aspects: management ideas, editing process, personalized services and so on. Results a) Time of foundation: UpToDate founded in 1992 is the earliest-established evidence-based medicine database; b) Management ideas: All 4 databases aim to integrate all the high quality evidences about some clinical topics and help doctors to make the most reasonable decisions at present; c) Editing process: The inclusive criteria of Clinical Evidence is more strict than other databases, for the evidence needs to go through 18 steps before it is included; and d) Update rate: DynaMed updates every day as the fastest than other databases. Conclusion A mature evidence-based medicine database needs a powerful methodology team, b financial support and a large number of literature services. Besides learning good foreign experiences, it is also very important to assemble a methodology team, and particularly to integrate domestic characteristics for the establishment of domestic evidence-based medicine database.
Objective To systematically review literature on the influencing factors related to adolescent sub-health problems. Methods We electronically searched the following four databases including CBM, VIP, CNKI and WanFang Data to collect Chinese literature on adolescent sub-health status and problems in China published before May 2012. Two reviewers independently screened literature, extracted data, and cross checked records. Then qualitative analysis was applied. Results According to the inclusion and exclusion criteria, 41 cross-sectional studies were included. The results of qualitative analysis showed that the influencing factors of adolescent sub-health could be classified into four categories including social factors, family factors, school factors, and interpersonal relationships. The main ones were social support, employment pressure, family economic conditions, learning burden, unhealthy habits, etc. Conclusions There are many influencing factors of adolescent sub-health with interaction. Due to the limitation of the included studies, more prospective cohort studies are needed to provide high quality evidence.
Objective To investigate pre-hypertension in aspects of its incidence, accompanied cardiovascular risk factors, and difference between urban and rural areas in Chengdu. Methods By cluster random sampling method, a total of 2 011 patients aged 35-70 years from urban and rural communities in Chengdu were selected as respondents. The investigation was conducted through questionnaire, physical examination and laboratory tests, so as to find out the main cardiovascular risk factors of pre-hypertension. All data were dual input into computer by a specially-assigned person. SPSS 13.0 software was used for analysis, Chi-square test was adopted for categorical data, and Plt;0.05 was taken as an index for significant difference. Results a) The incidence rate of pre-hypertensive in Chengdu was 33.6%, and it was 45.67% and 46.31% in urban and rural areas, respectively. In rural area, more male (51.04%) were affected than female (42.83%). b) The smoking population with pre-hypertension were mainly the male, and the ratio of rural male was 60% (132/220), far higher than that of urban male which was 32.6% (59/181). c) The pre-hypertensive population accompanied with diabetes was higher in urban (27.97%) than rural (14.01%). d) The pre-hypertensive population accompanied with hypercholesterolemia or low HDL was 33.04% (150/454) in urban, as twice as that in rural which was 16.41% (76/471). e) The pre-hypertensive population accompanied with abdominal obesity was far higher in urban (28.41%) than rural (12.74%). Conclusion Smoking is the risk factor which needs to be primarily intervened for male hypertensive patients in rural area. Impaired glucose tolerance is the common risk factor for both urban and rural residents, and hyperlipidemia is the most primarily risk factor for urban pre-hypertensive patients, followed by diabetes, and abdominal obesity.