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Objective: Previous studies have demonstrated that some single-nucleotide polymorphisms (SNPs) in miRNAs are related to the risk of ischemic stroke (IS), but the conclusions are still controversial and inconclusive. We performed this meta-analysis to further assess the association between miR-146a C>G (rs2910164), miR-149 T>C (rs2292832), miR-196a2 T>C (rs11614913), miR-499 A>G (rs3746444) and risk of IS in Chinese individuals. Methods: Relevant studies were identified in the databases of PubMed, Embase. The strength of correlation between microRNAs polymorphisms and IS risk was assessed by odds ratios (ORs) and 95% confidence intervals (95% CIs) under five genetic models. Results: 5 studies, containing 2,632 cases and 3,191 controls, were included in this meta-analysis. The overall results of meta-analysis indicated that there were no significant association between miR-146a C>G (rs2910164), miR-149 T>C (rs2292832), miR-196a2 T>C (rs11614913), and the IS risk in the overall analyses. MiR-499 A>G (rs3746444) was associated with an increased IS risk under allele model (OR = 1.30, 95% CI = 1.02-1.66), heterozygous model (OR = 1.35, 95% CI = 1.01-1.79) and dominant model (OR = 1.36, 95% CI = 1.02-1.80) in Chinese. The sensitivity analysis results of these four polymorphisms were similar to the overall results. Conclusion: MiR-499 A>G (rs3746444) G allele and AG, AG + AA genotype might be risk factors of IS in Chinese. No significant association was observed between miR-146a C>G (rs2910164), miR-149 T>C (rs2292832), miR-196a2 T>C (rs11614913), and IS risk. The associations may be different due to geographical factors of China. More explorations in more diverse geographically regions with large sample size are expected to further verify the findings in the future. [ABSTRACT FROM AUTHOR]

Background: Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide. Hence, this study aimed to investigate the association between periodontal disease and the risk of benign prostatic hyperplasia., Methods: A total of 4930 participants were selected from an available health examination that was carried out in 2017, only males were considered for further analysis. All eligible males were divided into benign prostatic hyperplasia and normal groups, the benign prostatic hyperplasia group was then divided into prostate volume ≤ 60 g and > 60 g subgroups; all their periodontal status was extracted and then into normal (CPI score of 0), periodontal disease (CPI score between 1 and 4), and periodontitis (CPI score between 3 and 4) groups. The correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control analysis. Subgroup analysis based on prostate volume was also performed. All analyses were conducted with SAS 9.4 software., Results: A total of 2171 males were selected for this analysis. The presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times (OR = 1.68, 95% CI: 1.26-2.24), and individuals with periodontitis showed a higher risk (OR = 4.18, 95% CI: 2.75-6.35). In addition, among matched cases and controls, this association remained robust (periodontal disease: OR = 1.85, 95% CI: 1.30-2.64; periodontitis: OR = 4.83, 95% CI: 2.57-9.07). Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well (for prostate volume ≤ 60 g: OR = 1.64, 95% CI: 1.22-2.20; for volume > 60 g: OR = 2.17, 95% CI: 1.04-4.53), and there was a higher risk in the group with a prostate volume greater than 60 g., Conclusion: Periodontal disease is significantly and positively associated with an increased risk of benign prostatic hyperplasia. Further validation studies should be performed to explore the relationship between periodontal treatment and benign prostate hyperplasia.

Objectives: The aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures., Design: Mixed-method research study to collect and analyse both quantitative and qualitative data., Setting: Class A tertiary hospitals in China., Participants: The inclusion criteria for the questionnaire survey and qualitative research were (1) medical practitioners and (2) years of practice: above 5 years in a tertiary hospital., Methods: Questionnaires were distributed to medical staff in 11 cities to collect quantitative data. Frequency and ranking of barriers and enablers were analysed. Spearman correlations were computed to explore the correlation between years of practice, professional title ranking and educational background with self-reported guideline adherence. Using a constructivist grounded theory method, qualitative data were generated via in-depth face-to-face interviews with Chinese medical practitioners., Results: A total of 359 medical practitioners were surveyed and 32 medical practitioners interviewed in 11 cities. Higher frequency and higher ranking of barriers all converged on 'lack of access', 'less convenient', 'lack of applicability' and 'lack of evidence from Chinese sample'. Higher frequency and higher ranking of enablers converged on 'Short formats presentation', 'Utilisation of various media', 'Information visualisation' and 'Linking to patient electronic medical records'. There were no relationships between characteristics of respondents with self-reported adherence. This research produced a theoretical understanding of the experience of medical practitioners when using guidelines. Themes identified were as follows: existing intrinsic flaws in guidelines, deficient or incomplete system mechanism and being ambiguous., Conclusion: Our findings provide a comprehensive and culturally sensitive perspective in understanding guideline implementation in China. Strategies addressing those barriers should be further discussed and researched in the future., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The objective of this study was to evaluate association between body mass index (BMI) and prostate volume (PV), international prostate symptom scores (IPSS), maximum urinary flow rate ( Q max ), and post-void residual (PVR) of Chinese benign prostatic hyperplasia (BPH) patients. All newly diagnosed BPH patients between September 2016 and August 2018 were selected and 788 patients were included. According to BMI, the patients were categorized into four groups, while according to PV, IPSS, Q max , and PVR, they were categorized into two groups based on clinical significant cutoffs. Univariable and multivariable logistic regressions and a restricted cubic spline (RCS) were applied to explore the relationship of BMI with categorical PV, IPSS, Q max , and PVR. Compared with normal BMI, obesity presented significant association with increased risk of larger PV (>80 ml) in both unadjusted and adjusted models (unadjusted odds ratio [OR] = 1.772, 95% CI [1.201, 2.614], p = .004; adjusted OR = 1.912, 95% CI [1.212, 3.017], p = .005); however, underweight or overweight did not present a significant connection with such risk. No significant effect was identified for BMI on IPSS, Q max , or PVR in either unadjusted or adjusted model. Nonlinear test including BMI using RCS and adjusting for confounders showed no significance ( p > .05); however, a significant linear relationship was ascertained between BMI and the risk of larger PV ( p < .001). In conclusion, there was a significant linear association between BMI and the risk of larger PV in BPH patients. Hence, this suggests urologists should consider both BMI and PV when providing surgical treatment for BPH patients.

Aim: To investigate the clinical characteristics, diagnosis, treatment, and prognosis of primary adenosquamous carcinoma (ASC) of the esophagus., Methods: A total of 4015 patients with esophageal carcinoma underwent surgical resection between January 1995 and June 2012 at the Cancer Hospital of Shantou University Medical College. In 37 cases, the histological diagnosis was primary ASC. Clinical data were retrospectively analyzed from these 37 patients, who underwent transthoracic esophagectomy with lymphadenectomy. The χ(2) or Fisher's exact test was used to compare the clinicopathological features between patients with ASC and those with squamous cell carcinoma (SCC). The Kaplan-Meier and Log-Rank methods were used to estimate and compare survival rates. A Cox proportional hazard regression model was used to identify independent prognostic factors., Results: Primary esophageal ASC accounted for 0.92% of all primary esophageal carcinoma cases (37/4015). The clinical manifestations were identical to those of other types of esophageal cancer. All of the 24 patients who underwent preoperative endoscopic biopsy were misdiagnosed with SCC. The median survival time (MST) was 21.0 mo (95%CI: 12.6-29.4), and the 1-, 3-, and 5-year overall survival rates were 67.5%, 29.4%, and 22.9%, respectively. In multivariate analysis, only adjuvant radiotherapy (HR = 0.317, 95%CI: 0.114-0.885, P = 0.028) was found to be an independent prognostic factor. The MST for ASC patients was significantly lower than that for SCC patients [21.0 mo (95%CI: 12.6-29.4) vs 46.0 mo (95%CI: 40.8-51.2), P = 0.001]. In subgroup analyses, the MST for ASC patients was similar to that for poorly differentiated SCC patients., Conclusion: Primary esophageal ASC is a rare disease that is prone to be misdiagnosed by endoscopic biopsy. The prognosis is poorer than esophageal SCC but similar to that for poorly differentiated SCC patients., (© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.)