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OBJECTIVE: To study the association of single nucleotide polymorphisms (SNPs) of transcription factors (NKX2.5, GATA4, TBX5, and FOG2) with congenital heart disease (CHD) in the Chinese population. METHODS: PubMed, Google Scholar, CNKI, Wanfang Data, and Weipu Data were searched for articles on the association of SNPs of target genes with CHD in the Chinese population. If one locus was mentioned in at least two articles, the random or fixed effect model was used to perform a pooled analysis of study results and to calculate the pooled OR and its 95%CI. If a locus was mentioned in only one article, related data were extracted from this article to analyze the association between the SNPs of this locus and CHD. RESULTS: Twenty-three articles were included. The Meta analysis showed that there were significant differences between the CHD and control groups in the genotype and allele frequencies of GATA4 rs1139244 and rs867858 and the genotype frequency of GATA4 rs904018, while there were no significant differences in the SNPs of the other genetic loci between the two groups. The single-article analysis showed that there were significant differences between the two groups in the allele frequencies of NKX2.5 rs118026695/rs703752, GATA4 rs884662/rs12825/rs12458/rs3203358/rs4841588, and TBX5 rs6489956. There were no significant differences in the SNPs of FOG2 locus between the two groups. CONCLUSIONS: The SNPs of some loci in NKX2.5, GATA4, and TBX5 are associated with CHD in the Chinese population, but the association between the SNPs of FOG2 locus and the development of CHD has not been found yet.

Background Gross target volume of primary tumor (GTV-P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma (NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity-modulated radiotherapy (IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to find a suitable cut-off value of GTV-P for prognosis prediction. Methods Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver operating characteristic (ROC) curves were used to identify the cut-off values of GTV-P for the prediction of different endpoints [overall survival (OS), local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS)] and to test the prognostic value of GTV-P when compared with that of the American Joint Committee on Cancer T staging system. Results The 358 patients with locally advanced NPC were divided into two groups by the cut-off value of GTV-P as determined using ROC curves: 219 (61.2%) patients with GTV-P ≤46.4 mL and 139 (38.8%) with GTV-P >46.4 mL. The 3-year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV-P ≤46.4 mL than in those with GTV-P > 46.4 mL (all P 46.4 mL was an independent unfavorable prognostic factor for patient survival. The ROC curve verified that the predictive ability of GTV-P was superior to that of T category (P 46.4 mL is an independent unfavorable prognostic indicator for survival after IMRT, with a prognostic value superior to that of T category.

Background Brainstem dose limitations influence radiation dose reaching to tumor in the patients with locally-advanced nasopharyngeal cancer (NPC). Methods A retrospective analysis of the prognostic value of the distance between the primary tumor and brainstem (Dbs) in 358 patients with locally-advanced NPC after intensity-modulated radiation therapy (IMRT). Receiver operating characteristic (ROC) curves were used to identify the cut-off value to analyze the impact of Dbs on tumor dose coverage and prognosis. Results The three-year overall survival (OS), local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 88.8 vs. 78.4 % (P = 0.007), 96.5 vs. 91.1 % (P = 0.018), 87.8 vs. 79.3 % (P = 0.067), and 84.1 vs. 69.6 % (P = 0.002) for the patients with the Dbs > 4.7 vs. ≤ 4.7 mm, respectively. ROC curves revealed Dbs (4.7 mm) combined with American Joint Committee on Cancer (AJCC) T classification had a significantly better prognostic value for OS (P

Search strategies. Appendix 2. Beggs’funnel plot. (DOCX 18 kb)

Objective: To explore the relationship between posttraumatic stress disorder (PTSD) and preflood behavioral characteristics among children aged 7–15 years in Hunan, China. Subjects and Methods: In 2000, a retrospective study was carried out among children who had been exposed to the 1998 floods in Hunan. A multistage sampling method was used to select subjects from the flood-affected areas. A structured questionnaire administered to the children selected was used to diagnose PTSD based on the DSM-IV criteria. A parent questionnaire was used to measure preflood behavioral characteristics related to health, behavioral, and habit problems. The association between PTSD and preflood behavioral characteristics was assessed using χ2-tests and multivariate logistic regression. Results: A total of 7,038 children from 13,450 households, aged 7–15 years, were investigated. The overall prevalence of PTSD was 2.05%. Generally, the PTSD-positive rate increased with increasing scores for behavioral characteristics. Conclusion: Preflood behavioral characteristics are an important factor influencing the prevalence of PTSD among children exposed to floods. It is therefore necessary to give special attention to children with behavioral problems in order to reduce the psychological impact of floods.

BACKGROUND Previous studies showed that the prognostic factors for superficial transitional cell carcinoma of the bladder varied with the findings of different cohorts. Few multivariate analyses of prognostic factors for superficial bladder tumors have been reported in China and bladder preservation as a prognostic index of superficial bladder tumors is limited and scarce in Chinese patients. This study was conducted to analyze a group of risk factors for prognostic outcomes for patients with primary superficial transitional cell carcinoma of the bladder. METHODS Between January 1980 to December 2000, 198 patients [172 men and 26 women; mean age (52.98 +/- 11.28) years] with primary superficial transitional cell carcinoma who were pathologically classified as Ta or T1 in Hunan Provincial Tumor Hospital (Changsha, China) were enrolled in this study. Surgical methods included local resection and electric coagulation of bladder tumors, transurethral resection of bladder tumors and partial cystectomy. After initial surgical treatment, patients were followed through a cystoscopy every three months during the first two years and every six months thereafter in the design of retrospective cohort. Survival analysis was performed to analyze risk factors of the prognostic outcomes for transitional cell carcinoma of the bladder. Canonical correlation analysis was conducted to present and interpret synthetically the multi-correlation between all kinds of prognostic outcomes and risk factor in multiply dimensions. RESULTS The average follow-up period was (6.65 +/- 4.74) years. Assessments at three, five, and 10 years showed recurrence rates, respectively, of (28.32 +/- 3.45)%, (35.31 +/- 3.83)%, and (42.48 +/- 4.40)%; progression rates of (8.89 +/- 2.14)%, (15.16 +/- 2.94)%, and (23.88 +/- 4.19)%; bladder-preservation rates of (94.68 +/- 1.74)%, (93.87 +/- 1.91)%, and (91.51 +/- 2.49)%; metastasis rates of (8.25 +/- 2.05)%, (11.24 +/- 2.47)%, and (28.94 +/- 4.93)%; and cancer-related survival rates of (95.02 +/- 1.62)%, (90.70 +/- 2.45)%, and (77.14 +/- 4.88)%. The main risk factors for recurrence were histological grade, blood transfusion during surgery and the duration of symptoms. Progression was affected by blood transfusion during surgery, histological grade, the number of re-examinations, and the length of the recurrence-free period. Metastasis was associated with tumor multifocality, hydronephrosis, microscopic growth pattern, and the recurrence-free period. Cancer-related survival was influenced by microscopic growth pattern and the recurrence-free period. Bladder preservation involved only the recurrence-free period. The comprehensive results from canonical correlation analysis showed that the main prognostic outcomes were cancer-related survival, metastasis and progression respectively, while the dominate risk factors were histological grade, tumor multifocality and blood transfusion. CONCLUSIONS The risk factors were different for each prognostic outcome of transitional cell carcinoma of the bladder. This is helpful for predicting the prognosis of transitional cell carcinoma of the bladder and designing therapeutic and follow-up strategies for this cancer.

Despite existence of a highly effective intervention, maternal syphilis still causes substantial perinatal morbidity and mortality, even in China, where antenatal health services are strong. This study sought to address personal, programmatic, and other risk factors for congenital syphilis (CS) and adverse pregnancy outcomes (APOs) among pregnant women in Shenzhen, China.Pregnant women attending antenatal services were offered serologic tests, and those diagnosed as having syphilis were recruited from April 2007 to October 2012. In a nested case-control study for the pregnancy outcomes of syphilis-infected women, we assessed risk factors comparing infants born with CS (group II) and with any APOs (group III) to infants without CS or APOs (group I).During the 66-month study period, we screened 279,334 pregnant women and identified 838 (0.3%; 95% confidence interval, 0.28%-0.32%) women infected with syphilis. Among infants born to syphilitic mothers, 8.2% (34/417) were diagnosed as having CS and 24.7% (103/417) were diagnosed as having APOs. Compared with group I, maternal baseline titers of nontreponemal antibodies (adjusted odds ratio [aOR], 2.13), stage of syphilis (aOR, 21.56), length of time between the end of the first treatment to childbirth (aOR, 11.93), gestational week at treatment (aOR, 2.63), and fathers' cocaine use (aOR, 15.44) and syphilis infection status (aORpositive vs. negative, 5.84; aORunknown vs. negative, 5.55) were positively associated with CS, but prenatal care (aOR, 0.11) and complete treatment (aOR, 0.20) were negatively associated with CS. Maternal age (aOR, 1.43), marriage (aOR, 2.41), history of cocaine use (aOR, 3.79) and ectopic pregnancy (aOR, 5.91), baseline titers of nontreponemal antibodies (aOR, 1.30), stage of syphilis (aOR, 8.89), length of time between the end of the first treatment to childbirth (aOR, 2.52), gestational week at treatment (aOR, 1.78), and fathers' syphilis infection status (aORunknown vs. negative, 2.02) were also positively associated with APOs, but maternal history of syphilis (aOR, 0.44), prenatal care (aOR, 0.29), and complete treatment (aOR, 0.25) were negatively associated with APOs,Syphilis was an important cause of pregnancy loss and infant disability, particularly among women who did not receive prenatal care or had late or inadequate treatment. These study results can inform antenatal programs on the importance of early syphilis testing and prompt and appropriate treatment. Some strategies targeted at other risk factors areas may be helpful.

To find out the current situation of physical activity and its influencing factors among Chinese primary and middle school students.A total of 166 812 students aged 9 - 18 finished the questionnaires of physical activities and lifestyle behaviors who were selected from "2010 National Physical Fitness and Health Surveillance". The subjects were sampled by stratified cluster sampling method in 30 provinces (autonomous regions, municipalities) except Tibet. The physical activity for a total of at least 60 minutes per day, attitudes on physical activity, parents' supports toward physical activity of children, development of school physical education, the schoolwork burden and sedentary lifestyle were all analyzed. Logistic regression was used to analyze the association between the physical activity for a total of at least 60 minutes per day and individual, family, school and sedentary behavior.A total of 22.7% (37 867/166 757) of primary and middle school students aged 9 - 18 had been physically active doing any kind of physical activity for a total of 60 minutes or more per day, the prevalence was higher among male (25.4%, 21 086/83 159) than female (20.1%, 16 781/83 598) students (P0.05). In the 9 - 12 age group, the prevalence was higher among urban (37.6%, 5 980/15 912) than rural (32.0%, 4 917/15 375) students (P0.05), but in the 16 - 18 age group, the case was opposite. The prevalence of doing physical activity for a total of 60 minutes or more per day among students who liked physical education (23.7%, 11 866/50 073), were willing to participate in the extracurricular sports activities (23.2%, 13 460/57 907), and were willing to participate long running exercise (26.9%, 9 185/34 153) was higher than those who dislike physical education (15.9%, 589/3705), were not willing to participate in the extracurricular sports activities (15.9%, 567/3565), and were not willing to participate long running exercise (12.1%, 2 246/18 493), respectively. The prevalence was higher among students whose parents supported their physical activity (20.4%, 15 148/74 312) than those students without parents' support (17.5%, 1626/9270) (P0.05). And the prevalence was higher among students whose parents often took part in the physical activity (22.7%, 12 864/56 769) than those students whose parents did not (14.6%, 3 906/26 780) (P0.05). Logistic regression analysis (adjusted sex, age and urban or not) demonstrated that variables associated with physical activity for a total of 60 minutes or more per day were the initiative will on the physical activity and parental physical activity (OR: 1.478, 95%CI: 1.398 - 1.562). The students without adequate physical education class in school were less likely to do physical activity for a total of 60 minutes or more per day than those who with adequate physical education class in school (OR: 0.536, 95%CI: 0.523 - 0.550), and the students in the school with the phenomenon of "crowding out" or "no" physical education were less likely to do physical activity for a total of 60 minutes or more per day than those whose school without these with phenomenon (OR: 0.712, 95%CI: 0.666 - 0.761). The heavy homework burden (OR: 0.926, 95%CI: 0.899 - 0.953) and long homework time (OR: 0.879, 95%CI: 0.853 - 0.906) were reversely related to the physical activity.The prevalence of having been physically active for a total of 60 minutes per day in Chinese students is still low. The strong initiative will on the physical activity, parental physical activity, and better school sports atmosphere are good for students to carry out physical activity, and the students with the heavy homework burden and long homework time are less likely to take part in the physical activity.

To analyze the characteristics of physical activity in Chinese primary and middle school students, and to provide scientific basis for school physical education and health work.The data were collected from 166 812 Han primary school pupils above grade 4, junior and senior middle school students who participated in 2010 National Physical Fitness and Health Surveillance in 30 provinces (excluding autonomous regions, municipalities).Nationwide in 2010, 22.7% of the students had been physically active doing any kind of physical activity for a total of at least 60 minutes per day, the prevalence rates of the 9 to 13, 13 to 16, 16 to 19 age groups were 32.7%, 20.7% and 12.5%, respectively (P0.01). The prevalence of having been physically active for a total of at least 60 minutes per day was higher among the Eastern Region's students than the Western Region's students in the different age groups (P0.05), of whom 61.8% reported that they sweated and felt a little bit tired in physical education, 68.6% thought that they liked their physical education, 72.4% were willing to take part in extracurricular physical activities organized by their school, and 46.4% were willing to participate in the long distance running exercise. "Fear of fatigue or/and hardship" was the most important reason why the students did not actively participate in physical activities and long-distance running exercise among both the boys and girls in the different age groups.The prevalence of having been physically active for a total of at least 60 minutes per day in Chinese students is still low, and there is an obvious difference in the different groups. In the future, not only should the students' physical exercise time and intensity be further guaranteed, but also their awareness strengthened and their habits of physical exercise cultured.

Aim: To identify the factors influencing diagnosis and treatment of chronic prostatitis (CP) among Chinese urologists. Methods: A sample of 656 urologists from 29 provinces of China were asked to complete a questionnaire that explored attitudes towards CP as well as diagnosis and treatment patterns in the management of CP. Both univariate and multivariate logistic regression analysis schemes were used to determine the factors that influence the diagnosis and treatment of CP. Results: A total of 656 questionnaires were given out. All were returned and 410 of those were included in the final univariate and multivariate analysis. Multivariate logistic regression analysis indicated that belief of bacterial infection in the etiology of CP (odds ratio [OR], 2.544; 95% confidence interval [CI], 1.650–3.923; P < 0.001) was the most significant factor influencing the routine performance of bacterial culture test. Using the same model, the type of hospital (OR, 2.799; 95% CI, 1.719–4.559; P < 0.001) and the routine use of the 4- or the 2-glass test (OR, 3.194; 95% CI, 2.069–4.931; P < 0.001) were determined to be significant factors influencing the use of the National Institutes of Health (NIH) new classification system. According to the same model, belief of bacterial infection in the etiology of CP (OR, 3.415; 95% CI, 2.024–5.762; P < 0.001) and the routine use of bacterial culture test (OR, 2.261; 95% CI, 1.364–3.749; P < 0.01) were important factors influencing the routine prescription of antibiotics. Conclusion: Our findings suggest that attitudes towards CP, and the characteristics of individual urologists’ practices may influence the diagnosis and treatment of CP among Chinese urologists. (Asian J Androl 2008 Jul; 10: 675–681)

To explore the effect of health service and its influential factors in flood disaster areas.Fifty-five towns were sampled randomly from Dongting Lake area suffering from flood in 1998. The health service level, effect, and its influence factors were investigated retrospectively.The incidence rate of notifiable infectious diseases was 11.7 per thousand, prevalence rate of chronic disease was 51.2 per thousand, infant mortality rate was 43.1 per thousand, neonatal mortality rate was 10.2 per thousand, and the total mortality rate was 554.3/100,000 in Dongting Lake area. The health investment level was significantly associated with the incidence rate of notifiable infectious diseases, the infant mortality rate, and total mortality rate. Duration of flood and income per capita were important factors for the effect of health investment.Increasing health investment and residents' income in the flood disaster area, shortening the duration of flood would play positive role in residents' health in the flood disaster area.

To determine the damage of different types of floods on the residents health.The methods of standard mortality rate (SMR) and years of potential life lost (YPLL) were used to analyze the death of sample residents from flood areas in Dongting Lake in Hunan province.The order of death causes in the soaked area, the collapsed area and the non-flood area was the same. But the mortality rates of residents injury, poisoning and malignant neoplasm diseases in the soaked area and the collapsed area were higher than those of non-flood area. The resident standard rates of years of potential life lost (SYPLL) in the soaked area and the collapsed area were higher than that of the controls, especially in the age group of 30 to 45. The flood-attributed SYPLL in the male was higher than that of the female.Flood actually affected the health of residents. The more serious the flood is, the worse the effect is. It is very important to decrease the resident mortality rate of the injury, poisoning and malignant neoplasm, and to pay attention to protect people of 30 to 45 years old in flood areas.

To develop a public health index related to the comprehensive assessment on the impact caused by floods.A Analytic hierarchy process (AHP) theory was used to establish the initial evaluation system on the impact of floods. Modified-Delphi process was used to screen and determine the indicators and their weights while synthetical scored method was used to establish the comprehensive assessment model. Percentile was used to differentiate the degree of floods. Finally, analysis of variance (ANOVA) and correlation analysis were used to test the differentiability of the model for different degree of floods and the independence of these indicators.The model of comprehensive assessment on the impact of floods was set up, including six first-ranking indicators and twenty-four sub-indicators. The values of comprehensive assessment were divided into five grades by the percentiles. Verified results indicated that there were significant difference among the five grades (F = 76.11, P0.01) and all indicators were independent.An index of comprehensive assessment on the impact of floods was established, which could be used to evaluate the impact of floods and to differentiate the degree of flood, which seemed to have the characteristic of reliability, comprehensiveness and practicability.

To study the immediate and long-term effects of disasters caused by floods on residents health status.Stratified sampling by ranks of flood disaster occurred in 1996 and 1998, flood disaster areas and control areas were carried out. A retrospective study was also carried out to study all diseases involved during 1996 - 1999.The incident rates of acute infectious disease in flooding areas in 1996 and 1998 were both higher than those of non-flooding areas (863.181/100 000 and 736.591/100 000, respectively). But there was no different between the incident rate of the first years in flooding areas and that of non-flooding areas. The prevalence rates of 8 kinds of chronic diseases related to circulatory system, nervous system, digestive system, injury and poisonous diseases in flooding areas were also higher than that in the non-flooding areas. The highest incidence rates of most diseases were in the mountainous flooding areas, followed by areas collapsed by flooding, and the lowest were seen in soakedareas by floods. The incidence rates of intestinal infectious diseases and respiratory infectious diseases were lower in areas where prevention and control measures were weak.Flood could lead to the increase of incidence rates both on acute infectious diseases and non-infectious diseases. Interventions on non-infectious diseases should also be enforced to stop the epidemics when preventing and controlling acute infectious disease.

To study the expenses of hospitalization among the population in the flood disaster areas of Dongting Lake in Hunan province in 1998.Descriptive epidemiologic study were conducted to analyze hospitalization expenses of the residents of 55 villages in flood disaster areas in 1998; single factors analysis and logarithmic linear regression analysis were carried out to explore influencing factors about hospitalization expenses of the residents.The hospitalization rate was 4.59% with an average hospitalization expenses of 667.42 Yuan in the flood disaster areas' residents of Dongting Lake in 1998. Compared with populations without suffering from flood, hospitalization rate and the average hospitalization expenses of flood disaster Areas' residents of Dongting Lake in 1998 were higher and had significant difference. The average hospitalization expenses in 1998 was affected by flood types, family income, gender, age, literacy, occupation, outcome after leaving the hospital and hospital ranks.These results implied that the flood disease aggravated inhabitants' burden of disease in Dongting Lake areas; the factors influencing the average hospitalization expenses were multiple, and synthetic measures should be taken in the prevention and control of flood disaster.