A Nested Case-Control Study to Explore the Association between Immunoglobulin G N-glycans and Ischemic Stroke

Objective This study prospectively investigates the association between immunoglobulin G(IgG)N-glycan traits and ischemic stroke(IS) risk.Methods A nested case-control study was conducted in the China suboptimal health cohort study,which recruited 4,313 individuals in 2013–2014. Cases were identified as patients diagnosed with IS, and controls were 1:1 matched by age and sex with cases. Ig G N-glycans in baseline plasma samples were analyzed.Results A total of 99 IS cases and 99 controls were included, and 24 directly measured glycan peaks(GPs) were separated from Ig G N-glycans. In directly measured GPs, GP4, GP9, GP21, GP22, GP23, and GP24 were associated with the risk of IS in men after adjusting for age, waist and hip circumference,obesity, diabetes, hypertension, and dyslipidemia. Derived glycan traits representing decreased galactosylation and sialylation were associated with IS in men(FBG2S2/(FBG2 + FBG2S1 + FBG2S2): odds ratio(OR) = 0.92, 95% confidence interval(CI): 0.87–0.97;G1n: OR = 0.74, 95% CI: 0.63–0.87;G0n: OR =1.12, 95% CI: 1.03–1.22). However, these associations were not found among women.Conclusion This study validated that altered Ig G N-glycan traits were associated with incident IS in men, suggesting that sex discrepancies might exist in these associations.

Having a Partner and Having Children:Comparisons of Adults with Congenital Heart Disease and the General Population:A 15-Year Case-Control Study

Objectives:To examine whether patients with congenital heart disease(CHD)are less likely to have a partner or children than individuals from the general population.Methods:Longitudinal study with two assessments of the same patients(n=244)from a hospital population and controls(n=238)from the German Socio-Economic Panel(GSOEP)using parental education,patients age,and sex as matching criteria.The first patient study was conducted between 5/2003 and 6/2004,the second one between 5/2017 and 4/2019.Controls were drawn from GSOEP-surveys 2004 and 2018.CHD-severity was classified according to type of surgery:curative,reparative,or palliative.Living single was used as outcome measure,for offspring the outcome was having children or not.Results:Among women with CHD the rate of those living single was higher than among controls with the differences depending on disease complexity(curative:OR=5.5;reparative:OR=1.9;palliative:OR=2.7).No statistically significant differences between patients and controls emerged in the male study population.With respect to children a marked difference emerged between women with CHD and controls.Among patients the odds of having children were lower than among controls(curative:OR=0.3;reparative:OR=0.3;palliative:OR=0.2).The rate of patients with children with CHD(women:5.6%;men:4.9%)was higher than expected(1%)if compared with the general population.Conclusions:Using partnership and children as outcome criteria,patients with CHD are disadvantaged if compared to subjects from the general population.In female patients the social consequences of the disease turned out as more pervasive than in women.

Reduced risk of dementia in patients with type 2 diabetes mellitus using Chinese herbal medicine:A nested case-control study

BACKGROUND Dementia is a prevalent condition in type 2 diabetes mellitus(T2DM)patients.While Chinese herbal medicine(CHM)is often employed as complementary therapy for glycemic control,its effect in controlling likelihood of dementia has not yet been fully elucidated.AIM To compare the risk of dementia between T2DM patients with and without CHM treatment.METHODS We undertook a nested case-control study and obtained data on patients 20-70 years of age who received medical care for T2DM between 2001 and 2010 from the National Health Insurance Research database in Taiwan.Cases,defined as those with dementia that occurred at least one year after the diagnosis of T2DM,were randomly matched to controls without dementia from the study cohort at a 1:1 ratio.We applied conditional logistic regression to explore the associations between CHM treatment and dementia.RESULTS A total of 11699 dementia cases were matched to 11699 non-dementia controls.We found that adding CHM to conventional care was related to a lower risk of dementia[adjusted odds ratio(OR)=0.51],and high-intensity CHM treatment was associated with an adjusted OR of 0.22.CONCLUSION This study shows that the cumulative CHM exposure was inversely associated with dementia risk in an exposureresponse manner,implying that CHM treatment may be embraced as a disease management approach for diabetic patients to prevent dementia.

Rural implementation of the perioperative surgical home:A case-control study

BACKGROUND Perioperative surgical home(PSH)is a novel patient-centric surgical system developed by American Society of Anesthesiologist to improve outcomes and patient satisfaction.PSH has proven success in large urban health centers by reducing surgery cancellation,operating room time,length of stay(LOS),and readmission rates.Yet,only limited studies have assessed the impact of PSH on surgical outcomes in rural areas.AIM To evaluate the newly implemented PSH system at a community hospital by comparing the surgical outcomes using a longitudinal case-control study.METHODS The research study was conducted at an 83-bed,licensed level-III trauma rural community hospital.A total of 3096 TJR procedures were collected retrospectively between January 2016 and December 2021 and were categorized as PSH and non-PSH cohorts(n=2305).To evaluate the importance of PSH in the rural surgical system,a case-control study was performed to compare TJR surgical outcomes(LOS,discharge disposition,and 90-d readmission)of the PSH cohort against two control cohorts[Control-1 PSH(C1-PSH)(n=1413)and Control-2 PSH(C2-PSH)(n=892)].Statistical tests including Chi-square test or Fischer’s exact test were performed for categorical variables and Mann-Whitney test or Student’s t-test were performed for continuous variables.The general linear models(Poisson regression and binomial logistic regression)were performed to fit adjusted models.RESULTS The LOS was significantly shorter in PSH cohort compared to two control cohorts(median PSH=34 h,C1-PSH=53 h,C2-PSH=35 h)(P value<0.05).Similarly,the PSH cohort had lower percentages of discharges to other facilities(PSH=3.5%,C1-PSH=15.5%,C2-PSH=6.7%)(P value<0.05).There was no statistical difference observed in 90-d readmission between control and PSH cohorts.However,the PSH implementation reduced the 90-d readmission percentage(PSH=4.7%,C1-PSH=6.1%,C2-PSH=3.6%)lower than the national average 30-d readmission percentage which is 5.5%.The PSH system was effectively established at the rural community hospital with the help of team-based coordinated multi-disciplinary clinicians or physician comanagement.The elements of PSH including preoperative assessment,patient education and optimization,and longitudinal digital engagement were vital for improving the TJR surgical outcomes at the community hospital.CONCLUSION Implementation of the PSH system in a rural community hospital reduced LOS,increased directto-home discharge,and reduced 90-d readmission percentages.

Risk factors of intrahepatic cholangiocarcinoma in patients with hepatolithiasis:a case-control study

BACKGROUND:Why 3.3% to 10% of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma (ICC) remains unknown.We carried out a hospital-based case-control study to identify risk factors for the development of ICC in patients with hepatolithiasis in China.METHODS:Eighty-seven patients with pathologically diagnosed hepatolithiasis associated with ICC and 228 with hepatolithiasis alone matched by sex,age (±2 years),hospital admittance and place of residence were interviewed during the period of 2000-2008.Odds ratios (OR) and 95% confidence intervals (CI) were calculated for each risk factor.RESULTS:Among the patients with hepatolithiasis associated with ICC,the mean age was 57.7 years and 61.0% were female Univariate analysis showed that the significant risk factors for ICC development in hepatolithiasis were smoking,family history of cancer,appendectomy during childhood (under age 20),and duration of symptoms >10 years.In multivariate stepwise logistic regression analysis,smoking (OR=1.931,95% CI:1.000-3.731),family history of cancer (OR=5.175,95% CI:1.216-22.022),and duration of symptoms >10 years (OR=2.348 95% CI:1.394-3.952) were independent factors.CONCLUSION:Smoking,family history of cancer and duration of symptoms >10 years may be risk factors for ICC in patients with hepatolithiasis.

TNF-α and IL-1RA Polymorphisms and Silicosis Susceptibility in Chinese Workers Exposed to Silica Particles:A Case-Control Study

Abstract Objective To assess the association of TNF-α and IL-1RA SNPs with the risk of silicosis in Chinese workers exposed to silica particles. Methods Case-control study design was used to enroll 68 silicotic patients induced by silica particles and 68 healthy workers matched for length of silica particle exposure as controls. Both cases and controls were from the same company in southwest China, and each of them was requested to complete a questionnaire. Blood samples were drawn for genomic DNA extraction from each participant. The genotyping of TNF-α （-238 and -308） and IL-1RA （＋2018） was performed using polymerase chain reaction-based restriction fragment length polymorphism （PCR-RFLP） and SYBR green-based quantitative polymerase chain reaction {qPCR）, respectively. Unconditional logistic regression model was used to estimate odds ratios （ORs） and their 95% confidential intervals （Cl） for SNPs. Results No significant differences were found between cases and controls in particles exposure length, body mass index （BMI）, and status of smoking and alcohol consumption except for age （P=O.O01） and blood type （P=0.042）. The frequencies of TNF-c（（-238） and IL-1RA （＋2018） genotypes in cases were significantly different from those in controls, （P=O.O01 and P=0.O02, respectively）, while a borderline significant difference was found in the frequencies of TNF-α（-308） between cases and controls （P=0.063）. The variants of three SNPs increased the risk of silicosis in the Chinese workers exposed to silica particles. The adjusted ORs of TNFα（-308）, TNF-α（-238） and IL-1RA （＋2018） were 2.8 （95% Ch 2.1-7.5）, 20.9 （95% Ch 2.8-236.4） and 4.0 （95% CI： 2.6-10.2）, respectively. Conclusion It is suggested that cytokine polymorphisms of TNF-ct （-238, -308） and IL-1RA （＋2018） are associated with the risk of silicosis in the Chinese workers exposed to silica particles. Further independent studies on the interaction between SNPs and exposure to silica particles with a larger sample size are therefore warranted.

Risk of Active Pulmonary Tuberculosis among Patients with Coal Workers'Pneumoconiosis:A Case-control Study in China

The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.

Environmental and Psycho-social Factors Related to Prostate Cancer Risk in the Chinese Population:a Case-control Study

Objective To study the risk environmental and psycho-social factors associated to prostate cancer （PCa） in Chinese population. Methods 250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios （OR） and 95% confidence intervals （95% CI） for relationship between lifestyle, eating habits and psycho-social factors with PCa risk. Results Green vegetables and green tea were associated with a decreased risk of PCa （0R=0.39, 95% CI： 0.28-0.53; 0R=0.59, 95% Cl： 0.40-0.87, respectively）. Family history of PCa （0R=7.16, 95% CI： 2.01-25.49）, history of prostate diseases （0R=2.28, 95% Cl： 1.53-3.41）, alcohol consumption （0R=1.97, 95% CI： 1.33-2.90）, red meat consumption （0R=1.74, 95% CI： 1.20-2.52）, barbecued （0R=2.29, 95% CI： 1.11-4.73） or fried （0R=2.35, 95% CI： 1.24-4.43） foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks （0R=1.61, 95% CI： 2.00-2.59）, marital separation （0R=1.94, 95% CI： 1.29-2.91）, self-contained suffering {0R=2.37, 95% CI： 1.58-3.55）, and high sensitivity to the personal comments （0R=1.73, 95% CI： 1.18-2.54） were related to PCa. Conclusion Regular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population.

Mass screening-based case-control study of diet and prostate cancer in Changchun, China

Aim： To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods： We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value （〈 4.1 ng/mL） by 1：10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results： After adjustment for education, body mass index （BMI）, smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio （OR） of 0.38 （95% confidence interval [CI], 0.13-1.12）. In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 （95% CI, 0.11-0.79） compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion： Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.

Associations between coagulation factorⅫ,coagulation factorⅪ,and stability of venous thromboembolism:A case-control study

BACKGROUND Pulmonary embolism(PE)is a fatal clinical syndrome that is generally caused by an embolus from unstable deep venous thrombosis(DVT).However,clinical and biochemical factors that are related to the stability of DVT are not fully understood.AIM To evaluate the relationships between plasma antigen levels of factor XII(FXII:Ag)and factor XI(FXI:Ag)with the stability of DVT.METHODS Patients with DVT and no PE,DVT and PE,and controls with no DVT or PE that matched for age,gender,and comorbidities were included in this study.FXII:Ag and FXI:Ag in peripheral venous blood were measured using enzyme-linked immunosorbent assays.RESULTS Using the 95th percentile of FXI:Ag in patients with DVT and PE as the cut-off,a higher FXI:Ag was associated with a higher risk of unstable DVT(odds ratio:3.15,95%confidence interval:1.18-8.43,P=0.019).Stratified analyses showed consistent results in patients≤60 years(P=0.020),but not in those>60 years(P=0.346).CONCLUSION Higher plasma FXI:Ag might be a marker for unstable DVT,which might be associated with PE in these patients.

Risk factors for the occurrence of insulinoma: a case-control study

BACKGROUND: The etiology of insulinoma is poorly understood. Few studies investigated the possible roles of environmental factors and lifestyle in the pathogenesis of insulinoma. The aim of this study is to identify risk factors associated with occurrence of insulinoma in the Chinese population. METHODS: This study consisted of 196 patients with insulinoma and 233 controls. Demographic information of the patients and controls and risk factors of the disease were analyzed. Univariate and unconditional multivariable logistic regression analyses were made to estimate odds ratios (ORs) and possible risk factors. RESULTS: Approximately 68.88% (135/196) of the patients were from rural areas in contrast to 10.30% (24/233) of the controls (P【0.0001). This difference was confirmed by the multivariate analysis (OR=4.950; 95% CI: 2.928-8.370). Family history of pancreatic endocrine tumor (OR=16.754; 95% CI: 2.125-132.057) and other cancers (OR=2.360; 95% CI: 1.052-5.291) was also related to a high-risk population of insulinoma. CONCLUSION: Rural residents or people who have a family history of pancreatic endocrine tumor and other cancers are a high-risk population of insulinoma.

How Work Organization Affects the Prevalence of WMSDs: A Case-control Study

Objective In this study, we aimed at exploring the association between work-related musculoskeletal disorders（WMSDs） and work organization based on a case-control study. Methods A total of 1938 workers who claimed to suffer from WMSDs were selected from Beijing, Henan, Hubei, and the Guangdong province. The control group consisted of 2009 workers employed in similar industries without severe disease or musculoskeletal discomforts. We used a modified version of the questionnaire developed by the NMQ and the DMQ to investigate individual and work-related factors. Results A total of 13 variables（P〈0.1） were selected by the chi-square test and finally, 7 variables entered into the equation, with 6 variables reaching statistical significance（P〈0.05）. The odds ratios（OR） of ＇work changing with season＇ and ＇sufficient rest time＇ did not reach 1（0.749 and 0.441, respectively）. In addition, ＇sufficient rest time＇ seemed to be the stronger protective factor according to its higher standardized coefficient. And ＇repetitive work every minute＇, ＇constantly repetitive work＇（every day）, ＇shortage of site personnel＇, and ＇often switching shifts with others＇ seemed to be the risk factors. Conclusion Work organization may have comprehensive effects on the occurrence of WMSDs. This pattern of associations suggests that further investigation into the mechanism of how work organization affects the prevalence of WMSDs is required.

Association between diabetes mellitus,hypertension,hyperlipidemia,chronic viral hepatitis,and the risk of multiple myeloma:a case-control study

Objective This case-control study aimed to investigate whether diabetes mellitus(DM),hypertension,hyperlipidemia,and chronic viral hepatitis are risk factors for multiple myeloma(MM).Moreover,the clinical characteristics of MM patients with or without the abovementioned exposure factors were analyzed.Methods In total,340 MM patients and 680 patients with benign diseases who were hospitalized from January 2012 to December 2017 were classified under the case group and control group,respectively.Data about medical history of DM,hypertension,hyperlipidemia and chronic viral hepatitis were collected by reviewing medical records.Univariate and multivariate analyses were conducted to compare the history of DM,hypertension,hyperlipidemia,and viral hepatitis between the two groups.Considering DM,hypertension,hyperlipidemia,and chronic viral hepatitis as exposure factors,clinical characteristics,such as renal function and presence of fungal and other types of infections,between the exposed and nonexposed groups were analyzed.Results No significant difference was observed in the prevalence of DM,hypertension,and hyperlipidemia between the case and control groups.MM patients had a higher prevalence of chronic viral hepatitis than those with benign diseases.No significant difference was observed in the prevalence of renal dysfunction,fungal infection,and non-fungal infections in MM patients with or without DM,hypertension,and hyperlipidemia.MM patients with chronic viral hepatitis had a significantly higher prevalence of nonfungal infections during hospitalization than those without.Conclusion No significant association was noted between MM and DM,hypertension,and hyperlipidemia.Chronic viral hepatitis is correlated to a significantly higher risk of MM,and MM patients with chronic viral hepatitis were more susceptible to non-fungal infections during hospitalization.Although a non-significant trend was observed in this study,we believe that DM and hypertension might be associated with a higher risk of MM.Thus,large-scale studies must be conducted to validate the results of the current study.

A Case-control Study of Environmental Risk Factors for Nonsyndromic Cleft of the Lip and/or Palate in Xuzhou,China

In this study, we sought to determine the association between environmental factors and nonsyndromic cleft of the lip and/or palate （NSCLP） to understand the etiology of the disease. A total of 200 NSCLP cases and 327 controls were recruited at the Maternal and Child Health Hospital of Xuzhou City. We conducted face-to-face interviews with the mothers of both cases and controls. The factors increasing the risk of NSCLP were a positive family history [odds ratio （OR）=56.74], pesticide exposure （OR=8.90）, and indoor decoration pollution （OR= 4.32）. On the other hand, the factors decreasing the risk of NSCLP were a high education level （OR=0.22） and supplementation of folic acid （OR=0.23） and multivitamins （OR=0.16）. Positive family history, pesticide exposure, and indoor decoration pollution are associated with the risk of NSCLP. In contrast, high education level and folic acid and multivitamin supplementation are protective factors against NSCLP.

Metabolic syndrome,ApoE genotype,and cognitive dysfunction in an elderly population:A single-center,case-control study

BACKGROUND Metabolic syndrome(MetS)is related to poor cognitive function.However,the results of previous studies were inconsistent,and whether the ApoEε4 allele modifies the association remains unclear.AIM To elucidate the relationships among MetS,ApoEε4,and cognitive dysfunction in an elderly population in China.METHODS One hundred elderly patients with MetS and 102 age-and gender-matched controls were included in the study.Baseline clinical characteristics and biochemical index for glucose and lipid metabolism were obtained.The distribution of ApoEε4 was assessed with PCR restriction fragment length polymorphism analysis.Cognitive function was evaluated by mini-mental status examination at the 1-year follow-up examination.RESULTS Compared with controls,MetS patients had worse cognitive function and decreased ability to participate in activities of daily life(P=0.001 and 0.046,respectively).Patients with cognitive dysfunction had higher prevalence of MetS(62.1%vs 36.4%,P<0.001)and were more likely to carry the ApoEε4 allele(22.3%vs 10.1%,P=0.019).Multivariate logistic regression analyses showed that diagnosis with MetS,severe insulin resistance,status as an ApoEε4 carrier,higher systolic blood pressure,and larger waist circumference were risk factors for cognitive dysfunction(P<0.05).Repeated-measures analysis of variance,performed with data collected at the 1-year follow-up,revealed continuous influences of MetS and ApoEε4 on the deterioration of cognitive function(time×team,P<0.001 for both).CONCLUSION Diagnosis of MetS and ApoEε4 carrier status were persistently associated with cognitive dysfunction among an elderly population in China.

Nutrient patterns and risk of cataract：a case-control study

AIM：To assess the relation between nutrient patterns and cataract risk.METHODS：This is a hospital-based case-control study with 97 cataract patients and 198 matched controls.Dietary consumption was collected through a valid food frequency questionnaire（FFQ）.Nutrient patterns were detected by applying factor analysis.Unconditional logistic regression models were used to estimate odds ratio（ORs） and 95%CIs.RESULTS：We extracted 5 main nutrient patterns.Factor 1 included niacin,thiamin,carbohydrates,protein,zinc,vitamin B6 and sodium（sodium pattern）.Factor 2 was characterized by oleic acid,monounsaturated fats,polyunsaturated fats,linoleic acid,trans fatty acid,linolenic acid,vitamin E and saturated fats（fatty acid pattern）.The third factor represented high intake of vitamin B12,vitamin D,cholesterol and calcium（mixed pattern）.The 4^（th） pattern was high in intake of beta and alpha carotene,vitamin A and vitamin C（antioxidant pattern）.Finally,the 5^（th） pattern loaded heavily on docosahexaenoic acid（DHA） and eicosapentaenoic acid（EPA）（omega-3 pattern）.In crude and multivariate analysis,the sodium pattern was associated with increased risk of cataract（OR=1.97,95%CI：1.09-3.96）.The fatty acid pattern elevated the risk of cataract（OR=1.94,95%CI：1.1-3.86）.Antioxidant pattern was associated with a significant 79% reduced risk（2^（nd） category compared with the 1st）.Omega-3 pattern was significantly negatively associated with risk of cataract（P=0.04）.CONCLUSION：These findings imply that nutrient patterns reflecting a combined consumption of nutrients might be important in the etiology of cataract.Additional studies with more efficient designs are warranted to confirm our findings.

AB015.The relationship between copy number variations and high myopia in Chinese:a case-control study

As a complex disease,myopia is the most common eye disease worldwide.Many myopia susceptibility genes or variants have been successfully identified in the past years by genome-wide genetic association studies(GWAS),which focus mainly on the single-nucleotide polymorphisms.Little attention has been paid to examine the role of copy number variations(CNVs)in refractive error and myopia.This study adopted a systematic strategy to investigate the role of CNVs in high myopia.In the discovery phase,a pilot GWAS suggests putative CNVs for follow-up.Multiplex ligation-dependent probe amplification was then used to quantify the copy number of 89 CNV segments in 737 case-control samples in the second phase and then 24 top-ranking CNVs in a second group of 1,029 case-control samples in the final validation phase.This validation phase identified 22 significant CNVs.Further work is needed to examine the role of these few CNVs in myopia development.

Genetic polymorphisms in pri-let-7a-2 are associated with ischemic stroke risk in a Chinese Han population from Liaoning, China: a case-control study

Ischemic stroke is a complicated disease, and its pathogenesis has been attributed to the occurrence of genetic polymorphisms.Evidence has suggested that the microRNA let-7a is involved in the pathogenesis of ischemic stroke.Pri-miRNA is the primary transcript, which undergoes several processing steps to generate pre-miRNA and, later, mature miRNAs.In this case-control study, we analyzed the distribution of prilet-7a-2 variants in patients at a high risk for ischemic stroke and the interactions of pri-let-7a-2 variants and environmental factors.Blood samples and clinical information were collected from 1086 patients with ischemic stroke and 836 healthy controls between December 2013 and December 2015 at the First Affiliated Hospital of China Medical University.We found that the rs1143770 CC genotype and the C allele were associated with a decreased risk of ischemic stroke, whereas the rs629367 CC genotype was associated with an increased risk for ischemic stroke.Moreover, these two single-nucleotide polymorphisms were in linkage disequilibrium in this study sample.We analyzed gene-environment interactions and found that rs1143770 exerted a combined effect on the pathogenesis of ischemic stroke, together with alcohol use, smoking, and a history of hypertension.Therefore, the detection of pri-let-7a-2 polymorphisms may increase the awareness of ischemic stroke risk.This study was approved by the Institutional Ethics Committee of the First Affiliated Hospital of China Medical University, China(approval No.2012-38-1) on February 20, 2012, and was registered with the Chinese Clinical Trial Registry(registration number: ChiCTR-COC-17013559) on December 27, 2017.

Interaction and Its Solution in Individual Matching Case-control Study

Objective To indicate the deficiency of the classical method for analyzing data on individual matching case-control study in consideration of the interaction between the study factor (exposure) and the matching factor, and to find out a proper method for handling this deficiency. Method First, experimental data with 50 pairs of cases and controls were used for strata analysis according to the values of a matching factor to illustrate the possible interaction between a risk factor (exposure) and the matching factor. Second, a detailed procedure was proposed for analyzing such data. Results Interaction between the study factor and matching factor was demonstrated by using strata analysis and unconditional logistic regression analysis. Therefore the results from the classical analysis for such data might be incorrect. Conclusion Data from individual matching case-control study design should be dealt with strata analysis or multivariate analysis to explore and evaluate the possible interaction between the s

Driver Sleepiness and Risk of Car Crashes in Shenyang, a Chinese Northeastern City: Population-based Case-control Study

Objective To estimate the association of driver sleepiness with the risk of car crashes. Methods A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively. Results There was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sleepiness score≥10 vs <10; adjusted odds ratio 2.07, 95% confidence interval 1.30 to 3.29), but no increased risk was associated with measures of acute sleepiness. Conclusions Chronic sleepiness in car drivers significantly increases the risk of car crash. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy.