Background: The Air Force Health Study collected reproductive outcomes for live-born children of male Air Force veterans of the Vietnam War. Methods: Dioxin values for participants were obtained from blood samples. An...Background: The Air Force Health Study collected reproductive outcomes for live-born children of male Air Force veterans of the Vietnam War. Methods: Dioxin values for participants were obtained from blood samples. Analyses were conducted of occurrence of 16 specific categories of birth defects and developmental disabilities. Children were categorized as conceived before and after the start of participants’ Vietnam War service. Children conceived before the start of Vietnam War service were treated as being conceived when their fathers had unquantifiable dioxin values. Children conceived after the start of Vietnam War service for participants with missing dioxin values were excluded from primary analyses, but were used to assess the impact of their exclusion on conclusions. Correlation between values for specific categories for multiple children fathered by the same participant was accounted for. The dose-response relationship was treated as a step function increasing for dioxin values larger than adaptively identified individual thresholds changing with the specific category. Results: For 15 of 16 specific categories, the probability of occurrence increased substantially for a sufficiently high dioxin level above identified thresholds. Exclusion of children due to missing dioxin likely did not affect these results. Conclusions: Results supported the conclusion of substantial adverse effects on a wide variety of specific categories of birth defects and developmental disabilities due to sufficiently high exposures to dioxin, a toxic contaminant of Agent Orange used for herbicide spraying in the Vietnam War. Results may hold more generally, but might also have been affected by a variety of limitations.展开更多
目的:用Meta分析方法定量评价生理浓度范围内血清总胆红素水平与脑卒中发病风险之间的剂量-反应关系。方法:计算机检索PubMed、Embase、The Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、万方和维普数据库,查...目的:用Meta分析方法定量评价生理浓度范围内血清总胆红素水平与脑卒中发病风险之间的剂量-反应关系。方法:计算机检索PubMed、Embase、The Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、万方和维普数据库,查找符合纳入标准的临床研究。应用STATA 11.0软件进行统计分析。结果:纳入11项观察性研究、202641例受试者,其中包括4904例脑卒中患者。Meta分析结果显示,血清总胆红素水平与缺血性脑卒中及脑卒中发病风险呈负相关[OR(95%CI)分别为0.76(0.6~0.87)和0.74(0.64~0.86),P均<0.001]。剂量-反应Meta分析显示,随着血清总胆红素水平升高,脑卒中发病风险逐渐降低;血清总胆红素水平每增加1μmol/L,缺血性脑卒中及脑卒中发病风险分别降低1.2%(OR=0.988,95%CI:0.981~0.996,P=0.002)和1.5%(OR=0.985,95%CI:0.979~0.992,P<0.001)。结论:生理浓度范围内血清总胆红素水平与脑卒中发病风险呈线性负相关。展开更多
目的探讨大气SO2和NO2对2型糖尿病发病的影响。方法以"金昌队列"为平台,选择基线调查中尚未患2型糖尿病的19 884人为研究对象做前瞻性队列研究,根据每个研究对象基线调查时间,计算其过去5 a SO2和NO2污染物平均暴露水平,运用...目的探讨大气SO2和NO2对2型糖尿病发病的影响。方法以"金昌队列"为平台,选择基线调查中尚未患2型糖尿病的19 884人为研究对象做前瞻性队列研究,根据每个研究对象基线调查时间,计算其过去5 a SO2和NO2污染物平均暴露水平,运用多因素非条件Logistic回归模型与限制性立方样条函数,分析大气SO2和NO2与2型糖尿病发病的相关性。结果平均随访2.3 a后,研究对象中791例新发2型糖尿病,累计发病率为3.98%。控制潜在混杂因素,SO2、NO2暴露质量浓度每增加1μg/m3,2型糖尿病发病风险OR分别为1.059、1.291。分层分析结果显示,SO2与NO2对超重人群影响较显著,SO2、NO2暴露质量浓度每增加1μg/m3,超重人群2型糖尿病发病风险OR分别为1.127、1.675。结论大气SO2、NO2暴露可增加2型糖尿病发病风险,超重可增加其对2型糖尿病发病风险的健康效应。展开更多
Background:Following initiation of China’s National Malaria Elimination Action Plan(NMEAP)in 2010,the'1-3-7’approach was developed and rolled out in China to facilitate the malaria elimination programme and acce...Background:Following initiation of China’s National Malaria Elimination Action Plan(NMEAP)in 2010,the'1-3-7’approach was developed and rolled out in China to facilitate the malaria elimination programme and accelerate malaria elimination.This study aims to summarize and condense these experiences through a retrospective analysis in Jiangsu Province,which could be adapted and applied in other malaria elimination settings worldwide.Methods:A retrospective analysis of imported malaria cases into China identified through an improved surveillance and response system in Jiangsu Province was carried out for the period of 2001-2020.To improve the malaria surveillance and response system,Centers for Diseases Control and Prevention from the prefectures and counties in Jiangsu province conducted population-level health education to improve healthcare seeking behavior,strengthened capacity of health facilities to improve performance of malaria diagnosis and treatment,and raised the capacity of public health providers to improve implementation of the'1-3-7’approach.Categorical variables were carried out by Chi square tests with Fisher’s exact correction.Results:From 2001 to 2020,a total of 9,879 malaria cases were reported in Jiangsu Province.Since 2012,no indigenous malaria cases have been reported in Jiangsu Province.However,in recent years,there has been a substantial increase of imported falciparum malaria cases.Between 2012 and 2020,an estimated 61.57 million individuals have benefited from population-level health education in Jiangsu Province.For healthcare-seeking services among the 2,423 imported malaria cases,687(28.4%)and 1,104(45.6%)cases visited hospitals on the first day and the second day from symptom onset,respectively.A total of 1,502(61.9%)cases were diagnosed on the first day at medical facilities.Jiangsu Province achieved 100%,99.4%and 98.3%completion rate in terms of case detection and notification(within one day),case investigation(within three days)and foci response and disposition(within seven days),respectively.The improved surveillance and response system in Jiangsu Province plays an important role in preventing the re-introduction of malaria and maintaining the malaria-free status.Conclusions:Jiangsu Province has maintained its malaria-free status since 2012.The continuous improvement of a surveillance and response system plays an important role in the early detection and rapid response of potential malaria-related outbreaks in Jiangsu,China,and has important lessons for other malaria eliminating settings.Remaining vigilant in the detection of imported malaria cases and maintaining an active surveillance and response system is critical to sustain the success of malaria elimination.展开更多
文摘Background: The Air Force Health Study collected reproductive outcomes for live-born children of male Air Force veterans of the Vietnam War. Methods: Dioxin values for participants were obtained from blood samples. Analyses were conducted of occurrence of 16 specific categories of birth defects and developmental disabilities. Children were categorized as conceived before and after the start of participants’ Vietnam War service. Children conceived before the start of Vietnam War service were treated as being conceived when their fathers had unquantifiable dioxin values. Children conceived after the start of Vietnam War service for participants with missing dioxin values were excluded from primary analyses, but were used to assess the impact of their exclusion on conclusions. Correlation between values for specific categories for multiple children fathered by the same participant was accounted for. The dose-response relationship was treated as a step function increasing for dioxin values larger than adaptively identified individual thresholds changing with the specific category. Results: For 15 of 16 specific categories, the probability of occurrence increased substantially for a sufficiently high dioxin level above identified thresholds. Exclusion of children due to missing dioxin likely did not affect these results. Conclusions: Results supported the conclusion of substantial adverse effects on a wide variety of specific categories of birth defects and developmental disabilities due to sufficiently high exposures to dioxin, a toxic contaminant of Agent Orange used for herbicide spraying in the Vietnam War. Results may hold more generally, but might also have been affected by a variety of limitations.
文摘目的探讨大气SO2和NO2对2型糖尿病发病的影响。方法以"金昌队列"为平台,选择基线调查中尚未患2型糖尿病的19 884人为研究对象做前瞻性队列研究,根据每个研究对象基线调查时间,计算其过去5 a SO2和NO2污染物平均暴露水平,运用多因素非条件Logistic回归模型与限制性立方样条函数,分析大气SO2和NO2与2型糖尿病发病的相关性。结果平均随访2.3 a后,研究对象中791例新发2型糖尿病,累计发病率为3.98%。控制潜在混杂因素,SO2、NO2暴露质量浓度每增加1μg/m3,2型糖尿病发病风险OR分别为1.059、1.291。分层分析结果显示,SO2与NO2对超重人群影响较显著,SO2、NO2暴露质量浓度每增加1μg/m3,超重人群2型糖尿病发病风险OR分别为1.127、1.675。结论大气SO2、NO2暴露可增加2型糖尿病发病风险,超重可增加其对2型糖尿病发病风险的健康效应。
基金This study was supported by Bill&Melinda Gates Foundation(INV-018913)the National Natural Science Foundation of China(71904165)+2 种基金the Jiangsu Provincial Department of Science and Technology(BM2018020)the Jiangsu Provincial Health Commission(H2018102,and X201828)the Jiangsu Provincial Project of Invigorating Health Care through Science,Technology,and Education.
文摘Background:Following initiation of China’s National Malaria Elimination Action Plan(NMEAP)in 2010,the'1-3-7’approach was developed and rolled out in China to facilitate the malaria elimination programme and accelerate malaria elimination.This study aims to summarize and condense these experiences through a retrospective analysis in Jiangsu Province,which could be adapted and applied in other malaria elimination settings worldwide.Methods:A retrospective analysis of imported malaria cases into China identified through an improved surveillance and response system in Jiangsu Province was carried out for the period of 2001-2020.To improve the malaria surveillance and response system,Centers for Diseases Control and Prevention from the prefectures and counties in Jiangsu province conducted population-level health education to improve healthcare seeking behavior,strengthened capacity of health facilities to improve performance of malaria diagnosis and treatment,and raised the capacity of public health providers to improve implementation of the'1-3-7’approach.Categorical variables were carried out by Chi square tests with Fisher’s exact correction.Results:From 2001 to 2020,a total of 9,879 malaria cases were reported in Jiangsu Province.Since 2012,no indigenous malaria cases have been reported in Jiangsu Province.However,in recent years,there has been a substantial increase of imported falciparum malaria cases.Between 2012 and 2020,an estimated 61.57 million individuals have benefited from population-level health education in Jiangsu Province.For healthcare-seeking services among the 2,423 imported malaria cases,687(28.4%)and 1,104(45.6%)cases visited hospitals on the first day and the second day from symptom onset,respectively.A total of 1,502(61.9%)cases were diagnosed on the first day at medical facilities.Jiangsu Province achieved 100%,99.4%and 98.3%completion rate in terms of case detection and notification(within one day),case investigation(within three days)and foci response and disposition(within seven days),respectively.The improved surveillance and response system in Jiangsu Province plays an important role in preventing the re-introduction of malaria and maintaining the malaria-free status.Conclusions:Jiangsu Province has maintained its malaria-free status since 2012.The continuous improvement of a surveillance and response system plays an important role in the early detection and rapid response of potential malaria-related outbreaks in Jiangsu,China,and has important lessons for other malaria eliminating settings.Remaining vigilant in the detection of imported malaria cases and maintaining an active surveillance and response system is critical to sustain the success of malaria elimination.
