OBJECTIVETo evaluate the effect and safety of low-dose aspirin for primary prevention of cardiovascular events.

METHODSWe searched for randomized controlled trials (RCT) in the following electronic databases: MEDLINE, EMbase, the Cochrane Library (Issue 3, 2008), CBM, CNKI. Quality assessment and data extraction were conducted by two reviewers independently. All data were analyzed using Review Manager 4.2.

RESULTSSix studies (TPT, HOT, PPP, WHS, POPADAD, J-PAD) involving a total of 72,466 participants met the inclusion criteria. Meta-analysis results showed that: (1) Compared with placebo, the incidences of total cardiovascular events (RR = 0.85, 95% CI: 0.80-0.92), stroke (RR = 0.87, 95% CI: 0.77-0.98), nonfatal stroke (RR = 0.81, 95% CI: 0.70-0.95) and transient ischemic attack (RR = 0.76, 95% CI: 0.64-0.90) were significantly lower in low-dose aspirin group than those in placebo control group (all P < 0.05). (2) Nonfatal myocardial infarction (RR = 0.89, 95% CI: 0.77-1.02), death from cardiovascular causes (RR = 0.98, 95% CI: 0.86-1.13) and death from any cause (RR = 0.95, 95% CI: 0.88-1.02) were similar between the 2 groups (all P > 0.05). (3) The risk of coronary heart disease was reduced in low-dose aspirin group in the elderly (RR = 0.81, 95% CI: 0.70-0.94, P < 0.05). (4) The risk of bleeding was higher in low aspirin group compared to placebo group (RR = 1.15, 95% CI: 1.12-1.18, P < 0.01).

CONCLUSIONSLow-dose aspirin use could reduce the incidences of total cardiovascular events, stroke, nonfatal stroke and transient ischemic attack but increase the risk of bleeding, the incidence of nonfatal myocardial infarction, death from cardiovascular causes and death from any cause was not affected by low-dose aspirin use. Low-dose aspirin use was also significantly reduced the risk of coronary heart disease in the elderly.

Aspirin ; administration & dosage ; adverse effects ; therapeutic use ; Cardiovascular Diseases ; drug therapy ; Humans ; Platelet Aggregation Inhibitors ; administration & dosage ; adverse effects ; therapeutic use ; Primary Prevention ; Randomized Controlled Trials as Topic ; Treatment Outcome

This study was purposed to explore the correlation of chromosome karyotype with dyshaematopoiesis and reticulin in myelodysplastic syndrome (MDS). The data of 202 MDS patients diagnosed and treated in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed in term of chromosome karyotype, dyshaematopoiesis and reticulin detection results. The chromosome karyotypes were categorized according to the International Prognostic Scoring System (IPSS). The results showed that there was a positive correlation between chromosome karyotype grading and number of lineages with dyshaematopoiesis (r = 0.443, P < 0.05). The detected rates of multilineage dyshaematopoiesis in patients with good, intermediate and poor chromosome karyotypes were 44.4%, 71.4% and 96.3% respectively. There was a positive correlation between chromosome karyotype grading and reticulin grading (r = 0.451, P < 0.05). The positive rates of reticulin in patients with good grading, intermediate and poor chromosome karyotypes were 36.8%, 64.3% and 92.6% respectively. The detected rate of multilineage dyshaematopoiesis, number of lineages with dyshaematopoiesis, the positive rate of reticulin and reticulin grade in patients with poor karyotypes were higher than those in patients with intermediate or good chromosome karyotypes (separately P < 0.01). The above data in patients with intermediate chromosome karyotypes were higher than those in patients with good chromosome karyotypes (separately P < 0.01). It is concluded that the chromosome karyotype grading positively correlates with the number of lineages with dyshaematopoiesis and reticulin grading. When the chromosome karyotype changed from good to poor, the detected rate of multilineage dyshaematopoiesis, number of lineages with dyshaematopoiesis, positive rate of reticulin and reticulin grading became higher and higher.
Adolescent ; Adult ; Aged ; Bone Marrow Examination ; Female ; Humans ; Karyotype ; Karyotyping ; Male ; Middle Aged ; Myelodysplastic Syndromes ; diagnosis ; genetics ; pathology ; Reticulin ; analysis ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the effects of 54G/C polymorphism of sterol regulatory element-binding protein-1c gene (SREBP-1c) on serum lipid ratios and their response to high-carbohydrate/low-fat (HC/LF) diet in healthy youth.

METHODSAfter a regular diet for 7 days of wash-out, 56 healthy youth (22.89 +/- 1.80 yrs) were given HC/LF diet for 6 days. The regular diet contained 54% carbohydrate, 15% protein, and 31% fat of the total energy. The HC/LF diet contained 70% carbohydrate, 15% protein, and 15% fat of the total energy. The serum lipids and glucose were measured on the 1st, 8th and 14th days. The ratios of TG/HDL-C, log (TG/HDL-C), TC/HDL-C, and LDL-C/HDL-C were calculated. The 54G/C polymorphism of SREBP-1c gene was analyzed by PCR-RFLP method.

RESULTSNo significant difference was found in lipid ratios and glucose at baseline and after regular diet in subjects with different genotypes in either the whole studied population or in males or females only. However, after HC/LF diet, LDL-C/HDL-C was significantly lower in females carrying the C allele than those of GG homozygotes (P< 0.05). Compared with those before HC/LF diet, TC/HDL-C and LDL-C/HDL-C were significantly decreased in all the subjects (P< 0.05). When gender was taken into account, significant increase of TG/HDL-C and log(TG/HDL-C) was found only in females with GG genotype (P< 0.05). All the subjects experienced significant decrease of TC/HDL-C and LDL-C/HDL-C regardless of their genders and genotypes (P< 0.05).

CONCLUSIONThe 54G/C polymorphism of SREBP-1c gene can influence the response of TG/HDL-C and log(TG/HDL-C) to HC/LF diet in females. The C allele may be a protective factor to prevent the increase of TG induced by HC/LF diet in females.

Adult ; Dietary Carbohydrates ; pharmacology ; Dietary Fats ; pharmacology ; Female ; Gene Frequency ; Genotype ; Health ; Humans ; Lipids ; blood ; Male ; Polymorphism, Single Nucleotide ; Sex Characteristics ; Sterol Regulatory Element Binding Protein 1 ; genetics ; Young Adult

OBJECTIVETo explore the role of reversal multidrug resistance (MDR) using short hairpin RNA (shRNA) expression vectors in multidrug resistance human leukemia cell line K562/ADM.

METHODSThe oligonucleotides with 19-mer hairpin structure were synthesized. The shRNA expression vectors were constructed and introduced into K562/ADM cells. Expression of mdr1 mRNA was assessed by RT-PCR, and P-gp expression was determined by Western blot. The apoptosis and sensitivity of the K562/ADM cells to doxorubicin were quantified by flow cytometry and methyl thiazolyl tetrazolium (MTT) assays, respectively. Cellular daunorubicin accumulation was assayed by laser confocal scanning microscope (LCSM).

RESULTSIn positive clones of K562/ADM cells stably transfected with pSilencer 3.1-HI neo mdr1-A and mdr1-B shRNA expression vectors, RT-PCR showed that mdr1 mRNA expression was significantly reduced to 35.9% (P < 0.05), 27.5% (P < 0.01), respectively. Western blot showed that P-gp expression was significantly and specifically inhibited. Resistance against doxorubicin was decreased from 79-fold to 38-fold (P < 0.05), 30-fold (P < 0.01) respectively. Furthermore, the fluorescence intensity of K562/ADM cells was increased significantly compared with the control. shRNA vectors significantly enhanced the cellular daunorubicin accumulation. The percent of the apoptosis cell was significantly enhanced to 18.1% (P < 0.05) , 54.4% (P < 0.01) respectively.

CONCLUSIONSshRNA expression vectors can effectively reverse MDR, and restore the sensitivity of drug-resistance K562/ADM cells to conventional chemotherapeutic agents.

ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Apoptosis ; Doxorubicin ; pharmacology ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Genetic Vectors ; Humans ; K562 Cells ; RNA Interference ; RNA, Messenger ; genetics ; Transfection

Objective: To analyze the usage of catering software and the creation of recipes by schools, as part of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) 2013-2017. Methods: In each county of the 699 trial counties across 22 provinces in central and western area of China under the NNIPRCES, no less than 10% of primary and junior middle schools were randomly selected according to their catering mode (i.e., school feeding, food packages, and family feeding). School questionnaires were used to collect information concerning the schools and the creation of recipes. Results: From 2013 to 2017, the utilization rate of catering software was 11.7%, 8.0%, 17.8%, 16.9%, and 14.0%, respectively with significant differences(χ 2=345.09，P<0.01). The creators of school-meal recipes included schools, the Education Bureau, hospitals and colleges, the centers of disease prevention and control. Differences were observed in the proportion of recipe creators across school type, area, and catering mode, while annual trends also varied (P<0.01), as indicated by the following proportions: 74.9%, 20.0%, 3.7%, 1.3%, respectively. Food safety was identified as the main factor that needs to be considered when creating school recipes, the proportions of which were 58.0%, 78.4%, 70.6%, and 87.4% from 2014 to 2017. Conclusion From 2013 to 2017, the utilization rate and the frequency of catering software were both relatively low, and recipe creation was in need of professional guidance. It is necessary to strengthen the popularization of catering software and improve the nutritional knowledge and skills of canteen workers to ensure the quality of school meals.

Objective: To analyze the usage and influencing factors of quantified recipes in schools in the pilot areas of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES), and to provide references for student meal quality improvement. Methods: In 726 national pilot counties in 22 provinces where the NIPRCES was implemented, a total of 7 808 schools were included in the analysis as the survey objects in 2019. Data, including the usage of quantified recipes in schools and related factors, were collected through questionnaires. Multivariate Logistic regression was used to analyze the influencing factors of the schools use of quantified recipes. Results: Among the national pilot counties where the NIPRCES was implemented, 66.6 % of the monitored schools used quantified recipes, of which 69.7% of schools in the central region used quantified recipes, it was higher than that in the west region(65.2%) ( χ 2=15.13, P <0.01). Multivariate Logistic regression analysis showed that factors such as the schools in the central region, county based schools, the training frequency of canteen with 1-2 times per semester or once or more per month, regular training of nutrition knowledge, recipes provided by other departments, consideration of nutrition matching when formulating recipes, using catering software, providing local dietary allowances were positively correlated with the use of quantified recipes in schools( OR=1.31,0.72,1.44,1.73,1.75,3.20,2.15,2.72,1.17,P <0.05). Conclusion The proportion of using quantified recipes of schools in the NIPRCES area was relatively low, which might be affected by factors including the regional economic level, canteen training, and recipes sources. It is recommended to strengthen the construction of professional teams and canteen training. Schools need to be encouraged to use quantified recipes and promote school catering scientifically to improve healthy growth of students.

Objective: To analyze the height changes among children who had received subsidies of the National Nutrition Improvement Program for Rural Compulsory Education Students (NNIPRCES) by comparing data from the year of 2012 and 2017. Methods: Among 699 counties where NNIPRCES was implemented, at least 10% of elementary schools and primary middle schools with different food supply modes (school canteen meals, company meals, and mix meals) in the county were selected randomly. Forty students from one or two classes from each grade (grade 1 to grade 9) were randomly selected, to ensure equal proportion of boys and girls in each grade were surveyed, data on height from 1 655 793 students measured in 2012 were compared with 1 419 281 students measured in 2017. Height was measured by metal height pole within 0.1 cm accuracy. Results: From 2012 to 2017, the average increase of height in boys and girls aged 6-15 years was 1.9 and 2.0 cm, respectively. Among them, maximum increment was found in boys at the age of 13 years and in girls at the age of 12 years, respectively, which was 3.0 and 2.8 cm. The average increase in boys from the central and western region was 2.1 and 2.2 cm, respectively, while increase in girls from the central and western region was both 2.2 cm. Compared with the results from 2012, height of boys with the 5th, 50th and 95th height percentiles in 2012 increased by 1.7, 2.0 and 2.1 cm, respectively in 2017, while the increase in girls was 2.1, 2.0 and 2.2 cm, respectively. The average increment of western students with the 5th and 95th height percentiles was higher than those of students from the central region. Conclusion The average height of students has increased after the implementation of NNIPRCES. However, the development was unbalanced between the central and western region, which requires more targeted intervening strategies to improve the nutritional status of students.

Objective: To explore the prevalence of anemia and related factors among left-behind children in poverty-stricken rural areas in China, to provide basic information for anemia prevention and treatment for children. Methods: Data from the National Nutrition Improvement Program for Rural Compulsory Education Students in 2016 were used to express the prevalence of anemia among left-behind children. By using the multistage stratified random cluster sampling method, left-behind children of the 6-17-years-old in poverty-stricken rural areas were recruited in this study. Blood hemoglobin concentration of these students was determined by cyanmethemoglobin method. Anemia was judged by the WHO recommended standard and combined with the sea level elevation correction standard. Frequencies of food intake were collected through questionnaires. Data was then available for analysis including the level of hemoglobin and anemia rates. Relationship between anemia and food intakes as well as other influential factors was also analyzed. Results: The overall anemia prevalence (AP) was 11.6% among the participants. Rates of AP among the 6-, 7-, 15- and 16-17-years-old were 21.1%, 18.0%, 20.6% and 17.3%, respectively. Rates of AP among left-behind girls of 10-11-years-old and the 13-15-years-old were significantly higher than those in boys at the same age (P<0.01) group. Factors including: being girls (OR=1.34, 95%CI: 1.23-1.45), at grade 7 to 9 (OR=1.47, 95%CI:1.30-1.67) and mother being migrant worker (OR=1.32, 95%CI:1.16- 1.50) had higher proportions of getting anemia. Factors as living in the western area (OR=0.85, 95%CI: 0.78-0.93), taking breakfast every day (OR=0.70, 95%CI: 0.64-0.76), having meat more than twice per week (OR=0.84, 95%CI: 0.75-0.93) and having two kinds of vegetables per day (OR=0.85, 95%CI: 0.75-0.96) appeared protective. Conclusions Prevalence of anemia in left-behind children from the poverty-stricken rural areas was high, including junior middle school students from grade 7 to 9 at the early stage of youth development, girls and children with mothers as migrant workers. Anemia should be reduced by promoting the protective factors as having breakfast, increasing intakes of meat and fresh vegetables.

Objective: To analyze the status of parents sharing meal expenses in the national pilot areas of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) and its influencing factors, so as to provide scientific data for promoting the proper implementation of the NIPRCES and the healthy development of students. Methods: In the 726 national pilot counties in 22 provinces where the NIPRCES was implemented, 8 109 primary and junior high schools were selected as the survey objects and included in the analysis according to the three feeding methods of canteen feeding, enterprise feeding and mixed feeding. Data such as the basic information of the schools and counties, and the status of parents sharing meal expenses were collected through questionnaires. Multivariate Logistic regression analysis was used to analyze the influencing factors of parents sharing meal expenses. Results: In the national pilot areas of the NIPRCES, schools where parents shared meal costs accounted for 30.2% of all monitored schools in 2019. In central and western areas, the proportion of schools where parents shared meal costs were 51.5% and 20.3%, respectively. In schools where parents shared meal costs, no matter in primary school or junior high school, the difference in the amount of meal expenses shared by parents of students in middle and western schools was statistically significant ( χ 2= 181.78 , 89.54, P <0.01). Among 38.7% of the parents of primary school students in the central region shared meal expenses of ≥2 yuan, and 47.5% of the parents of primary school students in the western region. Multivariate Logistic regression analysis showed that the parents of schools in the central region, junior high schools or nine year system schools, canteen feeding or other feeding, large school size, the nutritious meal subsidy used for lunch, middle and high family income level, medium and low input level of the monitoring counties, monitoring counties with other nutrition public welfare projects and insufficient working funds share a higher proportion of meal expenses ( OR=3.22, 1.51, 1.36, 1.74, 3.74, 1.38, 11.58, 2.40, 3.15, 1.50, 2.12, 3.36, 1.34, P < 0.05). Conclusion The proportion of meals shared by parents of school students in the NIPRCES implementation area was relatively low, which may be affected by factors such as economic level, feeding mode, school scale, etc.

Objective: To analyze changes of school canteen construction and canteen meal provision in surveilled schools after the initiation of the National Nutrition Improvement Program for Rural Compulsory Education Student (NNIPRCES), therefore to provide data basis for improving efficacy of school canteen meals. Methods: From 2012 to 2017, among the 699 trial counties in 22 provinces under NNIPRCES, at least 10% of elementary schools and middle schools with each food supply model (canteen meals, enterprise meals, and family meals) were randomly selected in each county in each year. Questionnaire survey was conducted to collect school canteen construction and meal provision information. The sample size were around 8 000 to 11 000 schools every year. Results: From 2012 to 2017, the proportion of schools that have canteens only, have both canteen and dining room, as well as those have canteen and dining room with tables and chairs significantly increased with years(χ 2=3 043.95, 6 383.85, 6 731.17, P<0.01). The proportion of schools having canteen increased from 59.5% in 2012 to 87.0% in 2017. The proportion of schools with canteen providing breakfast, lunch or dinner varied across years(χ 2=51.85, 144.96, 189.19, P<0.01). The varieties of food groups of three meals all significantly increased during 2012, 2014 and 2017(χ 2=702.30, 892.38, 550.55, P<0.01). The canteen construction indicators, proportion of canteens providing three meals, and food groups included in three meals all significantly differed between elementary schools and middle schools, also between schools of central area and western area(P<0.05). The changing patterns with year were significantly different in elementary schools and middle schools, and in schools of central area and western area(P<0.05). Conclusion After the implementation of NNIPRCES, canteen construction and food variety in canteen meals significantly improved during 2012 to 2017. However, there are still gaps between changes of canteen construction and canteen meal provision. It is necessary to overcome obstacles to further increase the proportion of schools with canteen offering meals and the variety of food of meals.