The era of medical big data, translational medicine and precision medicine brings new opportunities for the study of etiology of chronic complex diseases. How to implement evidence-based medicine, translational medicine and precision medicine are the challenges we are facing. Systems epidemiology, a new field of epidemiology, combines medical big data with system biology and examines the statistical model of disease risk, the future risk simulation and prediction using the data at molecular, cellular, population, social and ecological levels. Due to the diversity and complexity of big data sources, the development of study design and analytic methods of systems epidemiology face new challenges and opportunities. This paper summarizes the theoretical basis, concept, objectives, significances, research design and analytic methods of systems epidemiology and its application in the field of public health.
Epidemiology ; Forecasting ; Humans ; Precision Medicine ; Translational Research, Biomedical

OBJECTIVES: To systematically evaluate the value of the platelet-to-lymphocyte ratio (PLR) in predicting coronary artery lesions (CAL) in Chinese children with Kawasaki Disease (KD). METHODS: A comprehensive search was conducted in databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, China Biomedical Literature Database, and China Science and Technology Journal Database from inception to December 2022. The quality of the included literature was assessed using the Newcastle-Ottawa Scale, and a Meta analysis was performed using Stata 15.1. RESULTS: A total of ten published reports, involving 3 664 Chinese children with KD, were included in this Meta analysis, of whom 1 328 developed CAL. The Meta analysis revealed a sensitivity of 0.78 (95%CI: 0.71-0.83), specificity of 0.71 (95%CI: 0.61-0.80), overall diagnostic odds ratio of 8.69 (95%CI: 5.02-15.06), and an area under the curve of the summary receiver operating characteristic of 0.82 (95%CI: 0.78-0.85) for PLR in predicting CAL in the children with KD. The sensitivity, specificity, and area under the curve of summary receiver operating characteristic were lower for PLR alone compared to PLR in combination with other indicators. Sensitivity analysis demonstrated the stability of the Meta analysis results with no significant changes upon excluding individual studies. However, a significant publication bias was observed (P<0.001). CONCLUSIONS PLR demonstrates certain predictive value for CAL in Chinese children with KD.
Child ; Humans ; Mucocutaneous Lymph Node Syndrome/pathology* ; Coronary Vessels/pathology* ; Lymphocytes ; Biomarkers ; China ; Coronary Artery Disease/pathology*

Cancer is a collection of complex diseases in which cell proliferation and apoptosis are dysregulated due to the acquisition of genetic changes in cancer cells. These genetic changes, combined with the interrelated physiologic adaptations of neo-angiogenesis, recruitment of stromal support tissues, and suppression of immune recognition, are measurable characteristics in tumor gene expression profiles and biochemical pathways. These measures can lead to identification of disease drivers and, ultimately, can be used to assign therapy. With advances in RNA sequencing technologies, the ability to simultaneously measure all genetic and gene expression changes with a single technology is now possible. The ability to create a comprehensive catalog of genotypic and phenotypic changes in a collection of histologically similar but otherwise distinct tumors should allow for a more precise positioning of existing targeted therapies and identification of new targets for intervention.
Animals ; Asian Continental Ancestry Group ; Cell Transformation, Neoplastic ; genetics ; Disease Models, Animal ; Drug Discovery ; Genes, Tumor Suppressor ; Helicobacter pylori ; Humans ; Neoplasms ; genetics ; Oncogenes ; Signal Transduction ; Stomach Neoplasms ; genetics ; microbiology ; therapy

Aged, 80 and over ; Brain ; Breast Neoplasms ; complications ; drug therapy ; physiopathology ; radiotherapy ; Cranial Fossa, Posterior ; diagnostic imaging ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; diagnosis ; radiotherapy ; Ophthalmoplegia ; complications ; diagnosis ; physiopathology ; radiotherapy ; Radiography

OBJECTIVETo investigate the dose-dependent toxic effect of soybean isoflavone extracts (SIE) on reproductive development in immature rats.

METHODSGrowing male and female rats (n = 50 each, 4 weeks) were divided into five groups fed with a standard cereal-based diet and gastrogavaged daily with 0, 30, 150, 300, and 600 mg SIE/kg body weight, respectively, for 12 weeks. Body weight, organ weights, and serum level of estrogen and testosterone were measured.

RESULTSOral administration of SIE had no effect on food intake but decreased food efficiency ratio (P < 0.01). Suppression on body weight gain by SIE was dose-dependent and the effect was greater on male than on female rats (P < 0.01). SIE at high doses exhibited hepatotoxicity by increasing a relative liver weight, and also caused a smaller uterus but a greater relative ovary in female rats, while leading to larger relative testis and epididymis in male rats. SIE could decrease progesterone concentrations in female rats, whereas in male rats it reduced not only total testosterone level but also sperm count compared with the control group (P < 0.05).

CONCLUSIONSIE at a range of 50-1000 times of human intake level affects not only growth but also development of reproductive system in growing rats.

Animals ; Body Weight ; drug effects ; Epididymis ; drug effects ; growth & development ; Estradiol ; blood ; Female ; Isoflavones ; toxicity ; Liver ; drug effects ; growth & development ; Male ; Organ Size ; drug effects ; Ovary ; drug effects ; growth & development ; Progesterone ; blood ; Rats ; Rats, Sprague-Dawley ; Soybeans ; chemistry ; Sperm Count ; Testis ; drug effects ; growth & development ; Testosterone ; blood ; Uterus ; drug effects ; growth & development

To explore the mechanism of needling Ying method for treatment of sore throat. By the analysis of pathogenesis of sore throat, the authors think the key of its pathogenesis is stagnation of pathogenic factors such as hotness and phlegm accumulating, and meridian-vessel obstruction in the throat is its meridian foundation. There are several meridians passing through the throat, so the throat is closely related to viscera and meridians, and stagnation of pathogenic factors such as hotness and phlegm accumulating in the throat lead to sore throat when exogenous pathogenic factors invading or dysfunction of viscera and meridians. The treatment of needling Ying at local throat or combined with corresponding meridian point selection can dredge collaterals, dispel pathogenic factors, remove pathogenic factors to dispel swelling, resolve phlegm and dissipate stagnation and harmonize yin and yang, so as to relieve sore throat. In conclusion, needling Ying method is an important method in the treatment of sore throat.
Acupuncture Therapy ; methods ; Bloodletting ; Humans ; Meridians ; Needles ; Pharyngitis ; etiology ; therapy ; Yin-Yang

Endovascular embolization or embosurgery of brain tumors can be used to reduce neoplasm vascularity prior to surgical resection. Two challenges with embosurgery relate to insufficient perfusion pressure into the tumor and inadvertent escape of infused agents into parenchymal branches of the adjacent brain. This report describes a multi-catheter and coil technique to improve tumor perfusion and prevent reflux into normal branches.
Brain Neoplasms* ; Brain* ; Catheters* ; Perfusion ; United Nations

Objective: To evaluate the effectiveness of hepatitis B vaccination in Fujian province. Methods: Based on the hepatitis B immunization strategy of China, a cohort study was designed, involving the population in Fujian province. The population under study was divided into natural exposure birth cohort before 1992 and the immunization birth cohort after 1992 (including voluntary vaccination cohort and standardized vaccination cohort). By cleaning the database of hepatitis B cases which directly reported through network and looked into the incidence and related death outcomes of acute hepatitis B from 2004 to 2017, the incidence levels of hepatitis B and immunization effects were analyzed and evaluated among different birth cohorts. Results: During the observation period, the overall prevalence of hepatitis B in Fujian province was 44.594 per 100 000, with mortality rate as 0.010 per 100 000. The incidence of natural exposure cohort of birth was 56.885 per 100 000. The incidence of voluntary vaccination cohort of birth was 14.502 per 100 000. Compared with the voluntary vaccination cohort, the risk of hepatitis B increased significantly in the natural exposed cohort (RR=3.923), and the difference was statistically significant (P=0.000 7), with attributable risk as 42.383 per 100 000. The attributable risk ratio was 74.507. The population attributable risk ratio was 70.967%. The population attributable risk was 35.448 per 100 000. The attributable rate in standardized vaccination cohorts born after 2002 was 2.336 per 100 000. Compared with the cohorts born before 1992, the RR was 24.347 (P=0.000 0), the attributable risk was 54.549 per 100 000, and the attributable risk ratio was 95.893%, the population attributable risk ratio was 95.300%, the population attributable risk was 47.371 per 100 000, comparing to the natural exposed population. Conclusions: The effectiveness of hepatitis B immunization program had been remarkable in Fujian province since 1992. However, further studies on the persistency of hepatitis B vaccine immunization and its public health significance still needed to be carried out.
China/epidemiology* ; Cohort Studies ; Hepatitis B/prevention & control* ; Hepatitis B Vaccines/administration & dosage* ; Humans ; Immunization ; Incidence ; Odds Ratio ; Prevalence ; Risk Factors ; Vaccination/statistics & numerical data*

Intracranial hypotension (IH) can occur following lumbar drainage for clipping of an intracranial aneurysm. We observed 3 cases of IH, which were all successfully treated by epidural blood patch (EBP). Herein, the authors report our cases.
Blood Patch, Epidural* ; Cerebrospinal Fluid* ; Drainage* ; Intracranial Aneurysm* ; Intracranial Hypotension* ; Retrospective Studies*

STUDY DESIGN: Retrospective propensity score-matched cohort analysis of the Thomson Reuters MarketScan database. PURPOSE: To compare the outcomes of vertebral compression fracture (VCF) treatment options, with an emphasis on reoperation, complications, costand overall healthcare resource use between 2005 and 2009 in the United States. OVERVIEW OF LITERATURE: Options for the treatment of VCFs include conservative management, kyphoplasty, and vertebroplasty. The cost-effectiveness of surgical intervention for VCF has been criticized, and some suggest their outcomes to be similar to placebo. METHODS: Patients 18 years of age and older who developed a VCF were identified and separated into three treatment cohorts: vertebroplasty, kyphoplasty, and non-surgical. Propensity score matching was performed to match patients between cohorts. Main outcomes assessed included reoperation, complications, healthcare resource use and associated cost. Outcomes were compared at three separate time intervals (patients at index hospitalization; patients with at least 2-year follow-up data; and those with at least 4-year follow-up data). RESULTS: Twenty thousand seven hundred forty patients were identified with VCFs, yielding 7,290 after propensity score matching. The mean age of the patients was 78+/-12 years; and 5,507 (75.5%) were female. All reoperation rates ranged from 6%-17%, while complication rates ranged from 7%-10%, which did not differ significantly among the three cohorts at all follow-up periods. Overall costs were noted to be significantly greater in both the kyphoplasty and vertebroplasty groups at 1-year follow-up, not at 2-year and 4-year follow-up. CONCLUSIONS: Our data suggests that the treatment of a VCF patient will likely be associated with similar long-term operative and complication rates regardless of treatment modality.
Cohort Studies ; Costs and Cost Analysis ; Delivery of Health Care* ; Female ; Follow-Up Studies ; Fractures, Compression* ; Hospitalization ; Humans ; Kyphoplasty* ; Propensity Score ; Reoperation ; Retrospective Studies ; Treatment Outcome ; United States ; Vertebroplasty*