Objective: To explore the sampling method in China National Human Biomonitoring Program (HBP) and the related errors, so as to calculate and evaluate the study design in sampling. Methods: The sampling method of HBP is of multistage nature. Taking the results of sampling method from Guizhou province as an example, results related to sampling error and variation coefficient were calculated, using the multistage unequal probability sampling error method. Results: The HBP covered 152 monitoring sites in 31 provinces (autonomous regions and municipalities) and with 21 888 residents selected. The replacement rates at various stages were 5.26%, 6.35% and 40.6% respectively. The sampling error in Guizhou province was 3 207 594, and the coefficient of variation was 0.097. Conclusions: According to the multi-stage unequal probability sampling method, the sampling coefficient variability appeared small with high precision, in Guizhou province. However, this method did not consider the weight adjustment of non-sampling errors such as population missing rate and response rate. Methods related to the calculation on multi-stage sampling error among large-scale public health monitoring projects need to be further studied.
China ; Cities ; Environmental Monitoring ; Humans ; Research Design

Genes play an important role in the immune system response, and different gene loci may result in different vaccine immune response rates. This review focuses on the correlation between gene polymorphisms and vaccine immune response in order to investigate the influence of gene polymorphisms on the immune response to vaccines. It discusses the effect of an individual's immune response after vaccination at genetic level and provides a scientific basis for individualized immune development strategies. It reveals that human leukocyte antigen genes, various cytokines and their receptor genes, and Toll-like receptor genes all affect the vaccine immune response.
Cytokines ; Genetic Variation/immunology* ; Humans ; Immune System ; Immunity/physiology* ; Immunity, Active/immunology* ; Immunogenetics ; Polymorphism, Genetic ; Vaccination ; Vaccines/immunology*

OBJECTIVE: To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD). METHODS: Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: (1) according to the degree of SMA stenosis, the patients were divided into group I (stenosis degree ≤70%) and group II (stenosis degree > 70%); (2) LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis. RESULTS: The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group I (n = 64) and group II (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group I, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group II, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient. CONCLUSIONS Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.
Aged ; Aged, 80 and over ; Computed Tomography Angiography ; Constriction, Pathologic ; Female ; Humans ; Iliac Artery ; Lower Extremity ; Male ; Mesenteric Artery, Superior ; Middle Aged

Allyl Compounds ; Animals ; Lung ; Male ; Paraquat/pharmacology* ; Poisons ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Sulfides

Objective: To understand the epidemiological and molecular characteristics of typhoid and paratyphoid in China from 2009 to 2013, and provide evidence for the prevention and control of typhoid and paratyphoid, the development and improvement of surveillance strategies. Methods: Epidemiological analysis was conducted on the incidence data of typhoid and paratyphoid, and related public health emergencies in China during 2009-2013. Pathogen isolation and culture, serologic test were conducted for the typhoid and paratyphoid cases from 13 national surveillance sites. The isolates were subjected to antimicrobial susceptibility testing. Pulsed-field gel electrophoresis (PFGE) was performed for the molecular typing of these isolates. Results: The average incidence of typhoid and paratyphoid in China during this period was 1.03/100 000. The reported case number and incidence decreased with year. The provinces reporting high case numbers were Yunnan, Guizhou, Guangxi, Hunan, Zhejiang, Guangdong and Xinjiang. The incidence of age group 0-4 years was highest. The proportion of farmers and children outside child care settings showed an increasing tendency over time. The annual incidence peak was during July-August. Twenty five outbreaks occurred during 2009-2013. The results of pathogen isolation and culture showed that the positive rate was 3.00% (940/31 322), among the positive isolates, the proportion of Salmonella paratyphi A accounted for higher proportion (68.19%, 641/940) compared with Salmonella typhi (31.60%, 297/940). The drug resistances of Salmonella typhi and Salmonella paratyphi varied, but their resistances to nalidixic acid were highest (50.22% and 85.33%) respectively. A certain amount of Salmonella typhi isolates showed the resistance to the 3rd generation cephalosporins. PFGE analysis showed divergent patterns of Salmonella typhi compared with limited patterns of Salmonella paratyphi A. Conclusion: The epidemic level of typhoid and paratyphoid in China was relatively low, but the outbreak occurred occasionally. It is necessary to enhance the laboratory-based surveillance, particularly the capability of etiological diagnosis, outbreak investigation, response and antibiotic resistance monitoring, and conduct risk factor investigation in provinces with high incidences in recent years.
Child ; Child, Preschool ; China/epidemiology* ; Disease Outbreaks ; Drug Resistance, Bacterial/genetics* ; Electrophoresis, Gel, Pulsed-Field ; Epidemics ; Farmers ; Humans ; Incidence ; Infant ; Molecular Typing ; Paratyphoid Fever/microbiology* ; Population Surveillance ; Salmonella paratyphi A/isolation & purification* ; Salmonella typhi/isolation & purification* ; Typhoid Fever/microbiology*

Component malrotation is one of the major causes of failure in total knee arthroplasty.Based on previous researches,Insall line has excessive external rotation tendency.Although Akagi line is the most recognized anatomical axis at present,it still has a certain tendency of internal rotation.The tibial posterior condylar axis is not suitable for symmetrical component and yet the Curve-on-Curve technique is not suitable for anatomic component.In addition,reference to any fixed anatomical markers cannot ensure the rotation consistency of tibiofemoral component in extension position.Although range of motion technique is beneficial to tibiofemoral rotation synchronization,its clinical effect seems to be unstable.Nevertheless,Patients can obtain good postoperative results with all major techniques.Before the recognized "gold standard" is defined,orthopedic surgeons can determine the rotation alignment of tibial component according to their most accustomed surgical method.With a deeper understanding of knee anatomy,biomechanics and kinematics,digital assistive technology may be expected to become a breakthrough in the tibial rotational alignment.
Arthroplasty, Replacement, Knee/methods* ; Femur/surgery* ; Humans ; Knee Joint/surgery* ; Knee Prosthesis ; Osteoarthritis, Knee/surgery* ; Range of Motion, Articular ; Tibia/surgery*

Objective: To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events. Methods: During 2009- 2010, out of the 11 623 individuals, 1 000 participants aged 35-64 years, were recruited and divided into 12 age-groups, to have received a study on CVD risk factors. Information on the risk factors of cardiovascular diseases was also collected. Fasting blood sample was gathered for all the participants, with hs-CRP tested. Participants in 7 out of the 12 sites were followed, with 6.21 years (36 075 person-years) as the median follow-up period. Cardiovascular and all-cause mortality events were collected. A total of 6 177 participants had been followed after excluding participants who had baseline infections, or did not take hs-CRP test/physical examination at the baseline. Finally, 5 984 participants were included for analysis. Participants were categorized into three groups based on the hs-CRP (mg/L) values: <1, 1-3 and >3, respectively. Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events, after adjusting for confounding factors. Results: Mean age of the participants was 50.2 years. The incidence rates of cardiovascular disease events were 3.6/1 000 person-years, 7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years, 5.7/1 000 person-years, 9.1/1 000 person-years for all-cause mortality events, respectively. After adjusting for confounding factors, the hazard risks (HR) for cardiovascular events were 1.33 (95%CI: 0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95%CI: 1.20-2.60) in the hs-CRP>3 mg/L group when comparing with the hs-CRP<1 mg/L group (trend test P=0.003). The HRs for all-cause mortality events were 1.76 (95%CI: 1.23-2.54) and 2.64 (95%CI: 1.74-4.01) (trend test P<0.001), respectively. Conclusion: Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.
Adult ; Asian People ; C-Reactive Protein/metabolism* ; Cardiovascular Diseases/mortality* ; China/epidemiology* ; Female ; Hospital Mortality ; Humans ; Incidence ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Factors

Objective: To explore the long-term effects of maternal pregnancy bisphenol A (BPA) exposure on emotional and behavioral problems appeared in their preschool children. Methods: The study sample was a subset of the China-Anhui Birth Cohort Study (C-ABCS). A unified questionnaire was used to collect basic information on both pregnant women and their children. Free BPA concentration in maternal serum was determined by high-performance liquid chromatographytandem mass spectrometry (HPLC-MS/MS). The parent-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to estimate the emotional and behavioral problems in preschool children. A total of 1 713 pairs of mothers and children were included in this study. Association between BPA exposure during pregnancy and the emotional and behavioral problems in preschool children was evaluated with multinomial logistic regression model. Results: Prevalence rates in 1 713 preschool children appeared as: 6.48% of emotional problems, 8.11% for conduct problems, 8.35% for hyperactivity/inattention, 2.86% for peer problems, 11.38% for prosocial behaviors and 7.94% for total difficulties. Subjects were divided according to the degrees of exposure and the results showed as: low exposure group (≤0.120 ng/ml), medium exposure group (0.120OR=1.876, 95% CI: 1.161-3.029), more obvious in boys (OR=2.291, 95%CI: 1.126-4.661). Conclusion: Maternal exposure to high level of BPA during pregnancy might increase the detrimental effects of abnormal conducts in their preschool children, more obviously seen in boys.
Benzhydryl Compounds/toxicity* ; Child Behavior Disorders/etiology* ; Child, Preschool ; China/epidemiology* ; Cohort Studies ; Emotions/physiology* ; Environmental Exposure ; Environmental Pollutants ; Female ; Gas Chromatography-Mass Spectrometry ; Humans ; Male ; Maternal Exposure ; Mothers ; Phenols/toxicity* ; Pregnancy ; Prenatal Exposure Delayed Effects ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Tandem Mass Spectrometry

Objective: To explore the interaction effect between mother's educational level and preschoolers' dietary pattern on attention-deficit/hyperactivity disorder (ADHD). Methods: In 2014, there were 16 439 children aged 3-6 years old from 91 kindergartens in Ma'anshan municipality of China. A semi-quantitative food frequency questionnaire and the 10-item Chinese version of the Conners' Abbreviated Symptom Questionnaire (C-ASQ) were administered to assess the usual dietary intake and symptoms on ADHD. Social-demographic information was collected through questionnaires. Unconditional logistic regression was used to analyze the multiplication interaction effect between mother's educational level and preschoolers' dietary pattern on ADHD. Excel software was used to analyze the additive interaction effect of mother's educational level and preschoolers'dietary pattern on ADHD. Results: Results showed that factors as: mother's low educational level[aOR=1.31 (1.13-1.52)], scores related to preschoolers in the top quintile of "food processing" [aOR=1.31 (1.16-1.48)] and "snack" [aOR=1.45 (1.29-1.63)]patterns showed greater odds while preschoolers in the top quintile of "vegetarian" [aOR=0.80 (0.71-0.90)]showed less odds for having ADHD symptoms. Both multiplication and additive interactions were observed between mothers with less education. The processed dietary patterns (OR=1.17, 95%CI: 1.11-1.25), relative excess risk of interaction (RERI), attributable proportion (AP) and the interaction index (SI) appeared as 0.21, 0.13 and 1.47, respectively. Multiplication interaction was observed between levels of mother's low education and the snack dietary pattern (OR=1.21, 95%CI: 1.14-1.29), with RERI, AP and SI as 0.49, 0.26 and 2.36, respectively. However, neither multiplication interaction or additive interaction was noticed between levels of mother's low education and the vegetarian dietary pattern (OR=0.97, 95%CI: 0.92-1.03), with RERI, AP and SI as 0.09, 0.05 and 1.15, respectively. Conclusions: Levels of mother's low education presented a risk factor for ADHD symptoms in preschool children. Both multiplication interaction and additive interaction were observed between mother's low education levels and the processed dietary pattern. Multiplication interaction was noticed between mother's education levels and the snack dietary pattern but not with the vegetarian dietary pattern.
Attention Deficit Disorder with Hyperactivity/epidemiology* ; Child ; Child Nutritional Physiological Phenomena ; Child, Preschool ; China ; Diet ; Educational Status ; Feeding Behavior ; Female ; Humans ; Logistic Models ; Mothers ; Risk Factors ; Surveys and Questionnaires