2.Dynamic path analysis on life course epidemiology.
Z W TIAN ; G Y ZENG ; S L WU ; L T HUANG ; B Z WANG ; H Z TAN
Chinese Journal of Epidemiology 2018;39(1):86-89
In the studies of modern epidemiology, exposure in a short term cannot fully elaborate the mechanism of the development of diseases or health-related events. Thus, lights have been shed on to life course epidemiology, which studies the exposures in early life time and their effects related to the development of chronic diseases. When exploring the mechanism leading from one exposure to an outcome and its effects through other factors, due to the existence of time-variant effects, conventional statistic methods could not meet the needs of etiological analysis in life course epidemiology. This paper summarizes the dynamic path analysis model, including the model structure and significance, and its application in life course epidemiology. Meanwhile, the procedure of data processing and etiology analyzing were introduced. In conclusion, dynamic path analysis is a useful tool which can be used to better elucidate the mechanisms that underlie the etiology of chronic diseases.
Chronic Disease/epidemiology*
;
Epidemiologic Studies
;
Humans
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Models, Theoretical
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Risk Factors
;
Time
3.Concurrent intermediate uveitis and an enhancing intracranial lesion as the initial manifestation of sarcoidosis.
Elaine H Z HUANG ; Kim-Teck YEO ; Wee-Kiak LIM ; Cora Y P CHAU ; William Y K HWANG
Annals of the Academy of Medicine, Singapore 2006;35(4):266-269
INTRODUCTIONPosterior segment involvement has been described to be associated with central nervous system involvement in sarcoidosis as a result of direct sarcoid tissue infiltration or mass effect of a cerebral lesion. However, isolated intermediate uveitis occurring concurrently with central nervous system involvement prior to extensive systemic disease is rare.
CLINICAL PICTUREWe describe a patient with neuro-ophthalmic manifestations of intermediate uveitis and an enhancing basal ganglia lesion at initial presentation, in the absence of extensive systemic disease.
TREATMENTHe was treated with high-dose systemic steroids which was progressively tailed down over 6 months.
OUTCOMEThere was prompt resolution of vitritis with good preservation of visual acuity.
CONCLUSIONThe difficulties of the initial diagnosis of sarcoidosis and the indications for initiation of steroid therapy are illustrated. We use this case to emphasise the need for a high clinical suspicion of sarcoidosis in the presence of similar unusual and seemingly unrelated combinations of neurological manifestations so as to facilitate the prompt institution of appropriate treatment when indicated.
Adult ; Angiography ; Basal Ganglia ; diagnostic imaging ; physiopathology ; Brain Ischemia ; complications ; diagnosis ; Comorbidity ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Sarcoidosis ; complications ; diagnosis ; Time Factors ; Tomography, X-Ray Computed ; Uveitis ; complications ; diagnosis
4.National experts consensus on clinical diagnosis and treatment of inhalation injury (2018 version).
Burn and Trauma Branch of Chinese Geriatrics Society ; F GUO ; Y S ZHU ; J HUANG ; Y H WU ; Z F SUN ; X B XIA ; Xiaobing FU
Chinese Journal of Burns 2018;34(11):770-775
Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation
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Consensus
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Humans
;
Lung
;
Smoke Inhalation Injury
;
diagnosis
;
therapy
5.Dose-response relationship between maternal thyroid hormones in the first twenty weeks and physical and neuropsychological development of infants: A prospective cohort study in China.
P Y SU ; J H HAO ; K HUANG ; Z H HUANG ; F B TAO
Chinese Journal of Epidemiology 2019;40(2):180-185
Objective: To study the dose-response relationship between maternal thyroid hormone levels in the first twenty weeks of pregnancy and the infant physical and neuropsychological development. Methods: In this prospective cohort study, a total of 945 women and their children were included. Maternal serum samples during first half of the pregnancy were collected and analyzed for levels of thyroid hormones by using the electro-chemiluminescence immunoassay. Maternal social demographic information was collected by using the a self-administered questionnaire. Physical measurements of newborns and neuropsychological evaluation of infants were performed by doctors of maternal and child health care. Results: The differences in newborns' birth length and head circumference were significant among the newborns of mothers with different percentiles of maternal serum (thyroid-stimulating hormone, TSH) levels (P<0.05). Newborns with maternal TSH level ≥P(95) or <P(5) had significantly lower birth length and birth head circumference, compared with the newborns with maternal TSH level between P(25)-P(75) (P<0.05). Newborns' birth head circumferences showed an inverted U-shaped association with maternal serum TSH level (Y=33.940+0.003X-0.109X(2), F=4.685, P=0.009). The difference in mental development index (MDI) of the infants at 18-30 months were significant among the infants of mothers with different percentiles of maternal serum TSH level (P<0.05). Infants with maternal TSH level ≥P(90) showed lower MDI (6.39, 95%CI: 2.29-10.49, P=0.002) compared with the infants with maternal TSH level between P(25)-P(75). Infant's MDI at 18- 30 months also showed an inverted U-shaped association with maternal serum TSH level (Y=103.249-1.524X-0.939X(2), F=6.616, P=0.001). Conclusions: Maternal TSH level was associated with newborn's birth length, birth head circumference and infant's MDI at 18-30 months. Newborn's birth head circumference and infant's MDI at 18-30 months showed an inverted U-shaped association with maternal serum TSH-Z score.
Birth Weight/physiology*
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Child
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Child Development/physiology*
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China
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Female
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Fetal Blood/metabolism*
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Humans
;
Infant
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Infant, Newborn/blood*
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Pregnancy
;
Prenatal Exposure Delayed Effects/blood*
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Prospective Studies
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Thyroid Gland/physiology*
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Thyroid Hormones/metabolism*
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Thyrotropin/blood*
6.Epidemiological and pathogenic characteristics of mumps in Fujian province, 2005-2017.
D LI ; Z F CHEN ; X H YANG ; W Y PAN ; Q WANG ; S H ZHANG ; N X ZHENG ; L F HUANG ; Y ZHOU
Chinese Journal of Epidemiology 2018;39(10):1356-1361
Objective: To understand the epidemiological and etiological characteristics of mumps in Fujian province, 2005-2017. Methods: All the reported mumps cases were collected through the National Notifiable Disease Information Management System, 2005-2017. Active search and interviews were conducted to collect the information on vaccination of mumps. Throat swab specimens were collected for cells culture, genotyping and gene sequence analysis on mumps virus (MuV). Results: A total of 83 959 cases of mumps were reported in Fujian province from 2005 to 2017, with an average annual incidence of 17.6 per 100 000. Since 2007, the incidence appeared increasing but then decreasing, reaching the lowest level (7.5 per 100 000), after the setup of a monitoring program. Annually, the onset time of mumps showed an obvious two seasonal peaks, one from April to July, with a weakening trend, and the other from October to January with a rising trend. Most of the mumps cases occurred among students, kindergarten and scattered children (89.2%, 5 814/6 517), children aged 5-9 years (38.8%, 2 527/6 517), with cases reported from every region. Program from the pathogen surveillance showed that the transmission chain of G genotype mumps virus did exist in Fujian. Data from the sequence analysis revealed that mutations in the nucleotide of G genotype strain in 2015 had led to mutation of 6 amino acid sites in the SH gene coding region, resulting in the differences appearing in both nucleotide and amino acid homology with type A vaccine strain. Conclusions: The incidence of mumps decreased annually, in Fujian. Prevention programs should focus on primary and secondary school students. In Fujian province, we also noticed the transmission chain of mumps G genotype with some amino acid mutations in the SH gene coding region. Monitor programs on both epidemiologic and etiology, should be strengthened.
Child
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Child, Preschool
;
China/epidemiology*
;
Genotype
;
Humans
;
Incidence
;
Mumps/epidemiology*
;
Mumps virus/pathogenicity*
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Phylogeny
;
Sequence Analysis
8.A Meta-analysis on the relations between short-term exposure to PM(2.5) and both mortality and related emergency visits in China.
M LI ; Y WU ; Y H TIAN ; G Y CAO ; S S YAO ; P AI ; Z HUANG ; C HUANG ; X W WANG ; Y Y CAO ; X XIANG ; J JUAN ; Y H HU
Chinese Journal of Epidemiology 2018;39(10):1394-1401
Objective: To carry out a quantitative estimate that related to the effects of short-term exposure to PM(2.5) on all-cause mortality and emergency visits in China by using the systematic review and Meta-analysis. Methods: We selected all the studies published before March 2018 from China National Knowledge Infrastructure, Wanfang database, PubMed and EMBASE and data on relative risk (RR), excess risk (ER) and their 95%CIs: appeared in these papers were extracted. According to the differences in the size or direction (heterogeneity) of the results, we computed summary estimates of the effect values using a random-effect or fixed effect model. We also conducted the subgroup analysis and Meta-analysis to have assessed the selected studies for the evidence of study bias. Results: A total of 33 original studies, indexed in databases, were identified. Among those studies, 39 sets of data on mortality and 4 sets of data on emergency were valid to show that within the daily concentration range from 47.7 to 176.7 μg/m(3), for 10 μg/m(3) increases in PM(2.5) concentrations, it would increase the daily numbers of deaths by 0.49% (95%CI: 0.39%-0.59%) and 0.30% (95%CI: 0.10%-0.51%) for all-cause deaths and all-cause emergency-room visits, respectively. For subgroup analysis, the combined effect of PM(2.5) in causing short-term all-cause deaths in the northern areas (ER=0.42%, 95%CI: 0.30%-0.54%) seemed lower than that in the southern areas (ER=0.63%, 95%CI: 0.44%-0.82%). The combined effect of PM(2.5) concentration below 75 μg/m(3) (ER=0.50%, 95%CI: 0.37%-0.62%) was higher than that of PM(2.5) concentration ≥75 μg/m(3) (ER=0.39%, 95%CI: 0.26%-0.52%). Conclusion: Within the concentration range from 47.7 to 176.7 μg/m(3), short-term exposure to current level of PM(2.5) might increase both the all-cause daily mortality and daily emergency visits in China.
Air Pollutants
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Air Pollution/statistics & numerical data*
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China
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Databases, Factual
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Emergency Service, Hospital/statistics & numerical data*
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Environmental Exposure/statistics & numerical data*
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Female
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Humans
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Male
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Particulate Matter/toxicity*
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Time Factors
10.National experts consensus on clinical diagnosis and treatment of inhalation injury (2018 version).
Burn and Trauma Branch of Chinese Geriatrics Society ; F GUO ; Y S ZHU ; J HUANG ; Y H WU ; Z F SUN ; X B XIA ; X B FU
Chinese Journal of Burns 2018;34(11):E004-E004
Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation
;
Consensus
;
Humans
;
Lung
;
Practice Guidelines as Topic
;
Smoke Inhalation Injury
;
diagnosis
;
therapy