1.Risk Factors for Low Birth Weight and Preterm Birth: A Population-based Case-control Study in Wuhan, China
ZENG YUN ; NI ZE-MIN ; WANG GUI ; LIU SHU-YUN ; LI CAN ; YU CHAO-LI ; WANG QI ; NIE SHAO-FA
Journal of Huazhong University of Science and Technology (Medical Sciences) 2017;37(2):286-292
Low birth weight (LBW) and preterm birth (PB) are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from January 2011 to December 2013 in Wuhan,China.A total of 337 LBW newborn babies,472 PB babies,and 708 babies with normal birth weights and born from term pregnancies were included in this study.Information of newborns and their parents was collected by trained investigators using questionnaires and referring to medical records.Univariate and logistic regression analyses with the stepwise selection method were used to determine the associations of related factors with LBW and PB.Results showed that maternal hypertension (OR=6.78,95% CI:2.27-20.29,P=0.001),maternal high-risk pregnancy (OR=1.53,95% CI:1.06-2.21,P=0.022),and maternal fruit intake ≥300 g per day during the first trimester (OR=1.70,95% CI:1.17-2.45,P=0.005) were associated with LBW.BMI ≥24 kg/m2 of mother prior to delivery (OR=0.48,95% CI:0.32-0.74,P=0.001) and gestation ≥37 weeks (OR=0.01,95% CI:0.00-0.02,P<0.034) were protective factors for LBW.Maternal hypertension (OR=3.36,95% CI:1.26-8.98,P=0.016),maternal high-risk pregnancy (OR=4.38,95% CI:3.26-5.88,P<0.001),maternal meal intake of only twice per day (OR=1.88,95% CI:1.10-3.20,P=0.021),and mother liking food with lots of aginomoto and salt (OR=1.60,95% CI:1.02-2.51,P=0.040) were risk factors for PB.BMI ≥24 kg/m2 of mother prior to delivery (OR=0.66,95% CI:0.47-0.93,P=0.018),distance of house from road ≥36 meters (OR=0.72,95% CI:0.53-0.97,P=0.028),and living in rural area (OR=0.60,95% CI:0.37-0.99,P=0.047) were protective factors for PB.Our study demonstrated some risk factors and protective factors for LBW and PB,and provided valuable information for the prevention of the conditions among newborns.
2.The application of integrated surveillance system for symptoms in surveillance of influenza among children.
Li-hong TIAN ; Li TAN ; Yun-zhou FAN ; Ying WANG ; Jie ZHANG ; Li-wei CHENG ; Sheng WEI ; Li LIU ; Wei-rong YAN ; Biao XU ; Heng-jin DONG ; Shao-fa NIE
Chinese Journal of Preventive Medicine 2013;47(12):1095-1099
OBJECTIVETo explore the integrated application of sales of child-specific over-the-counter (OTC) cold related medications in retail pharmacies and healthcare visits of children for influenza-like illness (ILI) in surveillance and early warning of influenza among children.
METHODSAn integrated surveillance system (ISS) was implemented since 2012 in Qianjiang County, a rural area in Hubei Province of China. The daily information from August 1, 2012 to February 28, 2013 of health care visits of children for ILI reported by 80 health facilities and sales of 14 child-specific over-the-counter (OTC) cold related medications reported by 11 pharmacies were extracted from ISS database. Cumulative sums (CUSUM) model was conducted to analyze the degree of fitting and the early warning signal generated; the correlationship was then analyzed further.
RESULTSIn 212 days, 983 visits of children for ILI and 12 819 sales by person of child-specific OTC were reported. Conducting CUSUM model, the fitting degree was in the acceptable range, 31 warning signals were generated from ILI data series with 3 peak periods and 14 from OTC data series with 2 peak periods. A similar time trend of two data series was observed with a correlation(r = 0.497, P < 0.05), but without any spatial clustering. And the optimal correlation(r = 0.505, P < 0.05) appeared at a time offset of 4 days preceded by OTC sales.
CONCLUSIONThe availability of integrated surveillance system for symptoms could be applied for surveillance of influenza among children; while it could explore the possibility of real epidemic in the very early stage.
Child ; China ; epidemiology ; Disease Outbreaks ; prevention & control ; Humans ; Influenza, Human ; epidemiology ; prevention & control ; Nonprescription Drugs ; Population Surveillance
3.The influence of T lymphocyte activation on HIV-1 susceptibility of Han Chinese.
Xiao-hui WANG ; Yi-hua XU ; Lin CHEN ; Sheng WEI ; Zheng-rong YANG ; Xiang-dong SHI ; Yan ZHANG ; Yong-xia GAN ; Shao-fa NIE
Chinese Journal of Preventive Medicine 2012;46(4):320-323
OBJECTIVETo explore the influence of T lymphocyte activation on HIV-1 susceptibility of Han Chinese.
METHODSIn 2008, 37 HIV-1 highly exposed persistently seronegative individuals (ESNs) and 101 healthy controls were screened from Shenzhen. Flow cytometer was used to assay the expression difference of HIV-1 infection related co-receptor, the difference between the two groups were analyzed by Mann-Whitney U statistics methods.
RESULTST cell HLA-DR(+) CD4 T cells and HLA-DR(+) expression of ESNs (12.64 (5.94 - 21.90), 21.12 (10.74 - 30.21)) were all significantly lower than that of healthy controls (22.52 (7.91 - 58.60), 32.28 (14.72 - 67.82)) (P values all < 0.05). T cell CD45RA-RO(+), CCR5(+)CD4 expression of ESNs (58.68 (49.06 - 72.44), 21.93 (15.84 - 25.89)) were all significantly higher than that of healthy controls (53.17 (42.63 - 63.21), 16.14 (11.94 - 21.98)) (P values all < 0.05). T cell CXCR4(+)CD4 T cells expression of ESNs (93.67 (92.17 - 94.96)) was significantly lower than that of healthy controls (95.16 (92.99 - 96.77)) (P values all < 0.05). Healthy controls and ESNs could be divided into low expression group and high expression group according to HLA-DR(+)CD8 T cells bimodal distribution. A total of 89.2% (33/37) ESNs fell into HLA-DR + CD8 low expression group, and 58.4% (59/101) of the healthy controls located in low expression group (P < 0.05).
CONCLUSIONTo Han Chinese, the low activation status of T lymphocyte has significant correlation with HIV-1 low susceptibility.
Acquired Immunodeficiency Syndrome ; immunology ; pathology ; Adult ; Asian Continental Ancestry Group ; CD4-Positive T-Lymphocytes ; cytology ; immunology ; Case-Control Studies ; Disease Susceptibility ; Female ; HIV-1 ; Humans ; Lymphocyte Activation ; Male ; Young Adult
4.Application of log-linear model in the case-parent triad study
Ming ZHU ; Shao-Fa NIE ; Wei-Rong YAN
Chinese Journal of Epidemiology 2012;33(4):435-438
We were introducing a log-linear model for case-parent triad study.Data from a previous study of the association between MTHFR C677T aud cleft lip with or without cleft palate (CL/P) was analyzed,in order to investigate the maternal effect,fetal effect and their interaction,using a series of log-linear models.Our results showed that mothers who were carrying two copies of MTHFR C677T variant alleles appeared to have reduced the risk of CL/P in offspring,comparing to those with homozygous of wild-type allele.With S2=0.43 (95% CI:0.19-0.95).No significant association was found for fetal genotype and maternal-fetal iuteraction with CL/P.Log-linear model method seemed to be useful in the estimation of maternal effect,fetal effect and maternal-fetal interaction,in the case-parent triad study design.This approach showed specific benefit in studies that related to genetic effects on complex diseases such as pregnancy complications and diseases originated from fetus.
5.Construction of surveillance and early-warning-index-system on tuberculosis in China
Yong-Chun HOU ; Min WANG ; Xiao-Qian LI ; Wen SHU ; Shi-Ming CHENG ; Wei CHEN ; Shao-Fa NIE ; Yi-Hua XU
Chinese Journal of Epidemiology 2012;33(5):505-508
Objective To establish the surveillance and warning index system corresponnding with the epidemic characteristics of tuberculosis,in China.Methods Literature review and expert meeting were conducted to formulate the preliminary index system frame.Delphi method was used for screening the index and determining the weight of each index.Results Two-round Delphi consultations were performed.The activity coefficients were 87.0%,90.0% respectively,with means of authority coefficient as 0.850 ± 0.055 and 0.917 ± 0.017,respectively.Mean scores of the index were 7.063 ± 1.435,8.156 ± 0.611 respectively,with the means of coefficient of variation as 0.352 ±0.161 and 0.170 ± 0.057 respectively.The harmony coefficients were 0.322 (x2=499.472,P<0.05)and 0.393 (x2=241.126,P<0.05) respectively.After the two-round consultation,the tuberculosis monitoring and warning index system was developed,including 4 first-class indicators,9 second-class indicators and 48 third- class indicators.Conclusion An index system was established for tuberculosis monitoring and early warning that could provide evidence for tuberculosis prevention and control as well as for the forecasting and warning model of the disease.
7.The application of artificial neural networks to predict individual risk of essential hypertension
Shui-Hong ZHOU ; Shao-Fa NIE ; Chong-Jian WANG ; Sheng WEI ; Yi-Hua XU ; Xue-Hua LI ; En-Min SONG
Chinese Journal of Epidemiology 2008;29(6):614-617
Objective To establish models to predict individual risk of essential hypertension and to evaluate and explore new forecasting methods. Methods To select data of 3054 community residents from a epidemiological survey and divided them into 4 : 1 (2438 cases and 616 cases) ratio in accordance with the balance of age and sex to filter variables, and to establish, test and evaluate the prediction models. Using artificial neural network (ANN) and logistic regression analysis to establish models while applying ROC to evaluate the prediction models. Results Forecast results of the models applying to the test set proved that ANN had lower specificity but better veracity and sensitivity than logistic regression.In particular, the Youden's index of the ANN2 came up to 0. 8399 which was distinctly higher than the other two models.When the area was under the ROC curve of logistic regression, the ANN1 and ANN2 models equaled to 0. 732±0. 026,0. 900±0. 014 and 0. 918±0. 013 respectively, which proved that the ANN model was better in the prediction about individual health risk of essential hypertension. Conclusion Our results showed that ANN method seemed better than logistic regression in terms of predicting the individual risk from hypertension thus supplied a new method to solve the forecast of individual risk.
8.Evaluation on the highly active anti-retroviral therapy in 181 AIDS patients.
Yi-Hua XU ; Qiao-Hong LIAO ; Chong-Jian WANG ; Jian-Ping LIU ; Hao XIANG ; Peng RAN ; Wei-Hua HE ; Xiao-Dong ZHANG ; Xiao-Zhou JIN ; Shao-Fa NIE
Chinese Journal of Epidemiology 2007;28(7):704-707
OBJECTIVETo study the clinical effect under highly active anti-retroviral therapy (HAART) in AIDS patients and for improving the curative effect and prognosis.
METHODSEpidemiological method was used from five aspects to describe the post-treatment clinical symptoms of 181 AIDS patients in Suizhou, and to evaluate the change of virus load and immune function of 79 AIDS patients. Data was doubly recorded by Epi Data and database was set up by SPSS 13.0 for analysis.
RESULTSThe effective powers of anomal-fever, cough, diarrhoea, lymphadenectasis, weight drop, erythra, mycotic infection were 81.39%, 85.00%, 84.62%, 81.89%, 82.86%, 66.07% and 45.45% respectively. CD4+ T lymphocyte count rose obviously after treatment, with an averag of 276 x 10(6) cells/ml (65 x 10(6)-824 x 10(6) cells/ml), an 129 x 10(6) cells/ml increase in three months and was 294 x 10(6) cells/ml (102 x 10(6)-750 x 10(6) cells/ml) in six months. The count change of CD4+ T lymphocyte between 3 months and 6 months did not show sigificant difference. The number of deaths among drug withdrawals was 14, with a case fatality rate as 29.79%; while the number of deaths among non-drug withdrawals was 3, with the case fatality rate as 2.24%.
CONCLUSIONResults through this study showed that HAART could obviously improve the clinical symptom of AIDS patients, and to increase the number of virus load. Improving the compliance could also reduce the case fatality rate.
Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; pathology ; virology ; Adult ; Antiretroviral Therapy, Highly Active ; methods ; CD4-Positive T-Lymphocytes ; drug effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Surveys and Questionnaires ; Treatment Outcome
9.Study on the prognostic factors of colorectal cancer and on suggested model for prediction.
Wei LIU ; Shao-Fa NIE ; Ji-Gui CHEN ; Tian HUANG ; Jing-Jing HE ; Chang LIU
Chinese Journal of Epidemiology 2007;28(7):700-703
OBJECTIVETo explore the factors related to the prognosis of colorectal cancer (CRC) and to establish a prognostic model for evaluating the prognosis of the patients with CRC.
METHODS370 cases with CRC were selected in the study and clinical/pathological factors were collected and patients were followed. Kaplan-Meier method was used to calculate survival rate. Log-rank test and proportional-hazards regression model (Cox model) were used for univariate and multivariate analysis. Log cumulative hazards function plot was used to test Cox model proportional-hazards assumption (PH assumption). Prognostic index (P1) was calculated based on the results of multivariate analysis.
RESULTS(1) One-year, three-year and five-year survival rates were 90.5%, 78.3% and 76.5% respectively. (2) Lymphatic metastasis, Duckes classification and therapeutic measure were independent prognostic factors of CRC and all passed PH assumption. (3) Patients with different PI were classified into 3 groups and there were significant differences noticed in survival rates (P < 0.001). (4) Individual survival rate was evaluated based on the prognostic Cox model and PI.
CONCLUSIONLymphatic metastasis, Duckes classification and therapeutic measure were independent prognostic factors of CRC. To test PH assumption of the factors, selection of Cox model was essential. Cox model and PI seemed to be available in predicting the long term survivrate of patients with CRC.
Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; complications ; mortality ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Analysis
10.The relationship between the potential years of life lost of lung cancer and air pollution in Wuhan.
Qin HE ; Sen-Lin WU ; Fen XU ; Ji-Jun DUAN ; Shao-Fa NIE ; Yu-Guang CAO
Chinese Journal of Epidemiology 2007;28(12):1175-1178
OBJECTIVETo study the present situations of lung cancer in Wuhan and to explore the relationship between the potential years of life lost of lung cancer and air pollution, especially vehicle emissions.
METHODSData gathered between 1986 and 1995 in Wuhan city, including air pollution and tobacco production and data on lung cancer between 1991 and 2000 were collected extensively. Simple Correlation and Grey Relational Analysis were used to analyze the relationship of them.
RESULTSThere was a ascending tendency in variance of oxides of nitrogen (NOx). The degree of grey incidence (DGI) between the concentration of air pollutants and the male's or female's potential years of life lost of lung cancer (PYLL) were calculated respectively. In males, the values of DGI were 0.6702, 0.7071, 0.6199 on sulfur dioxide (SO2), NOx, total suspensions (TSP) respectively. In females,the values of DGI were 0.6188, 0.8555, 0.5842 according to the same order as listed above. Significant positive correlation was found between the concentration of NOx and with lung cancer in both males and females by spearman correlation test (rmale = 0.63523, P = 0.0484; rfemale = 0.76396, P = 0.0101).
CONCLUSIONWith the fast growing speed of the quantity of vehicles, pollution of vehicle emission-caused air pollution posed an important risk factor for lung cancer, despite the fact that tobacco smoking still played the leading role.
Air Pollution ; adverse effects ; China ; Female ; Humans ; Lung Neoplasms ; mortality ; Male ; Nitrogen Oxides ; analysis ; Sulfur Dioxide ; analysis ; Vehicle Emissions ; analysis

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