Background: Non-hodgkin lymphoma (NHL) is one of the most common and deadly cancers. There is limited analysis of gene-environment interactions for the risk of NHL. This study intends to explore the interactions between genetic variants and environmental factors, and how they contribute to NHL risk. Methods: A case-control study was performed in Shanghai, China. The cases were diagnosed between 2003 and 2008 with patients aged 18 years or older. Samples and SNPs which did not satisfy quality control were excluded from the analysis. Weighted and unweighted genetic risk scores (GRS) and environmental risk scores were generated using clustering analysis algorithm. Univariate and multivariable logistic regression analyses were conducted. Moreover, genetics and environment interactions (G × E) were tested on the NHL cases and controls. Results: After quality control, there are 22 SNPs, 11 environmental variables and 5 demographical variables to be explored. For logistic regression analyses, 5 SNPs (rs1800893, rs4251961, rs1800630, rs13306698, rs1799931) and environmental tobacco smoking showed statistically significant associations with the risk of NHL. Odds ratio (OR) and 95% confidence interval (CI) was 10.82 (4.34-28.88) for rs13306698, 2.84 (1.66-4.95) for rs1800893, and 2.54 (1.43-4.58) for rs4251961. For G × E analysis, the interaction between smoking and dichotomized weighted GRS showed statistically significant association with NHL (OR = 0.23, 95% CI = [0.09, 0.61]). Conclusions: Several genetic and environmental risk factors and their interactions associated with the risk of NHL have been identified. Replication in other cohorts is needed to validate the results.

We undertook a hospital-based case-control study to examine the associations between single nucleotide polymorphisms (SNPs) in selected immunoregulatory genes and non-Hodgkin lymphoma (NHL) risk in a Chinese population. One hundred and sixty-nine NHL patients diagnosed according to the World Health Organization (WHO) 2001 standard and 421 controls were recruited. Nine SNPs in three genes (IL-10, IL-1RN, and TNF-α) were selected based on predicted functions and previous study findings. Genetic association analysis was performed using the Cochran-Armitage trend test and multiple logistic regression. Four SNPs were associated with an increased risk of overall NHL: odds ratio per minor allele [ORper-minor-allele] and 95% confidence interval [CI] were 2.64 (1.75-3.98) for IL-10 rs1800893, 2.67 (1.72-4.16) for IL-1RN rs4251961, 1.80 (1.24-2.63) for TNF- α rs1800630, and 1.55 (1.02-2.37) for TNF- α rs2229094. These SNPs were also associated with an increased risk of diffuse large B-cell lymphoma (DLBCL). In addition, another SNP (TNF- α rs1041981) was associated with an increased risk of DLBCL (ORper-minor-allele=1.73, 95% CI 1.14-2.61). The findings provide evidence on the role of these immunoregulatory gene variants in NHL etiology.

Objective To evaluate the influence of environmental lead exposure on infant's blood lead through integrated exposure uptake biokinetic model for lead in children (IEUBK) model, based on environmental lead and prenatal lead exposure. Methods The data is from a prospective study conducted among pregnant women during 2005 -2007. Blood lead of the pregnant women in the late pregnancy, environmental lead values including lead concentration in soil, air and drink-water were measured. Moreover, the blood lead concentrations of infants were measured as well. Results Infants were exposed to lead from the pregnant women during the pregnancy, and in the late pregnancy the geometric mean blood lead of pregnant women was (40.3 +/- 3.7) microg/L. The geometric mean blood lead concentration of six-month old infants was (54.7 +/- 6.7) microg/L and there were 17.3% infants whose blood lead concentration were above 100 microg/L. Lead in soil,atmosphere and drink-water were 45.57 mg/kg, 0.023 microg/m3 and 3.25 microg/L respectively. While based on the calculation of the IEUBK model, the value attributed to environmental lead exposure was 12.4 microg/L, accounting for 22.7% of the real blood lead level. Conclusion The results indicated that environmental lead contamination in the rural area might not be the main reason of elevation in blood lead among infants, other lead resources such as food lead exposure might be the major sources for the intake of lead among infants and should be paid more attentions in future.

Risk factors of mydelodysplastic syndromes (MDS) remain largely unknown. We conducted a hospital‐based case–control study consisting of 403 newly diagnosed MDS patients according to World Health Organization classification and 806 individually gender and age‐matched patient controls from 27 major hospitals in Shanghai, China, to examine relation of lifestyle, environmental, and occupational factors to risk of MDS. The study showed that all MDS (all subtypes combined) risk factors included anti tuberculosis drugs [odds ratio (OR) adj = 3.15; 95% confidence interval (CI) = 1.22–8.12] as an independent risk factor, benzene (OR adj = 3.73; 95% CI = 1.32–10.51), hair dye use (OR = 1.46; 95% CI = 1.03–2.07), new building and renovations (OR = 1.69; 95% CI = 1.11–2.00), pesticides (OR = 2.16; 95% CI = 1.22–3.82), and herbicides (OR = 5.33; 95% CI = 1.41–20.10) as relative risk factors. Risk factors of MDS subtype refractory cytopenia with multiple dysplasia (RCMD) were benzene (OR adj = 5.99; 95% CI = 1.19–30.16) and gasoline (OR adj = 11.44; 95% CI = 1.31–100.03) as independent risk factors, and traditional Chinese medicines (OR = 2.17; 95% CI = 1.15–4.07), pesticides (OR = 2.92; 95% CI = 1.37–6.25), and herbicides (OR = 12.00; 95% CI = 1.44–99.67) as relative risk factors. Smoking tobacco was significantly associated with refractory anemia with excess of blasts (RAEB) (OR adj = 2.43; 95% CI = 1.02–5.77). Education is shown as an independent protective factor against all MDS (OR adj = 0.90; 95% CI = 0.83–0.99) and RCMD (OR adj = 0.89; 95% CI = 0.79–0.99). These findings suggest that multiple modifiable behavioral, environmental, and occupational factors play a role in MDS etiology, and various MDS subtypes may have different susceptibility. Am. J. Hematol. 86:163–169, 2011. © 2010 Wiley‐Liss, Inc.

【Objective】 To determine the effects of prenatal lead exposure(lower than 100 μg/L) on six-month-old infant's growth and development.【Methods】 The study subjects were 6-month-old infants whose mothers' blood lead were lower than 100 μg/L both during the 1st and 3rd trimester of gestation in a cohort study.Bayley infant development scale was used to evaluate the infants' development.The differences in mental development index(MDI) and psychomotor development index(PDI) of infant were compared across different prenatal blood exposure levels,using the P25,P50 and P75 of the blood lead during pregnancy as the dividing value of groups,respectively.【Results】 The MDI and PDI of 6-month-old infants tended to decrease as the increase of prenatal blood lead exposure level.The PDI of 6-month-old infants in the relative high lead level group was lower than that in the relative low lead group as the dividing value of groups was P25 and P50 of blood lead,and the difference were statistically significant(P0.05).There were no significant differences in the MDI of 6-month-old infants across groups.Besides,multivariate analysis indicated that the PDI of the infants whose prenatal lead concentration higher than P50 was 4.48 point lower than that of infants below P50.Similarly,the PDI of the infants whose prenatal lead concentration higher than P25 was 6.51 point lower than that of infants below P25.The differences were statistically significant.【Conclusion】 Low level prenatal lead exposure may exert an influence on infants' behavior development and such effect might be more significant at the low level of lead exposure,which merits further research.

The methylenetetrahydrofolate reductase (MTHFR) encodes a major enzyme in folate metabolism. It has been suggested that two MTHFR polymorphisms, 677C > T and 1298A > C, influence risk of acute lymphoblastic leukemia (ALL). Most studies on relation of MTHFR polymorphisms to ALL susceptibility have been in pediatric populations because ALL is relatively rare in adults. Here, we report a case-control study of 127 Chinese patients with adult precursor B lymphoblastic leukemia (B-ALL) to examine correlation between the MTHFR polymorphisms and B-ALL susceptibility in adults. Our data show that although the prevalence of genotype 1298CC was significantly higher in the female patients than in the controls (P = 0.04), the differences in distributions of combined genotypes of 1298CC with either 677CC or 677CT between the cases and the controls were statistically insignificant. Haplotype analysis revealed no significant difference between the cases and the controls. The prevalence for joint MTHFR genotypes 677CC/1298AC was significantly lower in the female B-ALL cases than in the controls [odds ratio (OR) = 0.06, 95% CI = 0.00-0.53, P = 0.0033] and no differences among the men [OR = 0.71, 95% CI = 0.20-2.53, P = 0.55], suggesting that protective effects of combined MTHFR 677CC/1298AC genotypes on susceptibility of adult B-ALL are gender bias toward women with 677CC/1298AC women being at a 17-fold reduced odds to develop B-ALL.

OBJECTIVE:To identify the prevalence of depression symptoms among employees in Shanghai and to explore the association of job stress factors with depression symptoms.METHODS:Seven kinds of occupations were selected as subjects by convenient cluster sampling. Job stresses were assessed by core job stress scale and depression symptoms were measured by epidemiological survey depression scale (CES-D). Logistic regression and hierarchical moderated multiple regression were used for analysis.RESULTS:There were 1301 participants completing the questionnaires. The CES-D score reached 16. 83 +/- 8.63 and depression symptoms were in 46.2% of participants. The CSE-D score and the rate of depression symptoms were varied in different age, education and occupational status. Personal hobbies were helpful to reduce depression symptoms (OR = 0.63, 95% CI = 0.48-0.82). High social supports and high rewards were protect factors for depression symptoms, and the ORs were 0.38 (95% CI= 0.25-0.55) and 0.35 (95% CI = 0.21-0.58) respectively. High over-commitment and effort-reward imbalance were risk factors for depression symptoms, and the ORs were 2.72 (95% CI = 1.76-4.21) and 2.77 (95% CI = 1.09-7.05) respectively. The effort-reward imbalance model is more powerful in predicting depression symptoms than the job demand-control model.CONCLUSION:Effort-reward imbalance and high over-commitment are the risk factors for depression symptoms, more social supports and having hobbies are the protect factors for depression symptoms.

[Objective] To investigate the change of blood lead concentration and possible influential factors during pregnancy in a lead-polluted area.[Methods] It was a prospective cohort study.Pregnant women were recruited as participants and all respondents signed an informed consent before participating in the study.Blood lead concentration in different phase of pregnancy(early pregnancy and late pregnancy)was examined to identify the status of participants' lead exposure.Besides,interviews were conducted among participants to collect the information of factors related to their blood lead concentration with questionnaire.[Results] The geometric mean of blood lead concentration of participants was 0.15 μmol/L in early pregnancy and it increased to 0.19 μmol/L in late pregnancy.Statistically significant difference(P 0.05)was found between the two stages.The multivariate analysis showed that,the logarithm of blood lead concentration of pregnant women who ate vegetables everyday was 0.16 in the early stage and 0.15 in the late stage of pregnancy,both higher than those who didn't eat vegetables everyday.The logarithm of blood lead concentration of those who had a history of heavy mental exposure before pregnancy was 0.12,higher than those who didn't in early pregnancy.The logarithm of blood lead concentration of pregnant women with higher educational level was 0.09,lower than those with lower educational level in late pregnancy.[Conclusion] The blood lead concentration of pregnant women changes during the pregnancy.Eating lead-contaminated vegetables and having a history of heavy metal exposure seem to be significant factors related to pregnant women's blood lead concentration in early pregnancy.In late pregnancy,eating lead-contaminated vegetables and participants' educational degree are two significant factors related to blood lead concentration.

To explore the influence of δ-aminolevulinate acid dehydratase(ALAD) gene polymorphism on reproductive toxicity induced by lead exposure. 163 lead workers from smelter and acid battery factories were selected. Blood lead levels were measured by flameless atomic absorption spectrophotometry. Serum luteinizing hormone(LH),follicle stimulating hormone(FSH) and testosterone(T) levels were measured by ELISA. ALAD genotyping was conducted by PCR-RFLP. No statistical difference in blood lead levels was found between ALAD11 and ALAD12 genotypes,and they were 1.45 μmol/L(30.16 μg/dL) and 1.56 μmol/L(32.49 μg/dL), respectively. After controlling age, exposure duration,blood lead and cumulative lead exposure levels,workers with ALAD12 genotype had higher LH level(8.9 IU/L) and FSH level(3.6 IU/L) than these of workers with ALAD11 genotype(LH=5.5 IU/L and FSH=2.3 IU/L). Among workers with ≥1.92 μmol/L(40 μg/dL) blood lead level, workers with ALAD12 genotype had higher serum LH levels(7.8 IU/L vs.6.0 IU/L,P=0.04) and FSH levels(3.5 IU/L vs.2.4 IU/L,P=0.07). [Conclusion] ALAD2 allele may be related to elevation of serum FH and FSH levels, and this suggests that ALAD2 allele may protect lead reproductive toxicity.

The article summarize the measures on constituting the model of oriented preventive education. The contents clinical preventive medicine and community health service which closely related with preventive have been added to the course; The teaching method problem based learning has been conducted through the combination of case discussion with theory introductior,; In addition, practice has beer regulated through criterion constitution. The reform has been evaluated in time and will be perfected in practice.

目的探讨维生素D受体(VDR)基因多态性与铅作业工人血压的关系.方法选择216名职业铅接触工人,测定血铅、尿铅、尿ALA、尿肌酐和测量血压.采用限制性片段长度多态(RFLP)技术进行基因型分析.结果 VDR-bb,VDR-Bb 和VDR-BB基因型的频率分别是90.7%,7.4%,1.8%.VDR-Bb/BB基因型的血铅几何均数(1.96 μmol/L)高于VDR-bb基因型的血铅几何均数(1.54 μmol/L),P＜0.05.VDR-Bb/BB基因型工人的血铅与收缩压呈剂量-效应关系,回归系数为53.195(P=0.003), 远大于不携带VDR-B等位基因(VDR-bb基因型)工人的回归系数(b=5.512,P=0.237).结论 VDR-B等位基因可能与血铅水平和收缩压升高有关.

δ-氨基-γ-酮戊酸脱水酶(ALAD)是血液中与铅结合力很强的蛋白.有多个研究表明,ALAD12/22组血铅水平高于ALAD11组,提示ALAD12/22人群为铅毒性易感人群[1-3].

Objective] The study was to evaluate the relationship between the accumulated exposure dosage and the occupational health hazard in workers exposed to vinyl chloride monomer (VCM). [Methods] 238 VCM exposed workers were selected as an exposed group while 212 unexposed workers as a control group. Entering the data of VCM concentration for 10 years and data of worker health status,and computing accumulated exposure dosage for each worker,and classifying the exposed workers into higher,middle and lower subgroups according to the dosage were carried out. Then,the frequency of symptoms and signs between the exposed group and the control group and among three subgroups of the exposed group was compared. [Results] The increase in incidence of the nerve debility syndrome and B ultrasonic of liver abnormality and the irritation symptom of pharynx appeared with the increase of VCM accumulated exposure dosage (trends χ 2 test, P 0 01 or 0 05). The frequencies of the symptoms and signs between the exposed group and the control group are remarkably different ( P 0 01 or 0 05). [Conclusion] There is significant relationship between VCM exposure and liver hazard and the irritation symptom of pharynx. VCM will cause health hazardous effects in the exposed workers even to the concentration lower than the health standard (MAC) of China.

预防和管理慢性非传染性疾病(以下简称慢性病)将成为上海21世纪的严峻挑战 .目前以临床治疗为主的措施,不仅作用有限,且费用昂贵.急需探讨慢性病预防与管理的新方法.

Objective This study was designed to investigate the relationship between vinyl chloride metabolizing enzymes(CYP2E1,GSTT1,GSTM1)genotype and liver damage in vinyl chloride monomer(VCM) exposed workers. Methods The excessive activity of serum alanine aminotransferase(ALT) and abnormal manifestation of liver B ultrasound were used as the parameters of liver damage.The subjects were 116 VCM exposed workers from two PVC factories in Shanghai.The genotypes of GSTT1,GSTM1,CYP2E1 were determined by polymerase chain reaction(PCR) and/or restriction fragment length polymorphism(RFLP) on white blood cell DNA. Results The following results were obtained:(1)When low and middle VCM exposure groups were merged to analyze,positive GSTT1 genotype was associated with decreased OR on liver damage( OR 0.35,95% CI 0.12～0.97, P 0.05).(2)At high VCM exposure group,CYP2E1 c1c2/c2c2 genotypes was associated with increased OR ( OR 4.55,95% CI 1.37～15.08, P 0.05).(3)Multiple Logistic regression analysis also showed significant interactions of VCM exposure with CYP2E1,CYP2E1 with GSTT1,and GSTT1 with GSTM1 to liver damage. Conclusion These results suggest CYP2E1 genotype may play an important role in the biotransformation of VCM,and its effect may lead to liver damage.GSTT1 genotype can help prevent liver injury induced by lower VCM exposure.These findings suggest that the interactions between VCM exposure and metabolizing enzyme genotypes would decide the degree of liver damage induced by VCM.

[目的]了解社区老年人群的健康功能状况及最主要的健康问题.[方法]老年综合健康功能评价的横断面调查研究. [结果]该社区老年人群中综合健康损害率为34.5%.其中58.1%的老年人至少有一项健康功能损害.5个单项功能中损害率居前3位的是躯体健康、经济维持能力和日常活动能力(ADL),损害率分别为41.0%、35.4%、15.4%.进一步分析发现,这3项功能损害各自又分别以慢性病患病率高、工具性日常活动能力(IADL)损害和经济收入低、缺乏经济储备能力、医疗保障差为主.不同年龄、性别、文化程度、职业和婚姻状况的老年人之间,5项功能损害率差异都有统计学意义. [结论]躯体健康、ADL和经济维持能力损害是该社区老年人中最主要的健康问题,三者往往同时出现在同一老年人身上.

曹家渡街道位于上海市中心城区,老龄化程度较高,60岁及以上老年人占23.8%.在人群疾病谱中,高血压病占第一位,1997年患病率达36.7%.而循环系统疾病为死因之首,1998年占全死因的41.03%.1998年,与本街道地段医院转制为社区卫生服务中心的改革过程相结合,参加上海市<脑卒中社区人群计划防治优化方案的研究和推广应用>的工作,开展高血压病社区防治研究,以探索切合社区实际的有效优化人群防治方案.

[目的 ] 了解上海某区老年人的意外伤害致死情况。 [方法 ] 对该区 1995～ 1999年 6 0岁及以上老年人的全部死亡报告资料进行意外伤害死亡率和标化死亡率分析。 [结果 ] 意外伤害在老年人全死因的顺位中居第 4位 ,意外伤害标化死亡率为 147.2 2 / 10万。机动车交通事故、意外跌落、自杀和淹死是意外死亡的主要原因。 [结论 ] 意外伤害是威胁老年人生命的主要危险因素之一 ,家庭和社会都应重视老年人意外伤害的防制工作。

[目的]了解高血压自我管理健康教育课程的近期效果，预试验慢性病自我管理方法在上海的可行性。[方法]在某社区成立一个高血压自我管理小组，由2名小组长按照指导手册指导组员一起学习高血压自我管理。每月活动一次，每次1．5小时。采用定性、定量研究方法综合评价其6个月后的近期效果，并收集参与者对该课程的看法、意见、建议。[结果]高血压自我管理近期效果明显，提高了参加者自我管理高血压的技能、信心，高血压管理和控制情况得到了改善。用非药物措施控制血压的比例增加了10％～40％，6个月后，收缩压平均降低了15mmHg，舒张压平均降低了8mmHg。[结论]慢性病自我管理方法在上海社区完全可行；该种病人教育形式适合我国的文化传统。