OBJECTIVE: To explore quality of life (QOL) in patients with colorectal cancer and a stoma and factors associated with their QOL. METHODS: A quantitative cross-sectional study was carried out in the stoma and wound care clinic of a cancer hospital in China. Participants were recruited from clinic patients. Investigators collected demographic data and clinical information; QOL was measured using a Chinese version of the stoma-QOL scale. RESULTS: In total, 359 participants took part; 161 (44.8%) had an ileostomy, whereas the others had a colostomy, and about half of the participants (46.5%) had a permanent stoma. The mean age was 57.86 +/- 11.92 years. The QOL scores of most participants were poor, with a median value of 49.44. Participants whose stoma was cared for by others had a significantly lower QOL score than those who cared for their own stomas (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.05-2.38; P=.029). Participants with a temporary stoma had a lower QOL score than those with a permanent stoma (OR, 2.08; 95% CI, 1.275-3.40; P=.004). Further, participants with a complication had a lower QOL score than those without (OR, 1.62; 95% CI, 1.07-2.43; P=.022). CONCLUSIONS: These findings suggest a need for well-developed interventions to improve the QOL of these patients. This study provides valuable insights to inform the development of future clinical practice and research in this area in China and beyond.

Background To assess the short-term impact of a comprehensive, community-based multilevel intervention on knowledge, beliefs and practices with respect to smoking, physical activity and diet in Hangzhou, China.Methods A non-randomised, controlled, before-after quasi-experimental trial was conducted in two intervention areas and one comparison area. The intervention built on a socioecological framework and took place across four settings: neighbourhoods, schools, workplaces and community health centres. Two independent cross-sectional surveys of adults aged 18-64 years at baseline and a subsequent follow-up were conducted in 2008/2009 and 2011 in the intervention and comparison areas. A 2-year intervention programme was begun in mid-2009 and continued until mid-2011.Results A total of 2016 adults at baseline and 2016 adults at follow-up completed the survey. Over the 2-year intervention period, the intervention areas showed a statistically significant decline (25.2% vs 18.7%, p<0.001) in the prevalence of smoking compared with the comparison area (18.0% vs 16.4%, p=0.343). The proportion of individuals who had noticed anyone smoking in any of nine locations in the previous 30 days demonstrated a statistically significant decline in the intervention (78.9% vs 66.5%, p<0.001) and comparison (76.3% vs 66.5%, p<0.001) areas. The fruit and vegetable consumption score increased in a statistically significant manner in the intervention (24.84 vs 25.97, p=0.036) and comparison (24.25 vs 26.67, p<0.001) areas. The metabolic equivalent of physical activity increased from 1204 to 1386 (p=0.023) in the intervention areas compared with 918 to 924 in the comparison area (p=0.201).Conclusions After a 2-year intervention, beneficial changes were noted in the intervention areas with respect to smoking and physical activity but not diet. A community-based multilevel intervention programme is feasible in urban China.

To cite: Lv J, Liu Q-M, Ren Y-J, et al. J Epidemiol Community Health 2014;68:333–339. ABSTRACT Background To assess the short-term impact of a comprehensive, community-based multilevel intervention on knowledge, beliefs and practices with respect to smoking, physical activity and diet in Hangzhou, China. Methods A non-randomised, controlled, before-after quasi-experimental trial was conducted in two intervention areas and one comparison area. The intervention built on a socioecological framework and took place across four settings: neighbourhoods, schools, workplaces and community health centres. Two independent cross-sectional surveys of adults aged 18–64 years at baseline and a subsequent follow-up were conducted in 2008/2009 and 2011 in the intervention and comparison areas. A 2-year intervention programme was begun in mid-2009 and continued until mid-2011. Results A total of 2016 adults at baseline and 2016 adults at follow-up completed the survey. Over the 2-year intervention period, the intervention areas showed a statistically significant decline (25.2% vs 18.7%, p<0.001) in the prevalence of smoking compared with the comparison area (18.0% vs 16.4%, p=0.343). The proportion of individuals who had noticed anyone smoking in any of nine locations in the previous 30 days demonstrated a statistically significant decline in the intervention (78.9% vs 66.5%, p<0.001) and comparison (76.3% vs 66.5%, p<0.001) areas. The fruit and vegetable consumption score increased in a statistically significant manner in the intervention (24.84 vs 25.97, p=0.036) and comparison (24.25 vs 26.67, p<0.001) areas. The metabolic equivalent of physical activity increased from 1204 to 1386 (p=0.023) in the intervention areas compared with 918 to 924 in the comparison area (p=0.201). Conclusions After a 2-year intervention, beneficial changes were noted in the intervention areas with respect to smoking and physical activity but not diet. A community-based multilevel intervention programme is feasible in urban China.

OBJECTIVE:To examine the changes in tobacco related knowledge, smoking habit and the amount if environmental tobacco smoke (ETS) among urban population before and after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou in March 2010.METHODS:Two independent cross-sectional surveys were conducted on random samples from adults aged 18 - 64 years in three districts of Hangzhou city between two petiods: October 2008 to August 2009 and June 2011 to February 2012.RESULTS:A total of 2016 adults at the initial stage and 2016 adults during the follow-up program completed the survey. Nine out of the ten indices related to the knowledge on tobacco presented an improvement during the follow-up process. All the participants (22.4% vs. 17.7%, P < 0.001) and men (44.2% vs. 37.3%, P = 0.004) showed statistically significant declines in the prevalence of smoking, when compared with women (1.7% vs. 1.2%, P = 0.379). The proportions of individuals who had noticed anyone smoking in the previous 30 days demonstrated statistically significant declines in nine types of places: school (5.6% vs. 2.7%, P < 0.001), health centre (11.4% vs. 3.7%, P < 0.001), public transportation (19.2% vs. 12.2%, P < 0.001), government building (11.3% vs. 5.6%, P < 0.001), restaurant (67.0% vs. 61.3%, P = 0.002), workplace (49.7% vs. 38.3%, P < 0.001), private office building (23.6% vs. 19.9%, P = 0.023), home (41.0% vs. 35.5%, P = 0.003), friend's home (33.9% vs. 29.5%, P = 0.017).CONCLUSION:Positive changes were noticed among urban population with respect to tobacco related knowledge, prevalence of smoking, and the environmental tobacco smoke (ETS) after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou.

OBJECTIVE:To evaluate the short-term impact of comprehensive community based intervention on physical activity (PA) of adults living in the three urban communities of Hangzhou city.METHODS:Within the framework of Community Interventions for Health (CIH) Program, a community trial was conducted in two urban areas (Xiacheng district and Gongshu district)and an urban area(Xihu district)as control, by a parallel comparison and random grouping based quasi-experimental design. Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the short-term impact of the intervention program.RESULTS:A total of 2016 adults at baseline and 2016 adults at follow-up stages, completed the survey, including 1016 adults from the intervention areas and 1000 from the comparison area. Over the two-year intervention period, the cognitive level on benefits of physical activity in the intervention areas were trending downward. The changes observed in the comparison area did not show statistical significance. Intervention areas showed a statistically significant increase (1204 vs. 1386, P = 0.023) in the level of physical activity(metabolic equivalent, MET-minutes/week)compared with the comparison area(918 vs. 924, P = 0.201). And results remained the same after eliminating the possible effects of age factor.CONCLUSION:After a two-year intervention, beneficial changes were noted in the intervention areas with respect to the level of physical activity. A community-based intervention program on physical activity seemed feasible and effective in the urban areas of Hangzhou.

The dried rhizome of Belamcanda chinensis is an important Chinese traditional medicine used for the treatment of inflammation and many other disorders. Previously, we reported the hypo- and antihyper-glycemic effects of the aqueous leaf extract of B. chinensis (BCL) and identified the isoflavones as its principal active fraction. In the present study, the alpha-glucosidase inhibitory effect of BCL and its rough isoflavone preparation (BIF) was tested in vitro and in vivo. Thirteen isoflavones were isolated from BCL and their alpha-glucosidase inhibitory activity was screened in vitro. The results showed that BCL (500 and 1000 mg/kg) and BIF (250 and 500 mg/kg) greatly inhibited the increase in blood glucose level after 5 g/kg starch loading in normal mice. Six out of the thirteen isoflavones (swertisin, 2 '' -O-rhamnosylswertisin, genistein, genistin, mangiferin and daidzin) exhibited strong alpha-glucosidase inhibitory activity in vitro. HPLC analysis showed that swertisin was the most abundant isoflavone in BCL accounting for 1.24% of BCL, 7.44% of BIF, and 11.24% of the total isoflavone fraction of BCL, respectively. These results demonstrate that BCL possesses significant alpha-glucosidase inhibitory activity and swertisin may be the principal active component of BCL in alpha-glucosidase inhibition.

Objective:To investigate the protective effect of Dai medicine Baogan Yihao(BGYH) on acute and chronic liver injury.Method: Three kinds of animal model were established in this study.Acute model of immunological hepatic injury was established by iv Bacillus Calmetle-Guerin(BCG)+Lipopolysaccharide(LPS) in mouse,and ConA respectively.Rat model of chronic hepatic fibrosis was developed by ih of(CCl4).BGYH with high,medium and low doses were orally administrated.Activity of alanine aminotransferase(ALT) and spartate aminotransferase(AST) in serum was determined,and pathological changes in liver were also examined.Result: BGYH at the concentration of 20.4 g·kg-1 showed significantly inhibition on the acute immunological liver injury in mice induced by BCG+LPS and ConA;BGYH at the concentration of 0.56 g·kg-1 also inhibited the chronic hepatic fibrosis induced by CCl4 in rat model.And BGYH showed protection for hepatic lesions in animal models.Conclusion: BGYH can obviously protect acute and chronic liver injuries.

BACKGROUND:Anti-tuberculosis drug induced liver injury (ATLI) is emerging as a significant threat to tuberculosis control in China, though limited data is available about the burden of ATLI at population level. This study aimed to estimate the incidence of ATLI, to better understand its clinical features, and to evaluate its impact on anti-tuberculosis (TB) treatment in China.METHODOLOGY/PRINCIPAL FINDINGS:In a population-based prospective study, we monitored 4,304 TB patients receiving directly observed treatment strategy (DOTS) treatment, and found that 106 patients developed ATLI with a cumulative incidence of 2.55% (95% Confidence Interval [CI], 2.04%-3.06%). Nausea, vomiting and anorexia were the top three most frequently observed symptoms. There were 35 (33.02%) ATLI patients with no symptoms, including 8 with severe hepatotoxicity. Regarding the prognosis of ATLI, 84 cases (79.25%) recovered, 18 (16.98%) improved, 2 (1.89%) failed to respond to the treatment with continued elevation of serum alanine aminotransferase, and 2 (1.89%) died as result of ATLI. Of all the ATLI cases, 74 (69.81%) cases changed their anti-TB treatment, including 4 (3.77%) cases with medication administration change, 21 (19.81%) cases with drugs replacement, 54 (50.94%) cases with therapy interruption, and 12 (11.32%) cases who discontinued therapy. In terms of treatment outcomes, 53 (51.46%) cases had TB cured in time, 48 (46.60%) cases had therapy prolonged, and 2 (1.94%) cases died. Compared with non-ATLI patients, ATLI patients had a 9.25-fold (95%CI, 5.69-15.05) risk of unsuccessful anti-TB treatment outcomes and a 2.11-fold (95%CI, 1.23-3.60) risk of prolonged intensive treatment phase.CONCLUSIONS/SIGNIFICANCE:ATLI could considerably impact the outcomes of anti-TB treatment. Given the incidence of ATLI and the size of TB population in China, the negative impact is substantial. Therefore, more research and efforts are warranted in order to enhance the diagnosis and the prevention of ATLI.

The aim of this work was to investigate whether reduced glutathione (GSH) could protect rats from the respiratory muscle injury induced by omethoate. Three groups named as control, OM (omethoate poisoning) and OM + GSH (omethoate poisoning treated with GSH) were arranged. The cholinesterase (ChE) activity was assayed and the pathological observation of respiratory muscles was carried out. Furthermore, activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and the free organophosphate (FOP) remained in the respiratory muscles were measured. The results indicated that ChE activity was significantly inhibited by omethoate and not be changed by GSH. GSH could attenuate the respiratory muscle injury after omethoate poisoning. No changes of SOD, GPx, CAT and FOP were found after GSH was given. The findings suggested that GSH could protect the respiratory muscle against injury induced by omethoate, which was not the result of GSH to reactivate ChE or regulate the antioxidant enzymes.

BACKGROUND:While human cases of highly pathogenic avian influenza A (H5N1) virus infection continue to increase globally, available clinical data on H5N1 cases are limited. We conducted a retrospective study of 26 confirmed human H5N1 cases identified through surveillance in China from October 2005 through April 2008. METHODOLOGY/PRINCIPAL FINDINGS:Data were collected from hospital medical records of H5N1 cases and analyzed. The median age was 29 years (range 6-62) and 58% were female. Many H5N1 cases reported fever (92%) and cough (58%) at illness onset, and had lower respiratory findings of tachypnea and dyspnea at admission. All cases progressed rapidly to bilateral pneumonia. Clinical complications included acute respiratory distress syndrome (ARDS, 81%), cardiac failure (50%), elevated aminotransaminases (43%), and renal dysfunction (17%). Fatal cases had a lower median nadir platelet count (64.5 x 10(9) cells/L vs 93.0 x 10(9) cells/L, p = 0.02), higher median peak lactic dehydrogenase (LDH) level (1982.5 U/L vs 1230.0 U/L, p = 0.001), higher percentage of ARDS (94% [n = 16] vs 56% [n = 5], p = 0.034) and more frequent cardiac failure (71% [n = 12] vs 11% [n = 1], p = 0.011) than nonfatal cases. A higher proportion of patients who received antiviral drugs survived compared to untreated (67% [8/12] vs 7% [1/14], p = 0.003). CONCLUSIONS/SIGNIFICANCE:The clinical course of Chinese H5N1 cases is characterized by fever and cough initially, with rapid progression to lower respiratory disease. Decreased platelet count, elevated LDH level, ARDS and cardiac failure were associated with fatal outcomes. Clinical management of H5N1 cases should be standardized in China to include early antiviral treatment for suspected H5N1 cases.

The blood-brain barrier (BBB) is a formidable obstacle for the delivery of therapeutic agents into the central nervous system. Hydroxysafflor yellow A (HSYA) has been shown to be effective in protecting cerebral ischemia. However, whether HSYA could cross the BBB has not been elucidated. In this work, the effect of cerebral ischemia/reperfusion injury on the BBB penetration for HSYA was investigated in normal, sham-operated and cerebral ischemia/reperfusion rats. The concentration of HSYA in homogenate of brain tissue was determined by reversed phase high performance liquid chromatography and the protein was assayed by Bradford assay. The results showed lower concentration of HSYA could be detected in normal rats at 10 to 60 min after HSYA administration. The HSYA concentration in ischemic hemisphere significantly increased, while there is no change in non-ischemic hemisphere. These results suggest that HSYA can penetrate the BBB with weak ability in physiologic condition, but cerebral ischemia/reperfusion injury increases HSYA penetration across BBB markedly.

利用聚合酶链反应-序列特异性引物(PCR-SSP)法,对138例银屑病患者及149例健康对照进行PCR反应,分析单倍型的分布情况,探讨汉族人寻常性银屑病与HLA单倍型的相关性.

To study the clinical and epidemiologic profile of childhood alopecia areata, we performed a survey in which a total of 226 childhood patients less than 16 years old were enrolled. Statistical analysis and heritability were performed using EPI INFO 6.0, SPSS10.0, and the Falconer method. The median age of onset was 10 years. The majority of patients (84.96%) presented with limited alopecia. The male : female ratio was 1.4:1. Boys appeared to have more severe involvement. The earlier the age of onset, the greater the severity of the disease. Sixty-seven patients (29.65%) had previous episodes of alopecia areata. Greater severity and longer duration were seen in the relapsing patients than in the primary patients. Six patients (2.65%) had an associated disease. A positive family history was reported in 25 patients (11.06%). The prevalence figures for alopecia areata in first-, second-, and third-degree relatives of the probands were 2.87%, 0.40%, and 0.13%, respectively. The heritabilities of AA in first-, second-, and third-degree relatives were 51.20%, 46.25%, and 25.65%, respectively. It can be speculated that the effect of genetic factors is important in the occurrence of this disease.

Objective To study ATP2A2 gene mutation in a family with Darier's disease. Methods A patient was diagnosed as Darier's disease by pathology and clinical features. PCR and DNA sequencing were used to detect the gene mutation of the family. Results A A1541G transition was found in ATP2A2 gene of the patient. This mutation resulted in K514R substitution in ATP binding domain. No mutation was found in other healthy family members and normal controls. Conclusions K514R,the novel mutation, may be an underlying cause of Darier's disease in this family, not a common polymorphism.

It has been shown that many antihistamines may have anti-inflammatory activity in addition to being H1 antagonists. Mizolastine (MIZ), a novel antihistamine, might also have anti-angiogenesis properties. In this study, we investigated the influence of MIZ on proangiogenesis factors, vascular endothelial cell growth factor (VEGF), tumour necrosis factor (TNF)-alpha and keratinocyte-derived chemokine (KC) in murine mast cells by using ELISA and RT-PCR, as compared with dexamethasone (DEX) and loratadine (LOR). Our results show that MIZ is effective in the inhibition of KC, VEGF and TNF-alpha release induced by an IgE-dependent mechanism, in a time- and dose-dependent manner. The differences between the inhibitory effects of the three drugs on these proangiogenic factors were rather subtle. Semiquantitative analysis using RT-PCR showed that the three drugs significantly reduced VEGF165, VEGF120, TNF-alpha and KC mRNA expression. Statistical results revealed that the effect of DEX on VEGF165 mRNA was different from that of MIZ or LOR (P < 0.01) and the differences between the three drugs on VEGF120, TNF-alpha and KC mRNA were not statistically significant (P > 0.05). These findings raise the possibility that MIZ can mediate anti-angiogenesis activity and that the effect may depend not only on the inhibition on the levels of cytokine proteins but also at the mRNA level.

Background Vitiligo is an acquired depigmentary disorder of the skin and hair which results from selective destruction of melanocytes. Serological typing and genotyping of human leukocyte antigen (HLA) have shown discrepancies in HLA associations with vitiligo in different ethnic populations.Methods Polymerase chain reaction sequence-specific primer (PCR-SSP) method was used to analyze the distribution of HLA-DQA(1) and -DQB(1), alleles among 187 patients with vitiligo and 273 healthy controls through Epi Info version 6 package (Centers for Disease Control and Prevention, Atlanta, GA, USA).Results The frequencies of HLA-DQA1*0302 (OR = 1.98, P-c < 0.01), -DQB1*0303 (OR = 3.14, P-c < 0.001), and -DQB1*0503 (OR = 3.36, P-c < 0.05) alleles were significantly increased in patients with vitiligo compared with controls, and HLA-DQA(1)*0501 (OR = 0.40, P-c < 0.01) allele frequency was highly decreased. HLA-DQA1*0302 (OR = 5.19, P-c < 0.001), -DQA1*0601 (OR = 2.95, P-c < 0.05), -DQB1*0303 (OR = 4.50, P-c < 0.001), and -DQB1*0503 (OR = 6.69, P-c < 0.001) alleles were positively associated, whereas HLA-DQA1*0501 (OR = 0.05, P, < 0.001) allele was negatively associated with childhood vitiligo patients, and HLA-DOB1*0303 (OR = 2.76, P-c < 0.001) allele was positively associated with adult vitiligo patients compared with controls. The frequency of HLA-DQB1*0303 (OR = 3.72, P-c < 0.001) allele was significantly increased in localized vitiligo patients vs. controls, whereas HLA-DQA1 *0302 (OR = 2.47, P-c < 0.01), -DQB1*0303 (OR = 2.67, P-c < 0.01), and -DQB1*0503 (OR = 4.46, P-c < 0.01) allele frequencies were significantly increased and -DQA1*0501 (OR = 0.27, P-c < 0.01) allele frequency was highly decreased in generalized vitiligo patients.Conclusions HLA-DQA1*0302, -DQA1*0601, -DQB1*0303, and -DQB1*0503 alleles could be susceptible alleles of vitiligo, while HLA-DQA1*0501 allele could be a protective allele in Chinese Hans. There may be different genetic backgrounds between vitiligo patients of childhood and adult, localized and generalized.

Objective To map the locus of the gene CYLD1 for multiple familial trichoepithelioma (MFT), and identify the mutation of this gene in a large Chinese Han family with MFT. Methods The local genome scan was performed using 18 microsatellite markers spanning 9p21 and 16q12-q13 in this MFT family. Linkage software was used for two-point linkage analysis. All 17 coding exons of the CYLD1 gene and the adjacent splice sites were amplified using PCR. Mutation scanning was carried out by DNA sequencing. Results ① Two-point linkage analysis revealed a LOD score of 3.31 under the assumption of an autosomal dominant inheritance with disease-allele frequency of 0.00001 and penetrance of 99.9%. ② A four-basepair deletion of exon 18 in the CYLD1 gene was detected, designated c.2355-2358delCAGA. Conclusions Multiple familial trichoepithelioma is a genetically heterogeneous disorder. The gene CYLD1 for this MFT family localizes to 16q12-q13, not 9p21.

Objective To refine the Marie Unna hereditary hypotrichosis (MUHH) locus to a narrow chromosome region and to make the gene cloning feasible. Methods Genotyping and linkage analysis were performed in two multi-generation Chinese families with high-density microsatellite markers spanning the previously mapped interval at 8p21. Results In pedigree 1, significant evidence for linkage was observed in this region with a maximum two-point lod score of 3.01 (θ=0). Haplotype analysis localized the MUHH locus within the region defined by D8S282 and D8S1839. But the linkage between the MUHH phenotype and the locus at 8p21 was excluded in the other family. Conclusion This study provides the evidence of genetic heterogeneity in MUHH.

Objective To identify the association of HLA-DQA1 and-DQ B1 alleles with vitiligo in Chinese Hans in Anhui province.Methods Polymerase chain reaction sequence-specific primer (PCR-SSP) method was used to analyze the distribution of HLA-DQA1 and-DQB1 alleles among 187 patients with vitiligo and 273 healthy controls.Results The frequencies of HLA-DQA1*0302,-DQB1*0303,-DQB1*0503 alleles were significantly increased in the patients with vitiligo compared with those in the controls,and HLA-DQA1*0501 allele frequency was mark edly decreased.HLA-DQA1*0302,-DQA1*0601,-DQB1*0303,-DQB1*0503 alleles were p ositively associated,whereas HLA-DQA1*0501 allele was negatively associated wit h childhood vitiligo,and HLA-DQB1*0303 allele was positively associated with ad ult vitiligo,in comparison with those in the controls.The frequency of HLA-DQB 1*0303 allele was significantly increased in localized vitiligo patients compare d with that in the controls,whereas frequencies of HLA-DQA1*0302,-DQB1*0303,-DQB1*0503 alleles were significantly increased and the frequency of HLA-DQA1*050 1 allele was markedly decreased in generalized vitiligo patients.Conclusions HLA-DQA1*0302,-DQA1*0601,-DQB1*0303 and-DQB1*0503 alleles could be the suscep tible alleles of vitiligo,while HLA-DQA1*0501 allele could be the protective al lele in Chinese Hans in Anhui province.There may be different genetic backgroun ds between childhood and adult patients,and between localized and generalized vitiligo.

目的:了解中国汉族人进行性对称性红斑角化症(PSEK)的临床表型和遗传学特点.方法:对我们收集的一个PSEK家系中患者的临床表型和遗传特点进行总结和分析,并将结果与1980年以来文献报道的5个中国汉族人PSEK家系进行系统对比分析.结果:(1)PSEK在家系中的传递符合常染色体显性遗传模式;(2)中国汉族人群中PSEK的临床表型特征为初发于掌跖的固定、边界清楚的角化性红色斑块,对称分布,部分患者皮损可扩展至四肢近端及躯干等处,但多局限,不影响患者健康,多幼年发病;(3)同一家系中不同患者的表现度可存在明显差异;(4)患者多不伴发其他疾病;(5)部分家系的发病情况呈现不规则显性.结论:PSEK是一种具有高外显率的常染色体显性遗传性皮肤病,中国汉族人群中报道不多;临床表型以对称分布的散在、固定的角化性红色斑块为特征,但不同患者表现度可存在差异.