MEDLINE查了一下，大陆发表的JAMA只能找到11篇，近年大约是每年1-2篇。
1: JAMA. 2008 Apr 9;299(14):1669-77.
Comment in:
JAMA. 2008 Apr 9;299(14):1716-8.
Chemoembolization combined with radiofrequency ablation for patients with
hepatocellular carcinoma larger than 3 cm: a randomized controlled trial.
Cheng BQ, Jia CQ, Liu CT, Fan W, Wang QL, Zhang ZL, Yi CH.
Department of Gastroenterology, Qilu Hospital School of Medicine, Jinan, China.
dcbq@sohu.comCONTEXT: Transarterial chemoembolization (TACE) combined with radiofrequency
ablation (RFA) therapy has been used for patients with large hepatocellular
carcinoma tumors, but the survival benefits of combined treatment are not known.
OBJECTIVE: To compare rates of survival of patients with large hepatocellular
carcinoma tumors who received treatment with TACE combined with RFA therapy
(TACE-RFA), TACE alone, and RFA alone. DESIGN, SETTING, AND PATIENTS: Randomized
controlled trial conducted from January 2001 to May 2004 among 291 consecutive
patients with hepatocellular carcinoma larger than 3 cm at a single center in
China. INTERVENTION: Patients were randomly assigned to treatment with combined
TACE-RFA (n = 96), TACE alone (n = 95), or RFA alone (n = 100). MAIN OUTCOME
MEASURES: The primary end point was survival and the secondary end point was
objective response rate. RESULTS: During a median 28.5 months of follow-up,
median survival times were 24 months in the TACE group (3.4 courses), 22 months
in the RFA group (3.6 courses), and 37 months in the TACE-RFA group (4.4
courses). Patients treated with TACE-RFA had better overall survival than those
treated with TACE alone (hazard ratio [HR], 1.87; 95% confidence interval [CI],
1.33-2.63; P < .001) or RFA (HR, 1.88; 95% CI, 1.34-2.65; P < .001). In a
preplanned substratification analysis, survival was also better in the TACE-RFA
group than in the RFA group for patients with uninodular hepatocellular carcinoma
(HR, 2.50; 95% CI, 1.42-4.42; P = .001) and in the TACE-RFA group than the TACE
group for patients with multinodular hepatocellular carcinoma (HR, 1.99; 95% CI,
1.31-3.00; P < .001). The rate of objective response sustained for at least 6
months was higher in the TACE-RFA group (54%) than with either TACE (35%; rate
difference, 0.19; 95% CI, 0.06-0.33; P = .009) or RFA (36%; rate difference,
0.18; 95% CI, 0.05-0.32; P = .01) treatment alone. CONCLUSION: In this patient
group, TACE-RFA was superior to TACE alone or RFA alone in improving survival for
patients with hepatocellular carcinoma larger than 3 cm. TRIAL REGISTRATION:
clinicaltrials.gov Identifier: NCT00479050.
Publication Types:
Comparative Study
Randomized Controlled Trial
PMID: 18398079 [PubMed - indexed for MEDLINE]
2: JAMA. 2008 Jan 9;299(2):185-93.
Lifestyle intervention and metformin for treatment of antipsychotic-induced
weight gain: a randomized controlled trial.
Wu RR, Zhao JP, Jin H, Shao P, Fang MS, Guo XF, He YQ, Liu YJ, Chen JD, Li LH.
Mental Health Institute of the Second Xiangya Hospital, Central South University,
Changsha, Hunan, China.
wurenrong2005@yahoo.com.cnCONTEXT: Weight gain, a common adverse effect of antipsychotic medications, is
associated with medical comorbidities in psychiatric patients. OBJECTIVE: To test
the efficacy of lifestyle intervention and metformin alone and in combination for
antipsychotic-induced weight gain and abnormalities in insulin sensitivity.
DESIGN, SETTING, AND PATIENTS: A randomized controlled trial (October
2004-December 2006) involving 128 adult patients with schizophrenia in the Mental
Health Institute of the Second Xiangya Hospital, Central South University, China.
Participants who gained more than 10% of their predrug weight were assigned to 1
of 4 treatment groups. INTERVENTIONS: Patients continued their antipsychotic
medication and were randomly assigned to 12 weeks of placebo, 750 mg/d of
metformin alone, 750 mg/d of metformin and lifestyle intervention, or lifestyle
intervention only. MAIN OUTCOME MEASURES: Body mass index, waist circumference,
insulin levels, and insulin resistance index. RESULTS: All 128 first-episode
schizophrenia patients maintained relatively stable psychiatric improvement. The
lifestyle-plus-metformin group had mean decreases in body mass index (BMI) of 1.8
(95% confidence interval [CI], 1.3-2.3), insulin resistance index of 3.6 (95% CI,
2.7-4.5), and waist circumference of 2.0 cm (95% CI, 1.5-2.4 cm). The
metformin-alone group had mean decreases in BMI of 1.2 (95% CI, 0.9-1.5), insulin
resistance index of 3.5 (95% CI, 2.7-4.4), and waist circumference of 1.3 cm (95%
CI, 1.1-1.5 cm). The lifestyle-plus-placebo group had mean decreases in BMI of
0.5 (95% CI, 0.3-0.8) and insulin resistance index of 1.0 (95% CI, 0.5-1.5).
However, the placebo group had mean increases in BMI of 1.2 (95% CI, 0.9-1.5),
insulin resistance index of 0.4 (95% CI, 0.1-0.7), and waist circumference of 2.2
cm (95% CI, 1.7-2.8 cm). The lifestyle-plus-metformin treatment was significantly
superior to metformin alone and to lifestyle plus placebo for weight, BMI, and
waist circumference reduction. CONCLUSIONS: Lifestyle intervention and metformin
alone and in combination demonstrated efficacy for antipsychotic-induced weight
gain. Lifestyle intervention plus metformin showed the best effect on weight
loss. Metformin alone was more effective in weight loss and improving insulin
sensitivity than lifestyle intervention alone. Trial Registration
clinicaltrials.gov Identifier: NCT00451399.
Publication Types:
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
PMID: 18182600 [PubMed - indexed for MEDLINE]
3: JAMA. 2007 Oct 24;298(16):1928-30.
Factors contributing to high costs and inequality in China's health care system.
Wang H, Xu T, Xu J.
Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.
houli_wang@yahoo.comPMID: 17954544 [PubMed - indexed for MEDLINE]
4: JAMA. 2006 Feb 15;295(7):776-83.
Body weight and mortality among men and women in China.
Gu D, He J, Duan X, Reynolds K, Wu X, Chen J, Huang G, Chen CS, Whelton PK.
Cardiovascular Institute and Fu Wai Hospital of the Chinese Academy of Medical
Sciences and Peking Union Medical College, and Chinese National Center for
Cardiovascular Disease Control and Research, Beijing, China.
gudongfeng@vip.sina.comCONTEXT: The effect of underweight and obesity on mortality has not been well
characterized in Asian populations. OBJECTIVE: To examine the relationship
between body mass index (BMI) and mortality in Chinese adults. DESIGN, SETTING,
AND PARTICIPANTS: A prospective cohort study in a nationally representative
sample of 169,871 Chinese men and women aged 40 years or older. Data on body
weight and covariables were obtained at a baseline examination in 1991 using a
standard protocol. Follow-up evaluation was conducted in 1999-2000, with a
response rate of 93.4% (n = 158,666). MAIN OUTCOME MEASURES: Body mass index and
all-cause mortality. RESULTS: After excluding those participants with missing
body weight or height values, 154,736 adults were included in the analysis. After
adjustment for age, sex, cigarette smoking, alcohol consumption, physical
activity, education, geographic region (north vs south), and urbanization (urban
vs rural), a U-shaped association between BMI and all-cause mortality was
observed (P<.001). Using those participants with a BMI of 24.0 to 24.9 as the
reference group, the relative risks of all-cause mortality across categories of
BMI were 1.65 (95% confidence interval [CI], 1.54-1.77) for BMI less than 18.5,
1.31 (95% CI, 1.22-1.41) for BMI 18.5 to 19.9, 1.20 (95% CI, 1.11-1.29) for BMI
20.0 to 20.9, 1.12 (95% CI, 1.04-1.21) for BMI 21.0 to 21.9, 1.11 (95% CI,
1.03-1.20) for BMI 22.0 to 22.9, 1.09 (95% CI, 1.01-1.19) for BMI 23.0 to 23.9,
1.00 (95% CI, 0.92-1.08) for BMI 25.0 to 26.9, 1.15 (95% CI, 1.06-1.24) for BMI
27.0 to 29.9, and 1.29 (95% CI, 1.16-1.42) for BMI 30.0 or more. The U-shaped
association existed even after excluding participants who were current or former
smokers, heavy alcohol drinkers, or who had prevalent chronic illness at the
baseline examination, or who died during the first 3 years of follow-up. A
similar association was observed between BMI and mortality from cardiovascular
disease, cancer, and other causes. CONCLUSIONS: Our results indicate that both
underweight and obesity were associated with increased mortality in the Chinese
adult population. Furthermore, our findings support the use of a single common
recommendation for defining overweight and obesity among all racial and ethnic
groups.
Publication Types:
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
PMID: 16478900 [PubMed - indexed for MEDLINE]
5: JAMA. 2005 Aug 3;294(5):557-62.
Comment in:
JAMA. 2005 Aug 3;294(5):621-3. JAMA. 2005 Dec 21;294(23):2968; discussion 2968-9.
Rates of adult schizophrenia following prenatal exposure to the Chinese famine of
1959-1961.
St Clair D, Xu M, Wang P, Yu Y, Fang Y, Zhang F, Zheng X, Gu N, Feng G, Sham P,
He L.
Bio-X Center, Shanghai Jiao Tong University, Shanghai, People's Republic of
China.
d.stclair@abdn.ac.ukCONTEXT: Schizophrenia is a common major mental disorder. Intrauterine
nutritional deficiency may increase the risk of schizophrenia. The main evidence
comes from studies of the 1944-1945 Dutch Hunger Winter when a sharp and
time-limited decline in food intake occurred. The most exposed cohort conceived
during the famine showed a 2-fold increased risk of schizophrenia. OBJECTIVE: To
determine whether those who endured a massive 1959-1961 famine in China
experienced similar results. DESIGN, SETTING, AND PARTICIPANTS: The risk of
schizophrenia was examined in the Wuhu region of Anhui, one of the most affected
provinces. Rates were compared among those born before, during, and after the
famine years. Wuhu and its surrounding 6 counties are served by a single
psychiatric hospital. All psychiatric case records for the years 1971 through
2001 were examined, and clinical and sociodemographic information on patients
with schizophrenia was extracted by researchers who were blinded to the nature of
exposure. Data on number of births and deaths in the famine years were available,
and cumulative mortality was estimated from later demographic surveys. MAIN
OUTCOME MEASURES: Evidence of famine was verified, and unadjusted and
mortality-adjusted relative risks of schizophrenia were calculated. RESULTS: The
birth rates (per 1000) in Anhui decreased approximately 80% during the famine
years from 28.28 in 1958 and 20.97 in 1959 to 8.61 in 1960 and 11.06 in 1961.
Among births that occurred during the famine years, the adjusted risk of
developing schizophrenia in later life increased significantly, from 0.84% in
1959 to 2.15% in 1960 and 1.81% in 1961. The mortality-adjusted relative risk was
2.30 (95% confidence interval, 1.99-2.65) for those born in 1960 and 1.93 (95%
confidence interval, 1.68-2.23) for those born in 1961. CONCLUSION: Our findings
replicate the Dutch data for a separate racial group and show that prenatal
exposure to famine increases risk of schizophrenia in later life.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 16077049 [PubMed - indexed for MEDLINE]
6: JAMA. 2004 Jun 2;291(21):2591-9.
Comment in:
ACP J Club. 2004 Nov-Dec;141(3):81. Int J Cardiol. 2005 Sep 30;104(2):228.
Predictive value for the Chinese population of the Framingham CHD risk assessment
tool compared with the Chinese Multi-Provincial Cohort Study.
Liu J, Hong Y, D'Agostino RB Sr, Wu Z, Wang W, Sun J, Wilson PW, Kannel WB, Zhao
D.
Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel
Diseases, Beijing, China.
jingliu0516@yahoo.com.cnCONTEXT: The Framingham Heart Study helped to establish tools to assess coronary
heart disease (CHD) risk, but the homogeneous nature of the Framingham population
prevents simple extrapolation to other populations. Recalibration of Framingham
functions could permit various regions of the world to adapt Framingham tools to
local populations. OBJECTIVE: To evaluate the performance of the Framingham CHD
risk functions, directly and after recalibration, in a large Chinese population,
compared with the performance of the functions derived from the Chinese
Multi-provincial Cohort Study (CMCS). DESIGN, SETTING, AND PARTICIPANTS: The CMCS
cohort included 30 121 Chinese adults aged 35 to 64 years at baseline.
Participants were recruited from 11 provinces and were followed up for new CHD
events from 1992 to 2002. Participants in the Framingham Heart Study were 5251
white US residents of Framingham, Mass, who were 30 to 74 years old at baseline
in 1971 to 1974 and followed up for 12 years. MAIN OUTCOME MEASURES: "Hard" CHD
(coronary death and myocardial infarction) was used as the end point in
comparisons of risk factors (age, blood pressure, smoking, diabetes, total
cholesterol, and high-density lipoprotein cholesterol [HDL-C]) as evaluated by
the CMCS functions, original Framingham functions, and recalibrated Framingham
functions. RESULTS: The CMCS cohort had 191 hard CHD events and 625 total deaths
vs 273 CHD events and 293 deaths, respectively, for Framingham. For most risk
factor categories, the relative risks for CHD were similar for Chinese and
Framingham participants, with a few exceptions (ie, age, total cholesterol of
200-239 mg/dL [5.18-6.19 mmol/L], and HDL-C less than 35 mg/dL [0.91 mmol/L] in
men; smoking in women). The discrimination using the Framingham functions in the
CMCS cohort was similar to the CMCS functions: the area under the receiver
operating characteristic curve was 0.705 for men and 0.742 for women using the
Framingham functions vs 0.736 for men and 0.759 for women using the CMCS
functions. However, the original Framingham functions systematically
overestimated the absolute CHD risk in the CMCS cohort. For example, in the 10th
risk decile in men, the predicted rate of CHD death was 20% vs an actual rate of
3%. Recalibration of the Framingham functions using the mean values of risk
factors and mean CHD incidence rates of the CMCS cohort substantially improved
the performance of the Framingham functions in the CMCS cohort. CONCLUSIONS: The
original Framingham functions overestimated the risk of CHD for CMCS
participants. Recalibration of the Framingham functions improved the estimates
and demonstrated that the Framingham model is useful in the Chinese population.
For regions that have no established cohort, recalibration using CHD rates and
risk factors may be an effective method to develop CHD risk prediction algorithms
suited for local practice.
Publication Types:
Comparative Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
PMID: 15173150 [PubMed - indexed for MEDLINE]
7: JAMA. 2003 Dec 24;290(24):3215-21.
Comment in:
JAMA. 2003 Dec 24;290(24):3251-3.
Evaluation of control measures implemented in the severe acute respiratory
syndrome outbreak in Beijing, 2003.
Pang X, Zhu Z, Xu F, Guo J, Gong X, Liu D, Liu Z, Chin DP, Feikin DR.
Beijing Center for Disease Prevention and Control, Beijing, People's Republic of
China.
CONTEXT: Beijing, China, experienced the world's largest outbreak of severe acute
respiratory syndrome (SARS) beginning in March 2003, with the outbreak resolving
rapidly, within 6 weeks of its peak in late April. Little is known about the
control measures implemented during this outbreak. OBJECTIVE: To describe and
evaluate the measures undertaken to control the SARS outbreak. DESIGN, SETTING,
AND PARTICIPANTS: Data were reviewed from standardized surveillance forms from
SARS cases (2521 probable cases) and their close contacts observed in Beijing
between March 5, 2003, and May 29, 2003. Procedures implemented by health
authorities were investigated through review of official documents and
discussions with public health officials. MAIN OUTCOME MEASURES: Timeline of
major control measures; number of cases and quarantined close contacts and attack
rates, with changes in infection control measures, management, and triage of
suspected cases; and time lag between illness onset and hospitalization with
information dissemination. RESULTS: Health care worker training in use of
personal protective equipment and management of patients with SARS and
establishing fever clinics and designated SARS wards in hospitals predated the
steepest decline in cases. During the outbreak, 30 178 persons were quarantined.
Among 2195 quarantined close contacts in 5 districts, the attack rate was 6.3%
(95% confidence interval [CI], 5.3%-7.3%), with a range of 15.4% (95% CI,
11.5%-19.2%) among spouses to 0.36% (95% CI, 0%-0.77%) among work and school
contacts. The attack rate among quarantined household members increased with age
from 5.0% (95% CI, 0%-10.5%) in children younger than 10 years to 27.6% (95% CI,
18.2%-37.0%) in adults aged 60 to 69 years. Among almost 14 million people
screened for fever at the airport, train stations, and roadside checkpoints, only
12 were found to have probable SARS. The national and municipal governments held
13 press conferences about SARS. The time lag between illness onset and
hospitalization decreased from a median of 5 to 6 days on or before April 20,
2003, the day the outbreak was announced to the public, to 2 days after April 20
(P<.001). CONCLUSIONS: The rapid resolution of the SARS outbreak was
multifactorial, involving improvements in management and triage in hospitals and
communities of patients with suspected SARS and the dissemination of information
to health care workers and the public.
Publication Types:
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
PMID: 14693874 [PubMed - indexed for MEDLINE]
8: JAMA. 1998 Jul 15;280(3):283-5.
Research design and statistical methods in Chinese medical journals.
Wang Q, Zhang B.
Clinical Epidemiology Unit, Hua Shan Hospital, Shanghai Medical University,
China.
qwang@shmu.edu.cnCONTEXT: Study design and statistical analyses have improved in journals
published in Western countries, but the type of research designs and statistical
methods used in medical journals outside Western countries has not been assessed.
OBJECTIVES: To determine the frequency of research designs and statistical
techniques used in Chinese medical journals, types of statistical errors present,
and trends over a 10-year period. DESIGN: Evaluation of all original articles
published in 5 leading journals in 1985 (N = 640) and in 1995 (N = 954). MAIN
OUTCOME MEASURES: Research designs and statistical methods. RESULTS: Compared
with 1985, significant improvement was seen in 1995; the percentages of original
articles reporting clinical trials, prospective studies, or basic science
research increased from 18% to 31% (P<.001), the proportion of papers using
statistical tests increased from 40% to 60% (P<.001), more sophisticated
statistical methods were used, and of those articles using statistics, the
proportion using appropriate methods increased from 22% to 46% (P<.001). In both
years, the most commonly used statistical methods were t tests and contingency
tables. The most common errors were presentation of P values without specifying
the test used, use of multiple t tests instead of analysis of variance, and use
of unpaired t tests when paired tests were required. CONCLUSIONS: The use of
statistical methods in Chinese medical journals research is improving, and by
1995, the frequency of using statistical methods in published articles was
similar to the results determined in previous studies of journals. However, the
lack of or inappropriate use of statistics remains a serious problem.
PMID: 9676683 [PubMed - indexed for MEDLINE]
9: JAMA. 1995 Oct 18;274(15):1232-4.
Cigarette smoking in China. Prevalence, characteristics, and attitudes in Minhang
District.
Gong YL, Koplan JP, Feng W, Chen CH, Zheng P, Harris JR.
Shanghai Medical University, People's Republic of China.
OBJECTIVE--To determine the prevalence, pattern, and financial implications of
cigarette smoking and the attitudes toward and knowledge of the health effects of
tobacco use in a population in China. DESIGN--A two-stage, stratified cluster
survey using door-to-door interviews. SETTING--Minhang District, China (near
Shanghai), with a population of 506,000. PARTICIPANTS--A total of 3423 males and
3593 females aged 15 years and older. MAIN OUTCOME MEASURES--Smoking prevalence,
age of initiation of smoking, reasons for smoking, knowledge of tobacco hazards,
and costs of smoking. RESULTS--A total of 2279 males (67%) but only 72 females
(2%) smoke. Many males initiate smoking in adulthood. A total of 1156 males
(50.7%) began smoking between 20 and 24 years of age, and 666 (29.2%) began
between 25 and 39 years of age. Among all respondents, 6202 (88.4%) believe
smoking is harmful for both the smoker and those exposed passively to the smoke.
Only 332 (14.1%) of all male smokers reported a desire to quit smoking. Current
smokers spent an average of 3.65 yuan daily on cigarettes or 1332 yuan yearly
(8.5 yuan per US dollar), which represents 60% of personal income and 17% of
household income. CONCLUSIONS--The survey reveals a dangerous health situation
that in all likelihood will worsen. More than two thirds of men smoke, and people
in successive age cohorts start smoking at earlier ages. Smokers spend a
substantial proportion of their income on cigarettes. There is a low rate of
quitting and a low desire to quit despite high awareness of the health hazards.
Tobacco control measures need to be implemented urgently in China.
PMID: 7563514 [PubMed - indexed for MEDLINE]
10: JAMA. 1990 Sep 26;264(12):1575-9.
Erratum in:
JAMA 1990 Dec 26;264(24):3149.
A comparison of smoking patterns in the People's Republic of China with the
United States. An impending health catastrophe in the middle kingdom.
Yu JJ, Mattson ME, Boyd GM, Mueller MD, Shopland DR, Pechacek TF, Cullen JW.
Peking Union Medical College, Ministry of Public Health, Beijing, People's
Republic of China.
Half of the global increase in tobacco use from 1976 to 1986 occurred in the
People's Republic of China. In 1984, the first national smoking survey was
conducted in China, involving over a half-million subjects. Sixty-one percent of
Chinese males over age 15 smoke, with higher rates in all occupational groups
than for corresponding groups in the United States. Current smoking patterns in
China are similar to those in the United States during the 1950s, and these
patterns forecast a steadily increasing epidemic of smoking-related deaths. It is
estimated that by 2025, two million Chinese men will die annually from smoking.
Foreign tobacco companies are mounting massive production and advertising
campaigns in China. Government health education programs lack funds to counter
these influences with sustained and comprehensive educational and interventional
campaigns. To avert an impending national health catastrophe, China must launch a
comprehensive smoking-control initiative aimed at public education, cessation,
and legislation and policy.
Publication Types:
Comparative Study
PMID: 2395200 [PubMed - indexed for MEDLINE]
11: JAMA. 1988 Sep 23-30;260(12):1755-7.
Microcirculation and traditional Chinese medicine.
Xiu RJ.
Institute of Microcirculation, Chinese Academy of Medical Sciences, Beijing,
China.
Publication Types:
Historical Article
PMID: 3045357 [PubMed - indexed for MEDLINE]
