Tumor necrosis factor a (TNFa) is a pleiotropic cytokine which can regulate a wide variety of cellular responses. Low concentrations of TNFa seem to increase tumor growth and progression. The -308 G/A polymorphism in TNFa has been implicated in breast cancer risk but the published data remain inconclusive. In order to derive a more precise estimation of the relationship, a meta-analysis was performed by searching PubMed, Web of Science, ScienceDirect, EBSCO, CNKI, and Chinese Biomedicine Database. 11 studies including 10,184 cases and 12,911 controls were collected for TNFa -308 G/A polymorphism. Crude ORs with 95% CIs were used to assess the strength of association between the TNFa -308 G/A polymorphism and breast cancer risk. The pooled ORs were performed for codominant model (GG versus AA; GA versus AA), dominant model (GG ? GA versus AA), recessive model (GG versus GA ? AA), and G allele versus A allele, respectively. Overall, significantly elevated breast cancer risk was found for recessive model (OR = 1.10, 95% CI = 1.04-1.17) and for G allele versus A allele (OR = 1.08, 95% CI = 1.02-1.14). In the subgroup analysis by ethnicity, significantly increased risks were also found among Caucasians for recessive model and for G allele versus A allele (for recessive model: OR = 1.10, 95% CI = 1.04-1.17; for G allele versus A allele: OR = 1.09, 95% CI = 1.03-1.14). However, no significant associations were found among Asians for all genetic models. In conclusion, this meta-analysis suggests that the TNFa -308 G allele is a risk factor for developing breast cancer, especially for Caucasians.
The COVID-19 caused an outbreak of respiratory disease and was first found in Wuhan, China, in December 2019 [1]. To cope with this emergency, designated hospitals for COVID-19 patients were set up quickly in China, including Hunan Province which is adjacent to Hubei Province. Those severely ill COVID-19 patients require centralized care in the constructed temporary critical care unit of the designated hospital. Intensivists, nurses, respiratory therapists, infection control experts, and administrative staff form the main core of the special intensive care team. As the critical care team members have multidisciplinary background, it is a big challenge to organize the nursing process. We therefore consulted local critical care and infection control experts in environment-based risk assessment and proposed an integrated and adoptable approach.
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