Family History, Tobacco Smoking, and Risk of Ischemic Stroke

BACKGROUND AND PURPOSE

Both genetic factors and smoking are associated with ischemic stroke (IS) risk. However, little is known about the potential interaction of these factors. We aimed to assess whether smoking and a positive family history interact to increase the risk of IS.

METHODS

The nationwide prospective study recruited 210,000 men and 300,000 women in 2004 to 2008 at ages 30 to 79 years. During 9.7 years of follow-up, we documented 16,923 and 20,656 incident IS cases in men and women without major chronic diseases at baseline, respectively. Multivariable Cox regression models were used to examine associations between family history and IS. Likelihood ratio tests were used to test the smoking-family history interactions on IS.

RESULTS

About 67.8% (n=135,168) of men ever smoked regularly compared with 2.7% (n=7,775) of women. Among men, a significant interaction between family history and smoking on IS was observed (P for interaction=0.03), with more pronounced association between family history and IS among ever-regular smokers (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.16 to 1.27) than among never-smokers (HR, 1.11; 95% CI, 1.01 to 1.23). The association between family history and IS among ex-smokers after more than 10 years of cessation (HR, 1.01; 95% CI, 0.85 to 1.20) appeared similar to that among never-smokers. Among women, a similar but not significant interaction between family history and smoking on IS was observed. Ever-regular smokers who had a family history of stroke had the highest risk of IS.

CONCLUSIONS

Among Chinese men, the association of family history with IS was accentuated by smoking, and such accentuation tended to be lowered by cessation.

Simultaneous and Ultrasensitive Detection of Foodborne Bacteria by Gold Nanoparticles-Amplified Microcantilever Array Biosensor

Foodborne pathogens, especially bacteria, are explicitly threatening public health worldwide. Biosensors represent advances in rapid diagnosis with high sensitivity and selectivity. However, multiplexed analysis and minimal pretreatment are still challenging. We fabricate a gold nanoparticle (Au NP)-amplified microcantilever array biosensor that is capable of determining ultralow concentrations of foodborne bacteria including Escherichia coli O157:H7, Vibrio parahaemolyticus, Salmonella, Staphylococcus aureus, Listeria monocytogenes, Shigella, etc. The method is much faster than using conventional tools without germiculturing and PCR amplification. The six pairs of ssDNA probes (ssDNA₁ + ssDNA₂ partially complementary to the target gene) that originated from the sequence analysis of the specific gene of the bacteria were developed and validated. The ssDNA₁ probes were modified with -S-(CH₂)₆ at the 5′-end and ready to immobilize on the self-assembled monolayers (SAMs) of the sensing cantilevers in the array and couple with Au NPs, while 6-mercapto-1-hexanol SAM modification was carried out on the reference cantilevers to eliminate the interferences by detecting the deflection from the environment induced by non-specific interactions. For multianalyte sensing, the target gene sequence was captured by the ssDNA₂-Au NPs in the solution, and then the Au NPs-ssDNA₂-target complex was hybridized with ssNDA₁ fixed on the beam of the cantilever sensor, which results in a secondary cascade amplification effect. Integrated with the enrichment of the Au NP platform and the microcantilever array sensor detection, multiple bacteria could be rapidly and accurately determined as low as 1–9 cells/mL, and the working ranges were three to four orders of magnitude. There was virtually no cross-reaction among the various probes with different species. As described herein, it holds great potential for rapid, multiplexed, and ultrasensitive detection in food, environment, clinical, and communal samples.

Synthesis, crystal structure, and two-dimension correlation infrared spectroscopy on two novel Pr carboxylic acid coordination polymers

Two new coordination polymers [Pr(PCPA)₃(H₂O)]_n1 and [Pr₂(PCPA)₆(H₂O)₃]_n·nH₂O 2(PCPA = p-chlorophenoxyacetic acid) have been synthesized under similar conditions by the hydrothermal method and characterized by single-crystal X-ray diffraction, elemental analyses, powder X-ray diffraction (PXRD) analysis, IR spectroscopy, two-dimensional correlation infrared spectroscopy(2D-IR COS) and ultraviolet-visible diffuse reflection integral spectroscopy (UV-Vis DRIS). 1 displays a 1D infinite chain, which is further linked by O/CH⋯O hydrogen bonds to form a 3D supra-molecular architecture. 2 shows a 2D layer structure, which is extended by CH⋯Cl hydrogen bonds generating a 3D network. Noteworthy, we also studied 2D-IR COS under the thermal perturbation to contribute to the development of theory. The 2D-IR correlation spectroscopy analysis is consistent with the analysis of structure and it is superior to 1D IR spectroscopy especially in the coordinated carboxyl group.

Using Nrf2/antioxidant response element-dependent signaling to assess the toxicity potential of fly ash particles

Epidemiological studies have demonstrated an association between ambient particulate pollution and adverse health effects in humans. The antioxidant-responsive element (ARE) cytoprotective system mediated by the transcription factor NF-E2 p45-related factor 2 (Nrf2) serves as a primary defense against the oxidative stress triggered by particulate matter. In this study, using a cell-based ARE-reporter assay, the fine fractions of the fly ash collected from the municipal solid waste incinerators at four cities in China were examined for their ability to activate Nrf2/ARE signaling. We found that, at a non-lethal dose, all the fly ash samples were able to activate the ARE-reporter gene in a dose- and redox-dependent manner, and this was correlated with their cytotoxicity and their ability to induce DNA damage. Study of the kinetics revealed that fly ash particles elicited a prolonged activation of the ARE-reporter activity. Upon exposure to the particles, the ARE-luciferase activity significantly increased in 2 h, reached a peak at 24 h, and remained high level at 72 h. This was in contrast to the transient activation of the ARE-reporter gene triggered by the Nrf2 activators tert-butylhydroquinone and sulforaphane, while ARE-luciferase activity dropped to the basal level at 72 h from the peak at 24 h. These results demonstrate the robustness of using cell-based ARE-reporter assays to evaluate the oxidative potential of fly ash. Our novel findings suggest that the sustained activation of the Nrf2/ARE signaling pathway induced by fly ash particles perturbs cellular redox homeostasis, which in turn contributes to toxicity.

Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people

OBJECTIVES

Chronic hepatitis B virus (HBV) infection is associated with a higher risk of liver diseases. Substantial uncertainty remains, however, about the associations of HBV infection with mortality from extrahepatic causes, especially from subtypes of cardiovascular diseases. We prospectively examined the association of chronic HBV infection with total and cause-specific mortality.

DESIGN

Population-based prospective cohort study.

SETTING

China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008.

PARTICIPANTS

475 801 participants 30-79 years of age without reporting major chronic diseases at baseline were enrolled. Hepatitis B surface antigen (HBsAg) was tested using an on-site rapid test strip at baseline.

PRIMARY AND SECONDARY OUTCOME MEASURES

Total and cause-specific mortality.

RESULTS

A total of 35 822 deaths were recorded during ~10 years of follow-up. In multivariable-adjusted analyses, compared with HBsAg-negative participants, HBsAg-positive participants had an increased risk of total mortality (HR=2.01, 95% CI: 1.91 to 2.12), which was higher in men (HR=2.16, 95% CI: 2.01 to 2.31) than in women (HR=1.74, 95% CI: 1.60 to 1.90). Presence of HBsAg was associated with increased mortality from liver cancer (1339 deaths, HR=13.95, 95% CI: 12.46 to 15.62), infections (410 deaths, HR=10.30, 95% CI: 8.21 to 12.94), digestive diseases (688 deaths, HR=6.83, 95% CI: 5.49 to 8.50), intracerebral haemorrhage (4077 deaths, HR=1.38, 95% CI: 1.14 to 1.68) and ischaemic heart diseases (4624 deaths, HR=1.31, 95% CI: 1.09 to 1.58). The positive association between HBsAg status and risk of death was stronger in participants younger than 50 years, smokers, physically active or non-hypertensive participants.

CONCLUSIONS

Among Chinese adults, chronic HBV infection was associated with increased mortality from a range of hepatic and extrahepatic diseases.

Nested Dilation Networks for Brain Tumor Segmentation Based on Magnetic Resonance Imaging

Aim: Brain tumors are among the most fatal cancers worldwide. Diagnosing and manually segmenting tumors are time-consuming clinical tasks, and success strongly depends on the doctor's experience. Automatic quantitative analysis and accurate segmentation of brain tumors are greatly needed for cancer diagnosis. Methods:This paper presents an advanced three-dimensional multimodal segmentation algorithm called nested dilation networks (NDNs). It is inspired by the U-Net architecture, a convolutional neural network (CNN) developed for biomedical image segmentation and is modified to achieve better performance for brain tumor segmentation. Thus, we propose residual blocks nested with dilations (RnD) in the encoding part to enrich the low-level features and use squeeze-and-excitation (SE) blocks in both the encoding and decoding parts to boost significant features. To prove the reliability of the network structure, we compare our results with those of the standard U-Net and its transmutation networks. Different loss functions are considered to cope with class imbalance problems to maximize the brain tumor segmentation results. A cascade training strategy is employed to run NDNs for coarse-to-fine tumor segmentation. This strategy decomposes the multiclass segmentation problem into three binary segmentation problems and trains each task sequentially. Various augmentation techniques are utilized to increase the diversity of the data to avoid overfitting. Results: This approach achieves Dice similarity scores of 0.6652, 0.5880, and 0.6682 for edema, non-enhancing tumors, and enhancing tumors, respectively, in which the Dice loss is used for single-pass training. After cascade training, the Dice similarity scores rise to 0.7043, 0.5889, and 0.7206, respectively. Conclusion: Experiments show that the proposed deep learning algorithm outperforms other U-Net transmutation networks for brain tumor segmentation. Moreover, applying cascade training to NDNs facilitates better performance than other methods. The findings of this study provide considerable insight into the automatic and accurate segmentation of brain tumors.

Causal associations of blood lipids with risk of ischemic stroke and intracerebral hemorrhage in Chinese adults

Stroke is the second leading cause of death worldwide and accounts for >2 million deaths annually in China^1,2. Ischemic stroke (IS) and intracerebral hemorrhage (ICH) account for an equal number of deaths in China, despite a fourfold greater incidence of IS^1,2. Stroke incidence and ICH proportion are higher in China than in Western populations^3-5, despite having a lower mean low-density lipoprotein cholesterol (LDL-C) concentration. Observational studies reported weaker positive associations of LDL-C with IS than with coronary heart disease (CHD)^6,7, but LDL-C-lowering trials demonstrated similar risk reductions for IS and CHD^8-10. Mendelian randomization studies of LDL-C and IS have reported conflicting results^11-13, and concerns about the excess risks of ICH associated with lowering LDL-C^14,15 may have prevented the more widespread use of statins in China. We examined the associations of biochemically measured lipids with stroke in a nested case-control study in the China Kadoorie Biobank (CKB) and compared the risks for both stroke types associated with equivalent differences in LDL-C in Mendelian randomization analyses. The results demonstrated positive associations of LDL-C with IS and equally strong inverse associations with ICH, which were confirmed by genetic analyses and LDL-C-lowering trials. Lowering LDL-C is still likely to have net benefit for the prevention of overall stroke and cardiovascular disease in China.

Cardiovascular risk factors and Parkinson's disease in 500,000 Chinese adults

OBJECTIVE

The objectives of this study were to compare the risks of Parkinson's disease among those with versus those without prior stroke or heart disease at baseline in a prospective study of 0.5 million adults in China, and to examine associations of cardiovascular disease risk factors (cigarette smoking, hypertension, diabetes, obesity) with risk of Parkinson's disease.

METHODS

During an average of 11.5 years of follow-up of 503,497 middle-aged participants in the China Kadoorie Biobank study, 603 incident cases were hospitalized with a diagnosis of Parkinson's disease. Cox proportional hazards models were used to assess associations of history of heart disease or stroke with Parkinson's disease in all participants, and of cardiovascular disease risk factors with Parkinson's disease in a subset without prior cardiovascular disease.

RESULTS

In this population the incidence rate of Parkinson's disease (mean [SD] age of cases, 61 [10] years) was 13.3 (95% confidence interval: 12.3-14.4) per 100,000 person-years. Incidence increased with age, and was higher in men than in women, and in urban than in rural residents. Prior stroke was associated with about twofold higher risk of Parkinson's disease (hazard ratio 1.94; 1.39-2.69). After adjustment for confounders in those without prior cardiovascular disease, a 5 kg/m2 higher body mass index was associated with 17% (1.17; 1.03-1.34: P = 0.019) higher risk of Parkinson's disease, but neither hypertension, diabetes, nor current cigarette smoking was significantly associated with Parkinson's disease.

INTERPRETATION

Prior stroke and adiposity were each associated with higher risks of Parkinson's disease, but none of the other cardiovascular disease risk factors were significantly associated with Parkinson's disease in this population.

Validation of Phosphodiesterase-10 as a Novel Target for Pulmonary Arterial Hypertension via Highly Selective and Subnanomolar Inhibitors

Pulmonary arterial hypertension (PAH) causes pathological increase in pulmonary vascular resistance, leading to right-heart failure and eventual death. Previously, phosphodiesterase-10 (PDE10) was reported to be a promising target for PAH based on the studies with a nonselective PDE inhibitor papaverine, but little progress has been made to confirm the practical application of PDE10 inhibitors. To validate whether PAH is ameliorated by PDE10 inhibition rather than other PDE isoforms, here we report an integrated strategy to discover highly selective PDE10 inhibitors as chemical probes. Structural optimization resulted in a PDE10 inhibitor 2b with subnanomolar affinity and good selectivity of >45 000-fold against other PDEs. The cocrystal structure of the PDE10-2b complex revealed an important H-bond interaction between 2b and Tyr693. Finally, compound 2b significantly decreased the arterial pressure in PAH rats and thus validated the potential of PDE10 as a novel anti-PAH target. These findings suggest that PDE10 inhibition may be a viable treatment option for PAH.

[Qualitative pathological assessment of liver fibrosis regression after antiviral therapy in patients with chronic hepatitis B]

Objective: To investigate the methods for qualitative pathological assessment of dynamic changes in liver fibrosis/cirrhosis after antiviral therapy in patients with chronic hepatitis B (CHB), since antiviral therapy can partially reverse liver fibrosis and cirrhosis caused by hepatitis B and semi-quantitative, rather than qualitative, pathological assessment is often used for the research on liver fibrosis regression. Methods: Previously untreated CHB patients with liver fibrosis and cirrhosis were enrolled, and liver biopsy was performed before treatment and at 78 weeks after the antiviral therapy based on entecavir. The follow-up assessment was performed once every half a year. Based on the proportion of different types of fibrous septum, we put forward the new qualitative criteria called P-I-R classification (predominantly progressive, predominantly regressive, and indeterminate) for evaluating dynamic changes in liver fibrosis. This classification or Ishak fibrosis stage was used to evaluate the change in liver fibrosis after treatment and Ishak liver inflammation score was used to evaluate the change in liver inflammation after treatment. Results: A total of 112 CHB patients who underwent liver biopsy before and after treatment were enrolled, and among these patients, 71 with an Ishak stage of ≥3 and qualified results of live biopsy were included in the final analysis. Based on the P-I-R classification, 58% (41/71) were classified as predominantly progressive, 29% (21/71) were classified as indeterminate, and 13% (9/71) were classified as predominantly regressive; there were no significant differences between the three groups in alanine aminotransferase, aspartate aminotransferase, albumin, HBeAg positive rate, HBV DNA, and liver stiffness (P < 0.05). After treatment, the proportion of predominantly progressive, indeterminate, or predominantly regressive patients changed to 11% (8/71), 11% (8/71), and 78% (55/71), respectively. Among the 35 patients who had no change in Ishak stage after treatment, 72% (25/35) were classified as predominantly regressive and had certain reductions in the Laennec score, percentage of collagen area, and liver stiffness. Conclusion: This new P-I-R classification can be used to assess the dynamic changes in liver fibrosis after antiviral therapy in CHB patients.

[Clinical effect and safety of pegylated interferon-α-2b injection (Y shape, 40 kD) in treatment of HBeAg-positive chronic hepatitis B patients]

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion: In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

[Post-marketing safety analysis of inactivated enterovirus A71 vaccines]

Objectives: To evaluate the safety of inactivated enterovirus A71(EV-A71) vaccines after large-scale immunization in the community. Methods: We selected EV-A71 susceptible people (healthy children) aged 6-59 months in vaccination clinics from 89 counties in Zhejiang Province between April 2016 and March 2018. All local and systematic adverse actions were collected by 30 min on-site inspection, within 3 days and 4-30 days follow-up. Chi-square test and Fisher's exact test were used to compare the difference of AEs incidence in various characteristics among two groups. Results: A total of 71 663 doses of vaccines were included for active safety analysis, which included 37 331 doses in boys and 34 332 doses in girls. Among all the doses, children aged 6 to 11 months, 12 to 23 months and 24 to 59 months were received 13 707, 32 639 and 25 317 doses respectively. The incidence of adverse reactions within 30 min, 3 days and 4-30 days were 0.33% (239 doses), 1.58% (1 133 doses) and 0.34% (244 doses) respectively. Adverse reactions within 3 days were 1 372 doses, with a incidence of 1.91%; among all the cases, 539 doses (0.75%) were grade 1, 677 doses (0.94%) were grade 2 and 156 doses (0.22%) were grade 3, no grade-4 adverse reaction was reported. The common local adverse reactions were redness, swelling and pruritus, with the incidence rates were 0.05% (39 doses), 0.02% (16 doses) and 0.02% (12 doses), respectively, while the most common systemic adverse reaction was pyrexia with an incidence of 1.19% (856 doses), followed by diarrhea and anorexia with the incidence rates were 0.15% (104 doses) and 0.13% (90 doses) respectively. Conclusion: Most adverse actions of EV-A71 vaccines were mild and moderate and majority of them were common adverse actions. No new adverse reactions were found in the study.

Patterns and trends of alcohol consumption in rural and urban areas of China: findings from the China Kadoorie Biobank

BACKGROUND

In China, alcohol consumption has increased significantly in recent decades. Little evidence exists, however, about temporal trends in levels and patterns of alcohol consumption and associated factors in adult populations.

METHODS

In 2004-08, the China Kadoorie Biobank recruited ~ 512,000 adults (41% men, mean age 52 years [SD 10.7]) from 10 (5 urban, 5 rural) geographically diverse regions across China, with ~ 25,000 randomly selected participants resurveyed in 2013-14. The self-reported prevalence and patterns (e.g., amount, beverage type, heavy drinking episodes) of alcohol drinking at baseline and resurvey were compared and related to socio-demographic, health and other factors.

RESULTS

At baseline, 33% of men drank alcohol at least weekly (i.e., current regular), compared to only 2% of women. In men, current regular drinking was more common in urban (38%) than in rural (29%) areas at baseline. Among men, the proportion of current regular drinkers slightly decreased at resurvey (33% baseline vs. 29% resurvey), while the proportion of ex-regular drinkers slightly increased (4% vs. 6%), particularly among older men, with more than half of ex-regular drinkers stopping for health reasons. Among current regular drinkers, the proportion engaging in heavy episodic drinking (i.e., > 60 g/session) increased (30% baseline vs. 35% resurvey) in both rural (29% vs. 33%) and urban (31% vs. 36%) areas, particularly among younger men born in the 1970s (41% vs. 47%). Alcohol intake involved primarily spirits, at both baseline and resurvey. Those engaging in heavy drinking episodes tended to have multiple other health-related risk factors (e.g., regular smoking, low fruit intake, low physical activity and hypertension).

CONCLUSIONS

Among Chinese men, the proportion of drinkers engaging in harmful drinking behaviours increased in the past decade, particularly among younger men. Harmful drinking patterns tended to cluster with other unhealthy lifestyles and health-related risk factors.

Dynamical Critical Behavior of an Attractive Bose-Einstein Condensate Phase Transition

When matter undergoes a continuous phase transition on a finite timescale, the Kibble-Zurek mechanism predicts universal scaling behavior with respect to structure formation. The scaling is dependent on the universality class and is irrelevant to the details of the system. Here, we examine this phenomenon by controlling the timescale of the phase transition to a Bose-Einstein condensate using sympathetic cooling of an ultracold Bose thermal cloud with tunable interactions in an elongated trap. The phase transition results in a diverse number of bright solitons and gray solitons in the condensate that undergo attractive and repulsive interactions, respectively. The power law dependence of the average soliton number on the timescale of the phase transition is measured for each interaction and compared. The results support the Kibble-Zurek mechanism, in that the scaling behavior is determined by universality and does not rely on the interaction properties.

Solid Fuel Use and Risks of Respiratory Diseases. A Cohort Study of 280,000 Chinese Never-Smokers

RATIONALE

Little evidence from large-scale cohort studies exists about the relationship of solid fuel use with hospitalization and mortality from major respiratory diseases.

OBJECTIVES

To examine the associations of solid fuel use and risks of acute and chronic respiratory diseases.

METHODS

A cohort study of 277,838 Chinese never-smokers with no prior major chronic diseases at baseline. During 9 years of follow-up, 19,823 first hospitalization episodes or deaths from major respiratory diseases, including 10,553 chronic lower respiratory disease (CLRD), 4,398 chronic obstructive pulmonary disease (COPD), and 7,324 acute lower respiratory infection (ALRI), were recorded. Cox regression yielded adjusted hazard ratios (HRs) for disease risks associated with self-reported primary cooking fuel use.

MEASUREMENTS AND MAIN RESULTS

Overall, 91% of participants reported regular cooking, with 52% using solid fuels. Compared with clean fuel users, solid fuel users had an adjusted HR of 1.36 (95% confidence interval, 1.32-1.40) for major respiratory diseases, whereas those who switched from solid to clean fuels had a weaker HR (1.14, 1.10-1.17). The HRs were higher in wood (1.37, 1.33-1.41) than coal users (1.22, 1.15-1.29) and in those with prolonged use (≥40 yr, 1.54, 1.48-1.60; <20 yr, 1.32, 1.26-1.39), but lower among those who used ventilated than nonventilated cookstoves (1.22, 1.19-1.25 vs. 1.29, 1.24-1.35). For CLRD, COPD, and ALRI, the HRs associated with solid fuel use were 1.47 (1.41-1.52), 1.10 (1.03-1.18), and 1.16 (1.09-1.23), respectively.

CONCLUSIONS

Among Chinese adults, solid fuel use for cooking was associated with higher risks of major respiratory disease admissions and death, and switching to clean fuels or use of ventilated cookstoves had lower risk than not switching.

Adiposity in relation to risks of fatty liver, cirrhosis and liver cancer: a prospective study of 0.5 million Chinese adults

Adiposity is an increasing public health problem in China. We aimed to examine the associations of adiposity with non-alcoholic fatty liver disease (NAFLD) and other chronic liver diseases in Chinese adults. The prospective China Kadoorie Biobank recruited 512,891 adults aged 30-79 years from 10 areas. During 10 years of follow-up, 7,386 incident liver disease cases were recorded among 503,991 participants without prior cancer or chronic liver disease at baseline. The mean body mass index (BMI) (SD) was 23.7 (3.3) kg/m² and mean waist circumference (WC) 80.3 (9.8) cm, with 33% having BMI ≥25 kg/m². Throughout the range examined (BMI 15-50) BMI showed a log-linear positive association with NAFLD (n = 1,298), with adjusted HR per 5 kg/m² of 2.81 (95% CI 2.63-3.01), adjusting for regression dilution. There were also positive associations of percent body fat, WC, and waist-to-hip ratio with NAFLD, with HRs per 1-SD of 2.27 (2.14-2.41), 2.60 (2.44-2.76), and 1.84 (1.76-1.92). BMI was unrelated to viral hepatitis (n = 1,477), and had a U-shaped association with cirrhosis (n = 2,082) and an inverse association with liver cancer (n = 2,568), which disappeared after excluding the first 5 years of follow-up. Among Chinese adults, adiposity was a major risk factor for NAFLD but not other chronic liver diseases.

Leukamenin E, an ent-kaurane diterpenoid, is a novel and potential keratin intermediate filament inhibitor

Many ent-kaurane diterpenoids exhibit notable antitumor activity in vitro and in vivo, and some have been used as cancer therapeutic agents in China. In this study, we identified a novel molecular target of leukamenin E, an ent-kaurane diterpenoid, using an available whole-cell model in combination with immunofluorescence imaging and mass spectrometry (MS). The cytoskeleton-disrupting drugs cytochalasin B and colchicine caused the depolymerization of microfilaments and the collapse of microtubules and vimentin filaments, respectively, but had little effects on HepG2 and NCI-H1299 cells spreading as well as keratin filament (KF) reassembly, indicating that KFs are involved in cell spreading. Leukamenin E blocked HepG2 and NCI-H1299 cells adhesion/spreading and KF reassembly at subtoxic concentrations, indicating that leukamenin E may target KFs. Moreover, leukamenin E, at 3 μM for 24 h or 10 μM for 3 h, induced massive KF depolymerization in well-spread HepG2 and NCI-H1299 cells treated with/without cytochalasin B and colchicine. MS analysis indicated that leukamenin E could covalently modify amino acid residue(s) in a synthetic peptide based on keratin 1 and keratin 10 sequences, suggesting that covalent modification of the synthetic peptide by leukamenin E caused assembly inhibition or disrupted KF polymerization in HepG2 and NCI-H1299 cells. In addition, acridine orange/ethidium bromide staining and western blotting confirmed that there was no correlation between the KF-disrupting effects and apoptosis or keratin expression. Thus, we propose that leukamenin E is a novel inhibitor of KF assembly, and as such, can serve as a chemical probe of KF functions and a potential molecular target for ent-kaurane diterpenoid-based therapeutics.

Betaine improves the growth performance and muscle growth of partridge shank broiler chickens via altering myogenic gene expression and insulin-like growth factor-1 signaling pathway

This study was conducted to investigate the effect of betaine on growth performance, carcass characteristics, myogenic gene expression, and insulin-like growth factor-1 (IGF-1) signaling pathway in partridge shank broiler chickens. A total of 192 one-day-old partridge shank broiler chickens were randomly divided into 4 groups with 6 replicates of 8 chickens for a 52-d feeding trial. Broilers were fed a basal diet supplemented with 0 (control), 250 (B250), 500 (B500), or 1,000 (B1000) mg/kg betaine. Compared with the control group, the B500 and B1000 groups had higher (P < 0.05) body weight gain (BWG), and the B500 group had a lower (P < 0.05) feed/gain ratio (F:G) during the whole trial period. Moreover, the B1000 group increased (P < 0.05) the breast muscle yield and decreased (P < 0.05) relative abdominal fat weight. The mRNA expression of myocyte enhancer factor 2B (MEF2B) and mechanistic target of rapamycin (mTOR) and mTOR phosporylation were higher (P < 0.05) in both breast and thigh muscles in the B500 and B1000 groups than those in the control group. The higher (P < 0.05) concentration and mRNA expression of IGF-1 were also observed in breast muscle in the B500 and B1000 groups. Additionally, the B1000 group up-regulated (P < 0.05) the mRNA level of myogenic differentiation factor 1 (MyoD1) in breast muscle and myogenin (MyoG) in thigh muscle. In conclusion, diets supplemented with 500 or 1,000 mg/kg betaine improved the growth performance of partridge shank broiler chickens during the whole trial period, and the B1000 group significantly improved the breast muscle growth. These improvements might result from increased mRNA expression of MyoD1 and MEF2B in breast muscle and MyoG and MEF2B in thigh muscle, and through alterations in IGF-1/mTOR signaling pathway.

[Clinicopathological characteristics of adult T cell leukemia/lymphoma]

Objective: To investigate the clinical presentation, clinicopathologic features, diagnosis and differential diagnosis of adult T cell leukemia/lymphoma (ATLL). Methods: Four cases of ATLL from Fujian Cancer Hospital between October 2017 and May 2018 were analyzed using hematoxylin-eosin and immunohistochemical stains and polymerase chain reaction (PCR) for HTLV-1 provirus genes. The relevant literature was reviewed. Results: There were two males and two females, age range 38-80 years. All patients were from coastal cities of Fujian province. Clinical presentations including lymphadenopathy, hepatomegaly and splenomegaly were detected in most patients; skin lesion, hypercalcemia and lymphocytosis were also commonly detected.Histologically, there was diffuse effacement of the normal architecture by tumor cells infiltration. The inflammatory background is usually sparse, with scanty eosinophils. The atypical lymphoid cells were typically medium to large sized with pronounced nuclear pleomorphism, irregular nuclei, chromatin clumping and prominent nucleoli. Blast-like cells with transformed nuclei were present in variable proportions. Giant cells with convoluted or cerebriform nuclear contours may be present. Rare cases may be composed predominantly of anaplastic tumor cells. Characteristic "flower cells" with large multi-lobated nuclei can be seen. The tumor cells were strongly positive for CD2, CD3, CD5, CD4 and CD25, but negative for CD7, CD8 and cytotoxic molecules (including TIA-1, Granzyme B and perforin). In three cases, the large transformed cells were positive for CD30. In one case, the anaplastic large cells were diffusely and strongly positive for CD30. All cases were negative for EBER, but positive for HTLV-1 provirus. Conclusions: ATLL is a rare type of T cell lymphoma with unique clinical and pathological features, and should be distinguished from peripheral T cell lymphoma, NOS, ALK negative anaplastic large cell lymphoma and mycosis fungoides. Hypercalcemia, systemic disease, characteristic "flower cells" and specific immunophenotypic profile of CD3(+), CD4(+), CD25(+), and CD7(-) are highly suggestive. However, ATLL can only be confirmed if the presence of HTLV-1 provirus.

Blood Pressure and Risk of Subarachnoid Hemorrhage in China

Background and Purpose- Subarachnoid hemorrhage (SAH) has a high case fatality rate and young mean age at onset compared with other types of stroke, but the pathogenesis of SAH is not fully understood. We examined associations of systolic and diastolic blood pressure with incident nontraumatic SAH in a large prospective study in China. Methods- In 2004 to 2008, 512 891 adults (59% women) from the general population were recruited into the CKB study (China Kadoorie Biobank). Participants were interviewed, measured, and followed up for fatal and nonfatal events. After excluding those with prior vascular disease, Cox regression analysis was used to relate blood pressure to incident SAH events. Analyses were adjusted for major confounders and corrected for regression dilution to give associations with long-term average blood pressure. Results- At baseline, mean age was 51 (SD, 11) years, and mean systolic blood pressure/diastolic blood pressure was 130.6/77.6 (SD, 21.0/11.1) mm Hg. During 3.5 million person-years of follow-up, there were 553 incident SAH cases (mean age at event, 61 [SD, 11] years), yielding an overall annual incidence rate of 12.9 per 100 000. Higher average levels of blood pressure were linearly and positively associated with higher risks of incident SAH: a 10 mm Hg higher systolic blood pressure and a 5 mm Hg higher diastolic blood pressure were associated with hazard ratios for SAH of 1.21 (95% CI, 1.13-1.29) and 1.20 (95% CI, 1.12-1.28), respectively. There was no evidence that the hazard ratios varied by age or sex or by levels of other vascular risk factors. Elevated blood pressure (systolic blood pressure, >120 mm Hg) accounted for 23% of all SAH cases. Conclusions- The incidence of SAH in China was comparable with estimates from Western populations. Higher levels of blood pressure were positively associated with higher risks of SAH, and elevated blood pressure accounted for about a quarter of all SAH cases.

The structural basis of human Spt16 N-terminal domain interaction with histone (H3-H4)2 tetramer

FACT (Facilitates Chromatin Transactions) is a heterodimeric protein complex involved in RNA polymerase II transcription elongation, playing essential roles in chromatin remodeling during transcription, replication, and DNA damage repair. The FACT subunit hSpt16 is essential for nucleosome reorganization. The N-terminal domain of hSpt16 (hSpt16-NTD) was recently described as a histone (H3-H4)₂-binding domain; however, its mode of interaction remains unknown. In this study, we solved the structure of hSpt16-NTD₄₃₇ at 2.19 Å and found that a long-disordered region (hSpt16-LDR), after the main body of hSpt16-NTD, is a novel histone-binding motif. Furthermore, hSpt16-LDR interaction with (H3-H4)₂ is H3 N-terminal tail-independent. Therefore, Spt16-NTD is a histone H3-H4-specific binding domain with a distinct mechanism of interaction between histones and histone chaperones.

Effects of Modified Palygorskite Supplementation on Egg Quality and Mineral Element Content, and Intestinal Integrity and Barrier Function of Laying Hens

This study was conducted to investigate effects of modified palygorskite (MPal) supplementation on the laying performance, egg quality and mineral element content, immunity, oxidative status, and intestinal integrity and barrier function of laying hens. A total of 360 52-week-old Hyline Brown hens were randomly assigned into four dietary treatments for a 7-week feeding trial. The birds were fed a basal diet supplemented with 0 (control group), 0.25, 0.5, and 1 g/kg MPal, respectively. The supplementation of MPal did not alter laying performance and egg quality among groups. Compared with the control group, MPal inclusion decreased lead (Pb) content in yolks at 49 days, and either 0.5- or 1-g/kg MPal supplementation decreased Pb accumulation in yolks at 25 days and manganese (Mn) accumulation in yolks at 25 and 49 days. The contents of jejunal secretory immunoglobulin A (SIgA), ileal SIgA, and immunoglobulin G were decreased by the dietary 0.5-g/kg MPal supplementation. The supplementation of MPal also decreased malondialdehyde content in jejunum and ileum, and decreased serum diamine oxidase activity of the laying hens at 25 and 49 days. The inclusion of 0.5 and 1 g/kg MPal enhanced villus height in jejunum and ileum, and also increased the ratio of villus height to crypt depth in ileum. In conclusion, MPal supplementation decreased Pb and Mn contents in yolks, and exhibited beneficial effects on the intestinal immunity, oxidative status, and intestinal integrity and barrier function of laying hens and its optimal dosage was 0.5 g/kg.

Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults

OBJECTIVE

To examine the associations between egg consumption and cardiovascular disease (CVD), ischaemic heart disease (IHD), major coronary events (MCE), haemorrhagic stroke as well as ischaemic stroke.

METHODS

During 2004-2008, over 0.5 million adults aged 30-79 years were recruited from 10 diverse survey sites in China. Participants were asked about the frequency of egg consumption and were followed up via linkages to multiple registries and active investigation. Among 461 213 participants free of prior cancer, CVD and diabetes, a total of 83 977 CVD incident cases and 9985 CVD deaths were documented, as well as 5103 MCE. Stratified Cox regression was performed to yield adjusted hazard ratios for CVD endpoints associated with egg consumption.

RESULTS

At baseline, 13.1% of participants reported daily consumption (usual amount 0.76 egg/day) and 9.1% reported never or very rare consumption (usual amount 0.29 egg/day). Compared with non-consumers, daily egg consumption was associated with lower risk of CVD (HR 0.89, 95% CI 0.87 to 0.92). Corresponding multivariate-adjusted HRs (95% CI) for IHD, MCE, haemorrhagic stroke and ischaemic stroke were 0.88 (0.84 to 0.93), 0.86 (0.76 to 0.97), 0.74 (0.67 to 0.82) and 0.90 (0.85 to 0.95), respectively. There were significant dose-response relationships of egg consumption with morbidity of all CVD endpoints (P for linear trend <0.05). Daily consumers also had an 18% lower risk of CVD death and a 28% lower risk of haemorrhagic stroke death compared to non-consumers.

CONCLUSION

Among Chinese adults, a moderate level of egg consumption (up to <1 egg/day) was significantly associated with lower risk of CVD, largely independent of other risk factors.