[Prevalence of attention deficit and hyperactivity disorder in children in China: a systematic review and Meta-analysis]

Objective: To understand the prevalence of attention deficit and hyperactivity disorder (ADHD) in children in China and provide scientific basis for early prevention and treatment of ADHD in children. Methods: A systematic literature retrieval was conducted by using CNKI, Wanfang data, CBM and VIP databases for the information about the prevalence of ADHD in children in China published from 1979 to 2017. Pubmed database was used to retrieve the literatures about ADHD prevalence in children in China published from 1946 to 2017. The quality of literature was evaluated based on the cross-sectional study criteria according to STROBE statement. Stata 12.0 was used for combined prevalence and subgroup analyses, including gender, regions, publication year, diagnostic criteria, sampling methods, and so on. Egger testing and the evaluation of funnel graph were used to evaluate the publication bias of these literatures, and sensitivity analysis was done by using different models and eliminating the influence of any one of these articles on combined effect value. Results: Twenty articles were included. The total sample size was 88 755, including 46 216 boys and 42 539 girls. The prevalence of ADHD in children in China was 5.6% (95%CI: 5.0%-6.3%). The prevalence was 7.7% (95%CI: 6.7%-8.8%) in boys and 3.4% (95%CI: 3.0%-3.8%) in girls, the difference was statistically significant (P<0.05). No statistically significance difference in the ADHD prevalence was observed between different regions publication years, diagnostic criteria and sampling methods. Conclusions: The prevalence of ADHD in children in China was high, and boys tended to have a higher prevalence compared with girls. Appropriate screening methods for early detection and intervention conduction of ADHD should be taken among children in China.

[Series study on the relationship between air quality index and tuberculosis incidence in Beijing]

Objective: To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing, and to provide evidence for setting up a better program regarding prevention and control of tuberculosis. Methods: Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing, from January 1, 2014 to November 9, 2016. Confounding factors as meteorological conditions and time trends were under control. Results: In Beijing, a total of 14 533 TB cases with definite dates of onset were collected during the study period, with 36 children excluded from the study. Finally, 14 497 cases were included in the study, including 9 513 men and 4 984 women, with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old). Data from the optimal single-day lag effect of GAM showed that,with every 10 increase of AQI, the percent of increase on the onsets of overall, male, female and adult; tuberculosis cases were 0.85% (95%CI: 0.26%-1.44%), 0.83% (95%CI: 0.24%-1.42%), 0.93% (95%CI: 0.24%-1.62%) and 0.88% (95%CI: 0.29%-1.46%), respectively. The optimal lag time of the single-day effects were 15 days (lag15), but 16 days (lag16) for male. The optimal cumulative lag effect showed that with every 10 AQI increase, the percent of increase on the onsets of overall, male, female and adult tuberculosis cases were 1.92% (95%CI: 0.23%-3.16%), 1.94% (95%CI:0.15%-3.72%), 2.04% (95%CI: 0.10%-3.97%) and 2.00% (95%CI: 0.30%-3.69%), respectively, with the optimal lag time of cumulative delayed effects as 17 days (lag0_17), 18 days (lag0_18), 16 days (lag0_16) and 17 days (lag0_17), respectively. However, there were no statistical significances noticed in the elderly cases. Conclusion: There was a positive correlation between AQI and the number of TB cases in Beijing, and the effects of AQI on the number of TB cases in different genders and age groups were different.

Design of Langmuir probe diagnostic system for the upgraded lower tungsten divertor in EAST tokamak

In order to achieve long-pulse H-mode plasma scenario over 400 s with high heating power in the Experimental Advanced Superconducting Tokamak (EAST) device, the lower graphite divertor will be upgraded into a tungsten (W) divertor with active water cooling, which consists of the W/Cu monoblock units and the W flat-tile units as the divertor plasma facing components. As a fundamental diagnostic tool, the divertor Langmuir probe (Div-LP) diagnostic system will be upgraded accordingly. This paper presents the design of two kinds of new Div-LP systems, which are planned to be utilized on the W/Cu monoblock units and the W flat-tile units for the upgraded lower tungsten divertor, respectively, including their structures and preliminary poloidal and toroidal layouts. The Div-LP diagnostic system can measure the plasma parameters with the schemes of triple-probe, double-probe, and single-probe, to obtain the spatial and temporal distribution of plasma behavior on the divertor targets, which is useful for the discharge control and operation in EAST. In addition, the thermal analysis of the two kinds of probe assemblies is also carried out by using the three-dimensional finite element code ANSYS, which is aimed to get the optimal designs to withstand the long-pulse and high-power operation in EAST future experiments.

Integrated analysis of long noncoding RNA and mRNA expression profiles reveals the potential role of long noncoding RNA in different bovine lactation stages

Long noncoding RNA (lncRNA) play a critical role in mammary development and breast cancer biology. Despite their important role in the mammary gland, little is known of the roles of lncRNA in bovine lactation, particularly regarding the molecular processes underlying it. To characterize the role of lncRNA in bovine lactation, 4 samples of Holstein cow mammary gland tissue at peak and late lactation stages were examined after biopsy. We then profiled the transcriptome of the mammary gland using RNA sequencing technology. Further, functional lncRNA-mRNA coexpression pairs were constructed to infer the function of lncRNA using a generalized linear model, followed by gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. More than 1,000 putative lncRNA were identified, 117 of which were differentially expressed between peak and late lactation stages. Bovine lncRNA were shorter, with fewer exon numbers, and expressed at significantly lower levels than protein-coding genes. Seventy-two differentially expressed (DE) lncRNA were coexpressed with 340 different protein-coding genes. The KEGG pathway analysis showed that target mRNA for DE lncRNA were mainly related to lipid and glucose metabolism, including the peroxisome proliferator-activated receptors and 5' adenosine monophosphate-activated protein kinase signaling pathways. Further bioinformatics and integrative analyses revealed that 12 DE lncRNA potentially played important roles in bovine lactation. Our findings provide a valuable resource for future bovine transcriptome studies, facilitate the understanding of bovine lactation biology, and offer functional information for cattle lactation.

Type 1 innate lymphoid cells are associated with type 2 diabetes

AIM

Type 1 innate lymphoid cells (ILC1s) play a major role in regulating systemic inflammatory diseases. However, the relationship between ILC1s and type 2 diabetes (T2D) remains unclear. Thus, the present study investigated the relationship between ILC1s and glucose homoeostasis in humans.

METHODS

A total of 37 newly diagnosed T2D patients and 32 subjects with normal glucose tolerance (NGT), matched for age and body mass index (BMI), were enrolled in the study. Flow cytometric analysis of ILC1s derived from peripheral blood mononuclear cells (PBMCs) and omental adipose tissue was performed.

RESULTS

T2D patients displayed greater numbers and frequencies of circulating and adipose tissue ILC1s (P < 0.05) compared with NGT subjects, and the two types of ILC1s correlated positively with each other. Circulating ILC1s were positively associated with glycated haemoglobin (HbA_1c), fasting plasma glucose (FPG), homoeostasis model assessment for insulin resistance (HOMA-IR), adipose tissue insulin resistance index (Adipo-IR) and serum free fatty acids (FFAs). A logistic regression model revealed that patients with higher ILC1 levels exhibited a 13.481-fold greater risk of developing T2D.

CONCLUSION

This study is the first to provide evidence that ILC1 abnormalities are involved in the development of diabetes. The data also suggest a potential role of ILC1s as therapeutic indicators in the treatment of T2D.

[Decision tree analysis in determinants of elderly visits in poor rural areas]

OBJECTIVE

To explore the influencing factors of elderly outpatient visits and to provide evidence for poverty reduction in health in the poor rural areas.

METHODS

Through stratified sampling, a total of 1 271 aged people in four poverty Qi/County of Ulanqabcity were surveyed, including Qahar Right Wing Front Banner, Qahar Right Wing Middle Banner, Qahar Right Wing Rear Banner and Liangcheng County. Their socioeconomic and demographic characteristics, daily consumption, EuroQol five dimensions questionnaire(EQ-5D) and visual analogue scale (VAS),social support, health service needs and utilization were collected through cross-sectional household questionnaires. 1 039 aged people who had experienced physical discomfort in the past 30 days were selected as subjects for the study. The differences between the groups were analyzed by chi-square test. A Logistic regression equation and a decision tree of elderly visits were built to find factors influencing decisionmaking of the aged.

RESULTS

The average age of the research subjects was 71.8 years, with 52.2% being illiterate and 85.8% with middle social support. 58.5% of the subjects living with their spouses, mostly living in 15 min medical circle and without any financial support from their children. The 30-day visiting rate when having physical discomfort was 31.0%. The chi-square test showed that the differences in visit rates among age, ethnic, residence patterns, daily consumption index, housing types, social support scores, grown children's economic assistance, travel time to medical institutions, and health self-assessment scores were statistically significant. Compared with Logistic analysis, the decision tree showed lower error rate of classification. Logistic regression model's error rate of classification was 31.4%, showing that the differences in visit rates among age, ethnic, residence patterns, daily consumption index, social support scores, travel time to medical institutions, and health self-assessment scores were statistically significant. The decision tree model's error rate of classification was 28.6%, showing six main influencing factors, including the travel time to medical institutions, cohabitants, education level, age, whether adult children provide economic support and social support score. The importance of these predictors were 0.42, 0.21, 0.13, 0.11, 0.07 and 0.06, respectively.

CONCLUSION

In poor rural areas, medical resources, economic affordability, family and individual socio-demographic characteristics are the key factors affecting decision-making for the aged. It is necessary to integrate the improvement of the health care of the aged into the overall development of the society. And comprehensive interventions should be adopted to improve the outpatient utilization for aged in poor rural areas.

CRISPR-mediated Loss of Function Analysis in Cerebellar Granule Cells Using In Utero Electroporation-based Gene Transfer

Brain malformation is often caused by genetic mutations. Deciphering the mutations in patient-derived tissues has identified potential causative factors of the diseases. To validate the contribution of a dysfunction of the mutated genes to disease development, the generation of animal models carrying the mutations is one obvious approach. While germline genetically engineered mouse models (GEMMs) are popular biological tools and exhibit reproducible results, it is restricted by time and costs. Meanwhile, non-germline GEMMs often enable exploring gene function in a more feasible manner. Since some brain diseases (e.g., brain tumors) appear to result from somatic but not germline mutations, non-germline chimeric mouse models, in which normal and abnormal cells coexist, could be helpful for disease-relevant analysis. In this study, we report a method for the induction of CRISPR-mediated somatic mutations in the cerebellum. Specifically, we utilized conditional knock-in mice, in which Cas9 and GFP are chronically activated by the CAG (CMV enhancer/chicken ß-actin) promoter after Cre-mediated recombination of the genome. The self-designed single-guide RNAs (sgRNAs) and the Cre recombinase sequence, both encoded in a single plasmid construct, were delivered into cerebellar stem/progenitor cells at an embryonic stage using in utero electroporation. Consequently, transfected cells and their daughter cells were labeled with green fluorescent protein (GFP), thus facilitating further phenotypic analyses. Hence, this method is not only showing electroporation-based gene delivery into embryonic cerebellar cells but also proposing a novel quantitative approach to assess CRISPR-mediated loss-of-function phenotypes.

CRISPR-engineered genome editing for the next generation neurological disease modeling

Neurological disorders often occur because of failure of proper brain development and/or appropriate maintenance of neuronal circuits. In order to understand roles of causative factors (e.g. genes, cell types) in disease development, generation of solid animal models has been one of straight-forward approaches. Recent next generation sequencing studies on human patient-derived clinical samples have identified various types of recurrent mutations in individual neurological diseases. While these discoveries have prompted us to evaluate impact of mutated genes on these neurological diseases, a feasible but flexible genome editing tool had remained to be developed. An advance of genome editing technology using the clustered regularly interspaced short palindromic repeats (CRISPR) with the CRISPR-associated protein (Cas) offers us a tremendous potential to create a variety of mutations in the cell, leading to "next generation" disease models carrying disease-associated mutations. We will here review recent progress of CRISPR-based brain disease modeling studies and discuss future requirement to tackle current difficulties in usage of these technologies.

Meta-analysis on shift work and risks of specific obesity types

AIMS

This systematic review and meta-analysis evaluated the associations between shift work patterns and risks of specific types of obesity.

METHODS

PubMed was searched until March 2017 for observational studies that examined the relationships between shift work patterns and obesity. Odds ratio for obesity was extracted using a fixed-effects or random-effects model. Subgroup meta-analyses were carried out for study design, specific obesity types and characteristics of shift work pattern.

RESULTS

A total of 28 studies were included in this meta-analysis. The overall odds ratio of night shift work was 1.23 (95% confidence interval = 1.17-1.29) for risk of obesity/overweight. Cross-sectional studies showed a higher risk of 1.26 than those with the cohort design (risk ratio = 1.10). Shift workers had a higher frequency of developing abdominal obesity (odds ratio = 1.35) than other obesity types. Permanent night workers demonstrated a 29% higher risk than rotating shift workers (odds ratio 1.43 vs. 1.14).

CONCLUSION

This meta-analysis confirmed the risks of night shift work for the development of overweight and obesity with a potential gradient association suggested, especially for abdominal obesity. Modification of working schedules is recommended, particularly for prolonged permanent night work. More accurate and detailed measurements on shift work patterns should be conducted in future research.

Versatile Roles of the Chromatin Remodeler CHD7 during Brain Development and Disease

CHD7 (Chromo-Helicase-DNA binding protein 7) protein is an ATP-dependent chromatin remodeler. Heterozygous mutation of the CHD7 gene causes a severe congenital disease known as CHARGE syndrome. Most CHARGE syndrome patients have brain structural anomalies, implicating an important role of CHD7 during brain development. In this review, we summarize studies dissecting developmental functions of CHD7 in the brain and discuss pathogenic mechanisms behind neurodevelopmental defects caused by mutation of CHD7. As we discussed, CHD7 protein exhibits a remarkably specific and dynamic expression pattern in the brain. Studies in human and animal models have revealed that CHD7 is involved in multiple developmental lineages and processes in the brain. Mechanistically, CHD7 is essential for neural differentiation due to its transcriptional regulation in progenitor cells.

Comparison of Immune Responses in Pigs Infected with Chinese Highly Pathogenic PRRS Virus Strain HV and North American Strain NADC-20

Introduction:

Chinese HP-PRRSV characterized by high morbidity and mortality of all ages of pigs emerged since 2006 in China. The immune response of HP-PRRSV was never compared with conventional low pathogenic PRRSV strain.

Objective:

In this study, we compared the immune responses elicited by a Chinese HP-PRRSV strain HV and a North American RRSV strain NADC20 infections.

Result:

Pigs infected with NADC-20 showed significantly higher Ab titers than HV-PRRSV infected pigs at 9 DPI. Infection with HV-PRRSV induced a significantly higher levels of TNF-α and IL-10 in both sera and lung tissues and higher IFN-α and IFN-γ in the serum. Flow cytometry analysis showed that HV-PRRSV infected pigs generated significantly higher frequencies of NK cells in the peripheral blood and Th/memory, CTLs, and T-reg cells in the lung as compared with NADC-20 infected pigs.

Conclusion:

This study demonstrates that different immunity profiles were elicited by HV-PRRSV and NADC-20, and these differences may contribute to the distinct pathogenesis of HV-PRRSV and NADC-20.

Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke

BACKGROUND AND PURPOSE

Motor impairment is the most common deficit after stroke. Our aim was to evaluate whether diffusional kurtosis imaging can detect corticospinal tract microstructural changes in the acute phase for patients with first-ever ischemic stroke and motor impairment and to assess the correlations between diffusional kurtosis imaging-derived diffusion metrics for the corticospinal tract and motor impairment 3 months poststroke.

MATERIALS AND METHODS

We evaluated 17 patients with stroke who underwent brain MR imaging including diffusional kurtosis imaging within 4 days after the onset of symptoms. Neurologic evaluation included the Fugl-Meyer Upper Extremity Motor scale in the acute phase and 3 months poststroke. For the corticospinal tract in the lesioned and contralateral hemispheres, we estimated with diffusional kurtosis imaging both pure diffusion metrics, such as the mean diffusivity and mean kurtosis, and model-dependent quantities, such as the axonal water fraction. We evaluated the correlations between corticospinal tract diffusion metrics and the Fugl-Meyer Upper Extremity Motor scale at 3 months.

RESULTS

Among all the diffusion metrics, the largest percentage signal changes of the lesioned hemisphere corticospinal tract were observed with axial kurtosis, with an average 12% increase compared with the contralateral corticospinal tract. The strongest associations between the 3-month Fugl-Meyer Upper Extremity Motor scale score and diffusion metrics were found for the lesioned/contralateral hemisphere corticospinal tract mean kurtosis (ρ = -0.85) and axial kurtosis (ρ = -0.78) ratios.

CONCLUSIONS

This study was designed to be one of hypothesis generation. Diffusion metrics related to kurtosis were found to be more sensitive than conventional diffusivity metrics to early poststroke corticospinal tract microstructural changes and may have potential value in the prediction of motor impairment at 3 months.

[Effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand]

Objective: To investigate the effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand. Methods: A total of 9 cases acute and chronic suppurative tenosynovitis patients from January 2013 to April 2015 in Puai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were retrospectively reviewed. There were 6 males and 3 females, aging from 27 to 65 years, the average age was 55 years. There were 3 cases of index finger, 3 cases of middle finger, 2 cases of ring finger, 1 case include three fingers. The infection causes included stabbing with fishbone in 3 cases, stabbing with animal bone fragments in 3 cases, wound by sawdust in 3 cases, meat grinder injury in 1 case, multiple fingers crush injury postoperative infection of garbage truck in 1 case. Bacterial infection included 2 cases with Staphylococcus aureus, 2 cases with Staphylococcus epidermidis, 1 case with normal Escherichia coli, 1 case with mixed infection of Enterobacter aerogenes, Klebsiella oxytoca and Staphylococcus, 1 case with Bauman Acinetobacter bacillus, 1 case with Proteus mirabilis and 1 case of no growth of pathogenic bacteria culture. After thorough debridement, vacuum sealing drainage was used to observe the characteristics of irrigation fluid, the formation of cavity inflammation, the prognosis of infection and the recovery of finger function. Results: Seven patients with suppurative tenosynovitis were treated for 7 to 14 days, replaced the vacuum sealing drainage dressing once; 1 patient was an illustration of the finger tip defect flap infected patients after 21 days of treatment, replaced the vacuum sealing drainage dressing twice, 1 patient was an illustration of the central refers to trauma, postoperative infection patients 28 d, replaced three times in the VSD. The follow-up time was 3 to 12 months (mean 8.2 months), 7 patients without tendon necrosis, secondary suture with no infection, 2 cases of traumatic surgery of patients with infection, tendon necrosis was removed, the infection has been effectively controlled, secondary suture with no infection. There were 6 cases were good and 3 cases were poor in the evaluation of postoperative finger function. Conclusion: Thoroughly debridement after vacuum sealing drainage in the treatment of suppurative tenosynovitis of hand has satisfactory curative effect.

Chd7 is indispensable for mammalian brain development through activation of a neuronal differentiation programme

Mutations in chromatin modifier genes are frequently associated with neurodevelopmental diseases. We herein demonstrate that the chromodomain helicase DNA-binding protein 7 (Chd7), frequently associated with CHARGE syndrome, is indispensable for normal cerebellar development. Genetic inactivation of Chd7 in cerebellar granule neuron progenitors leads to cerebellar hypoplasia in mice, due to the impairment of granule neuron differentiation, induction of apoptosis and abnormal localization of Purkinje cells, which closely recapitulates known clinical features in the cerebella of CHARGE patients. Combinatory molecular analyses reveal that Chd7 is required for the maintenance of open chromatin and thus activation of genes essential for granule neuron differentiation. We further demonstrate that both Chd7 and Top2b are necessary for the transcription of a set of long neuronal genes in cerebellar granule neurons. Altogether, our comprehensive analyses reveal a mechanism with chromatin remodellers governing brain development via controlling a core transcriptional programme for cell-specific differentiation.

[The advantage of artery approach in lymph node sorting of rectal cancer]

Objective: To explore the technical advantages of artery approach in lymph node sortingofrectal cancer. Methods: Sixty patients with rectal cancer who treated in general surgery department of Henan provincial tumor hospitalfrom July 2015 to January 2016 were enrolled. Patientswere divided into two groupsrandomly.Lymph node sorting methods of control group andobservation group were the traditional method and the artery approach method respectively. The total number of lymph nodes, the average inspection number, the patients number of lymph nodes less than 12, the number of positive lymph nodes, the metastasis rate of the patients, the number of average diameter less than 5 mm, the number of the positive lymph nodes which average diameter less than 5 mm, the sorting time of lymph nodes, the total number of every stationand other indicators were collected and compared. Results: There wasa significant difference between the observation group and the control groupin the total number(553 vs 395, P<0.05), the number of positive ones(96 vs 54, P<0.05), average inspection number(18.43±5.93 vs 13.27±1.96, P=0.000), the sorting time (min) (14.1±2.5 vs 17.4±3.2, P=0.000), the average diameter less than 5 mm number(4.73±1.31 vs 1.23±1.14, P=0.000), the number of positive ones average diameter less than 5 mm(0.97±1.03 vs 0.20±0.55, P=0.010), the first(8.17±4.58 vs 5.07±1.96, P=0.000) and second station(6.57±1.87 vs 4.90±1.69, P=0.001)inspection number.The inspection number less than 12, the positive rate of lymph node, the metastatic rate of the patient and the inspection number of third station have no significant differences (all P≥0.05). Conclusion: Theartery approach method inrectal cancer lymph node inspectionhas many advantages such as simple operation, obtaining more lymph nodes and more accurate pathological staging.