A comparison study on mental health status between suicide survivors and survivors of accidental deaths in rural China

Suicide has become a major public health problem worldwide. For every suicide there are six suicide survivors, a term referring to family members or friends of a person who has died by suicide. Within the literature there has been ongoing debate regarding the bereavement process and if it differs in survivors of suicide as opposed to survivors of those who have died from accidental death. There are scarcely any published reports on comparison between these two groups of survivors in China. In this study, we aimed to explore the difference of mental health status between suicide survivors and survivors of accidental deaths in China. We used a cross-sectional study design to collect data of survivors. Consecutive sampling was used and 92 suicide survivors and 64 survivors of accidental deaths were interviewed. The Symptom Checklist-90-Revised was used to assess the survivors' mental health status. After controlling for demographic variables and time interval between death and interview, no significant differences were found on mental health status between these two groups of survivors. Several explanations might account for the lack of differences. Further studies employing qualitative measures and suicide-specific instruments are needed to explore the bereavement of Chinese suicide survivors.

A systematic review of the prevalence of nutrition labels and completeness of nutrient declarations on pre-packaged foods in China

BACKGROUND

The Chinese government launched a voluntary nutrition labelling code in 2007 and made it mandatory since 1 January 2013. This article aims to quantify the prevalence of nutrition labels and the completeness of nutrient declarations on pre-packaged foods in China and to explore the impact of the 2007 code.

METHODS

A systematic search of the published and grey literature was done, and a random-effects meta-analysis was used to obtain summary estimates.

RESULTS

There were 15 surveys identified from 13 reports. For 44% (95% confidence interval: 37-51%) of the 22 636 food items, the product label provided information on one or more nutrients. There was significant heterogeneity between the surveys (I(2) = 99%, P < 0.001) raising some uncertainty about the reliability of the estimate. The heterogeneity was in part explained by differences in labelling between food categories (P < 0.001) but not by changes in the prevalence of nutrition labels over time (P = 0.36).

CONCLUSIONS

Most pre-packaged foods in this survey had a nutrition label non-compliant with current Chinese nutrition labelling standards. The voluntary code launched in 2007 had limited impact on nutrition labelling. There is significant scope for the recently introduced mandatory labelling requirements to improve nutrition labelling in China.

Muscarinic-mediated vasoconstriction in human, rat and sheep umbilical cords and related vasoconstriction mechanisms

OBJECTIVE

The umbilical cord provides nutrition and oxygen to the fetus. The aim of this study was to determine the effects of acetylcholine (ACh) on umbilical cords from humans and other mammals, and the mechanisms of ACh-mediated vasoconstriction in the human umbilical cord.

DESIGN

Human and animal umbilical cords used in vascular and cellular experiments.

SETTING

Institute for Fetology, First Hospital of Soochow University, Suzhou, China.

POPULATION

A total of 85 pregnant women, 16 Sprague Dawley rats and seven pregnant sheep.

METHODS

Umbilical cord veins and arteries from humans, rats and sheep, aortas and mesenteric arteries from rats, and mesenteric, carotid and femoral arteries from ovine fetuses were used to compare vascular functions in response to ACh and to determine the mechanisms of ACh-mediated umbilical vasoconstriction. Vascular tension and ion channel currents were measured on isolated vessels and smooth muscle cells from human umbilical cords.

MAIN OUTCOME MEASURES

Provision of new evidence to conclude that ACh-stimulated vasoconstriction is common to all umbilical cords, and cellular mechanisms are linked to potassium channels.

RESULTS

ACh caused reliable vasoconstriction in umbilical veins/arteries in humans, rats and sheep, but not in any other vessels, including fetal vessels. Atropine inhibited the effects of ACh. The mRNA of ACh-muscarinic receptor subtypes M1 -M5 was expressed in human umbilical vessels. The protein kinase C antagonist GF109203X and the calcium inhibitor nifedipine decreased ACh-induced vasoconstriction in human umbilical vessels. ACh also caused a reduction in whole-cell potassium channel currents and the single-channel current of large-conductance calcium-activated potassium (BKca) channels.

CONCLUSION

Umbilical vessels are significantly different from other vessels in their response to ACh. BKca channels in smooth muscle cells may play important roles in ACh-mediated vasoconstriction in human umbilical cords. This information may be important for fetal medicine and practice with regard to the effect on fetal development of umbilical vascular functions.

Stapled vs hand suture closure of loop ileostomy: a meta-analysis

AIM

Loop ileostomies are widely used in colorectal surgery to reduce the consequences of distal anastomotic failure. The optimal surgical technique for their closure has yet not been defined. A meta-analysis was performed to compare the outcome after stapled or hand sutured ileostomy closure.

METHOD

An electronic literature search of EMBASE, PubMed and the Cochrane Library was undertaken to identify studies reporting stapled and hand sutured ileostomy closure. End-points included postoperative small bowel obstruction (SBO), anastomotic leakage, wound infection, overall postoperative complications, operation time, hospital stay and surgery-related cost.

RESULTS

Fourteen studies including 5084 patients were identified. Meta-analysis showed that stapled closure was associated with a lower rate of SBO overall (OR = 0.56, P < 0.00001) and early (within 30 days of closure) SBO (OR = 0.51, P < 0.00001). This difference persisted for direct ileostomy closure (OR = 0.62, P = 0.02) or closure with bowel resection and hand sewn anastomosis (OR = 0.44, P < 0.00001). Stapled closure required a shorter inpatient stay (mean difference -1.22, P < 0.0001) and operating time (mean difference -11.21, P = 0.01). No significant difference was noted between the two techniques in terms of anastomotic leakage, wound infection, overall complications or cost.

CONCLUSION

Stapled side-to-side anastomosis is associated with fewer complications, especially SBO, than hand sewn ileostomy closure by direct suture or resection and anastomosis. It is quicker to perform and associated with fewer postoperative bowel obstructions.

Obesity index and the risk of diabetes among Chinese women with prior gestational diabetes

AIMS

There is some confusion regarding which anthropometric measurement of adiposity should be used to indicate diabetes, especially for Asians. The present study was to evaluate different indicators of adiposity (BMI, waist circumference and body fat) with Type 2 diabetes risk among women with prior gestational diabetes mellitus.

METHODS

We performed a cross-sectional survey in 1263 women with gestational diabetes at 1-5 years after delivery. Logistic regression models were used to estimate the association of BMI, waist circumference and body fat with Type 2 diabetes risk.

RESULTS

BMI, waist circumference and body fat were all associated with an increased risk of Type 2 diabetes among women with prior gestational diabetes (all P(trend) < 0.001). After adjustment for waist circumference and body fat, the positive association of BMI with Type 2 diabetes risk became non-significant and reversed. There was a significantly positive association of waist circumference with Type 2 diabetes risk after adjustment for BMI, and a significantly positive association of body fat with Type 2 diabetes risk after adjustment for both BMI and waist circumference. When the joint effects were examined, the significantly positive associations of waist circumference or body fat with Type 2 diabetes risk were consistent among women with different levels of BMI, and the positive association of BMI and Type 2 diabetes risk was significant among women with gestational diabetes with a waist circumference of ≥ 50% or body fat ≥ 50%.

CONCLUSIONS

BMI, waist circumference and body fat were all associated with an increased risk of Type 2 diabetes, and waist circumference and body fat were better indicators than BMI for Type 2 diabetes risk among Chinese women with prior gestational diabetes.

Identification and characterization of the novel Col10a1 regulatory mechanism during chondrocyte hypertrophic differentiation

The majority of human skeleton develops through the endochondral pathway, in which cartilage-forming chondrocytes proliferate and enlarge into hypertrophic chondrocytes that eventually undergo apoptosis and are replaced by bone. Although at a terminal differentiation stage, hypertrophic chondrocytes have been implicated as the principal engine of bone growth. Abnormal chondrocyte hypertrophy has been seen in many skeletal dysplasia and osteoarthritis. Meanwhile, as a specific marker of hypertrophic chondrocytes, the type X collagen gene (COL10A1) is also critical for endochondral bone formation, as mutation and altered COL10A1 expression are often accompanied by abnormal chondrocyte hypertrophy in many skeletal diseases. However, how the type X collagen gene is regulated during chondrocyte hypertrophy has not been fully elucidated. We have recently demonstrated that Runx2 interaction with a 150-bp mouse Col10a1 cis-enhancer is required but not sufficient for its hypertrophic chondrocyte-specific reporter expression in transgenic mice, suggesting requirement of additional Col10a1 regulators. In this study, we report in silico sequence analysis of this 150-bp enhancer and identification of its multiple binding factors, including AP1, MEF2, NFAT, Runx1 and TBX5. Using this enhancer as bait, we performed yeast one-hybrid assay and identified multiple candidate Col10a1-interacting genes, including cyclooxygenase 1 (Cox-1) and Cox-2. We have also performed mass spectrometry analysis and detected EF1-alpha, Fus, GdF7 and Runx3 as components of the specific complex formed by the cis-enhancer and nuclear extracts from hypertrophic MCT (mouse chondrocytes immortalized with large T antigen) cells that express Col10a1 abundantly. Notably, some of the candidate genes are differentially expressed in hypertrophic MCT cells and have been associated with chondrocyte hypertrophy and Runx2, an indispensible Col10a1 regulator. Intriguingly, we detected high-level Cox-2 expression in hypertrophic MCT cells. Electrophoretic mobility shift assay and chromatin immunoprecipitation assays confirmed the interaction between Cox-2 and Col10a1 cis-enhancer, supporting its role as a candidate Col10a1 regulator. Together, our data support a Cox-2-containing, Runx2-centered Col10a1 regulatory mechanism, during chondrocyte hypertrophic differentiation.

Bio-inspired varying subspace based computational framework for a class of nonlinear constrained optimal trajectory planning problems

Biological species have produced many simple but efficient rules in their complex and critical survival activities such as hunting and mating. A common feature observed in several biological motion strategies is that the predator only moves along paths in a carefully selected or iteratively refined subspace (or manifold), which might be able to explain why these motion strategies are effective. In this paper, a unified linear algebraic formulation representing such a predator-prey relationship is developed to simplify the construction and refinement process of the subspace (or manifold). Specifically, the following three motion strategies are studied and modified: motion camouflage, constant absolute target direction and local pursuit. The framework constructed based on this varying subspace concept could significantly reduce the computational cost in solving a class of nonlinear constrained optimal trajectory planning problems, particularly for the case with severe constraints. Two non-trivial examples, a ground robot and a hypersonic aircraft trajectory optimization problem, are used to show the capabilities of the algorithms in this new computational framework.

Role of somatic cells on dairy processes and products: a review

Somatic cells are an important component naturally present in milk, and somatic cell count is used as an indicator of udder health and milk quality. The role of somatic cells in dairy processes and products is ill-defined in most studies because the role of these cells combines also the concomitance of physicochemical modifications of milk, bacterial count, and the udder inflammation in the presence of high somatic cell count. The aim of this review is to focus on the role of somatic cells themselves and of endogenous enzymes from somatic cells in milk, in dairy transformation processes, and in characteristics of final products overcoming biases due to other factors. The immune function of somatic cells in the udder defense and their protective role in milk will be primarily considered. Different characteristics of milk induced by various somatic cell counts, types, and their endogenous enzymes influencing directly the technological properties of milk and the final quality of dairy products will be discussed as well. By comparing methods used in other studies and eliminating biases due to other factors not considered in these studies, a new approach has been suggested to evaluate the effective role of somatic cells on dairy processes and products. In addition, this new approach allows the characterization of somatic cells and their endogenous enzymes and, in future research, will allow the clarification of mechanisms involved in the release of these components from somatic cells during dairy processes, particularly in cheese technologies.

The effects of early life lead exposure on the expression of interleukin (IL) 1β, IL-6, and glial fibrillary acidic protein in the hippocampus of mouse pups

The present study was undertaken to investigate the effects of maternal lead (Pb) exposure on the expression of interleukin (IL) 1β, IL 6, and glial fibrillary acidic protein (GFAP) in hippocampus of mice offspring. Pb exposure initiated from the beginning of gestation to weaning. Lead acetate (PbAc) administered in drinking solutions was dissolved in distilled deionized water at the concentrations of 0.1, 0.5 and 1% groups ,respectively. On the postnatal day 21, the Pb levels in their blood and hippocampus were determined by graphite furnace atomic absorption spectrometry. The expression of IL 1β, IL 6, and GFAP in hippocampus was measured by immunohistochemistry and Western blotting. The Pb levels in blood and hippocampus of all Pb-exposed groups were significantly higher than that of the control group ( p < 0.05). The expression of IL-1β, IL-6, and GFAP was increased in Pb-exposed groups in comparison with the control group ( p < 0.05). The high expression of IL-1β, IL-6, and GFAP in the hippocampus of pups may contribute to the neurotoxicity associated with maternal Pb exposure.

Lung recruitment maneuver during proportional assist ventilation of preterm infants with acute respiratory distress syndrome

OBJECTIVE

To investigate the effect of lung recruitment maneuver (LRM) with positive end-expiratory pressure (PEEP) on oxygenation and outcomes in preterm infants ventilated by proportional assist ventilation (PAV) for respiratory distress syndrome (RDS).

STUDY DESIGN

Preterm infants on PAV for RDS after surfactant randomly received an LRM (group A, n=12) or did not (group B, n=12). LRM entailed increments of 0.2 cm H2O PEEP every 5 min, until fraction of inspired oxygen (FiO2)=0.25. Then PEEP was reduced and the lung volume was set on the deflation limb of the pressure/volume curve. When saturation of peripheral oxygen fell and FiO2 rose, we reincremented PEEP until SpO2 became stable.

RESULT

Group A and B infants were similar: gestational age 29.5 ± 1.0 vs 29.4 ± 0.9 weeks; body weight 1314 ± 96 vs 1296 ± 88 g; Silverman Anderson score for babies at start of ventilation 8.6 ± 0.8 vs 8.2 ± 0.7; initial FiO2 0.56 ± 0.16 vs 0.51 ± 0.14, respectively. The less doses of surfactant administered in group A than that in group B (P<0.05). Groups A and B showed different max PEEP during the first 12 h of life (8.4 ± 0.5 vs 6.7 ± 0.6 cm H2O, P=0.00), time to lowest FiO2 (101 ± 18 versus 342 ± 128 min; P=0.000) and O2 dependency (7.83 ± 2.04 vs 9.92 ± 2.78 days; P=0.04). FiO2 levels progressively decreased (F=43.240, P=0.000) and a/AO2 ratio gradually increased (F=30.594, P=0.000). No adverse events and no differences in the outcomes were observed.

CONCLUSION

LRM led to the earlier lowest FiO2 of the first 12 h of life and a shorter O2 dependency.

Platelets provoke distinct dynamics of immune responses by differentially regulating CD4+ T-cell proliferation

BACKGROUND

Platelets regulate responses of type 1 T helper (Th1), Th17, and regulatory T (Treg) cells. However, little is known about how platelets influence the dynamics of CD4(+) T-cell responses.

OBJECTIVES

To investigate the dynamics of platelet-regulated CD4(+) T-cell activation and cross-talk and their underlying mechanisms.

METHODS AND RESULTS

Human CD3/CD28-challenged CD4(+) T cells were cultured without or with autologous platelets. Th1, Th17, and Treg responses were monitored during 5 days. Platelets simultaneously enhanced activation of Th1, Th17, and Treg cells within 48-h coculture. Thereafter, platelets remained augmentative for Treg but turned suppressive for Th1/Th17 responses. Without platelets, FoxP3 blockade inhibited Treg activation, which subsequently enhanced Th1 activation. In platelet-T-cell cocultures, however, FoxP3 blockade had no effect on Treg or Th1 activation. Neutralization of platelet-derived transforming growth factor β, but not Treg-derived interleukin-10, enhanced Th1 activation. These data suggest that Treg cells have limited impact on, while platelets are the primary regulator for Th1 suppression during the second phase of coculture. Combining carboxyfluorescein succinimidyl ester and FoxP3 staining, platelets were found to enhance Treg response by promoting cell proliferation of FoxP3(+) T cells and to induce the suppression phrase of Th1 responses by inhibiting FoxP3(-) T-cell proliferation. The latter was markedly attenuated by TGFβ neutralization.

CONCLUSIONS

Platelets constantly promote Treg cell response but exert a biphasic regulation on Th1/Th17 activation, namely a transient enhancement followed by a secondary suppression. The distinct regulations are achieved by transforming growth factor β-mediated selective inhibition of FoxP3(-) T-cell proliferation. This represents a novel mechanism of platelet-regulated CD4(+) effector cell responses.