Phenotypic analysis of atopic dermatitis in children aged 1-12 months: elaboration of novel diagnostic criteria for infants in China and estimation of prevalence

BACKGROUND

Atopic dermatitis (AD) is the most common skin disorder in infancy. However, the diagnosis and definite significance of infantile AD remains a debated issue.

OBJECTIVE

To analyse the phenotypes of AD in infancy, to establish diagnostic criteria and to estimate the prevalence of this condition in China.

METHODS

This is a multicentric study, in which 12 locations were chosen from different metropolitan areas of China. Following careful and complete history-taking and skin examination, the definite diagnosis of AD was made and the severity based on the SCORAD index was determined by local experienced dermatologists. Based on the detailed phenotyping, the major and representative clinical features of infantile AD were selected to establish the diagnostic criteria and evaluate their diagnostic efficacy.

RESULTS

A total of 5967 infants were included in this study. The overall point prevalence of AD was 30.48%. The infantile AD developed as early as at the second month of life, and its incidence peaked in the third month of life at 40.81%. The proportion of mild, moderate and severe AD was 67.40%, 30.57% and 2.03%, respectively. The most commonly seen manifestations in the infantile AD were facial dermatitis (72.07%), xerosis (42.72%) and scalp dermatitis (27.93%). We established the novel diagnostic criteria of infants, which included: (i) onset after 2 weeks of birth; (ii) pruritus and/or irritability and sleeplessness comparable with lesions; and (iii) all two items above with one of the following items can reach a diagnosis of AD: (i) eczematous lesions distributed on cheeks and/or scalp and/or extensor limbs, and (ii) eczematous lesions on any other parts of body accompanied by xerosis.

CONCLUSIONS

In China, the prevalence of AD in infancy is 30.48% according to clinical diagnosis of dermatologists. The novel Chinese diagnostic criteria for AD in infants show a higher sensitivity and comparable specificity.

[A prospective cohort study on the duration of sleep and risk of all-cause mortality among patients with type 2 diabetes]

Objective: To investigate the relationship between duration of sleep and all-cause mortality in patients with type 2 diabetes. Methods: A total of 17 452 type 2 diabetic patients who were under the National Basic Public Health Service Project, in Changshu county, Qinghe district and Huai'an district in Huai'an city of Jiangsu province, were recruited as participants. Cox proportional hazards regression models were used to estimate the associations between different levels on the duration of sleep and all-cause mortality. Stratified analysis was performed according to factors as gender, age, and lifestyle. Results: Among the 67 912 person-years of observation, from the fo1low- up program, the median time of follow-up was 4 years, with 1 057 deaths occurred during the follow-up period. Taking patients with duration of sleep as 7 h/d for reference, the multivariate adjusted hazard ratios (95%CI) of all-cause mortality appeared as ≤6, 8, 9 and ≥10 h/d were 1.14 (0.94-1.37), 1.10 (0.91-1.32), 1.33 (1.05-1.70), and 1.52 (1.24-1.87), respectively which were associated with the duration of sleep. Data from the subgroup analysis showed that this was consistent with the whole population. Longer duration of sleep was associated with the all-cause mortality but no significant association was found between shorter duration of sleep and the all-cause mortality. Conclusion: Longer duration of sleep seemed to have increased the risk of all-cause mortality in type 2 diabetic patients.

[Estrogen and its receptors in hepatitis B virus-related hepatocellular carcinoma]

Hepatitis B virus (HBV) infection is the most common cause of hepatocellular carcinoma in China. Epidemiological surveys show that male have a much higher incidence of hepatocellular carcinoma than female. Studies have shown that estrogen and its receptors are associated to gender disparity in hepatocellular carcinoma, but the underlying molecular mechanisms has not yet been fully elucidated. This article reviews the possible mechanisms of estrogen and its receptors in the occurrence and progression of hepatitis B virus-related hepatocellular carcinoma.

[Impact of allergic airway diseases on risk of attention deficit hyperactivity disorder in school-age children]

Objective: To investigate the impact of allergic airway diseases on the risk of attention deficit hyperactivity disorder (ADHD) in school-age children. Method: Used stratified cluster sampling method, school-age children in first to sixth grade in primary schools in 9 randomly selected cities including Shanghai, Guangzhou, Xi'an, and Wuhan were enrolled in the study. Interview of parents with questionnaires, which included school-age individual and family social environment questionnaire (including history of diagnosed ADHD, allergic rhinitis, and bronchial asthma) and Children's Sleep Habits Questionnaire (CSHQ), were finished and collected during November to December in 2005.Diagnosed allergic rhinitis and asthma by specialist were independent variables and divided into following three categories as no allergic diseases (neither allergic rhinitis nor asthma), single allergic disease (allergic rhinitis or asthma), and combined allergic diseases (allergic rhinitis and asthma). Diagnosed ADHD as dependent variable, binary logistic regress model was used to analyze the risks of ADHD in school-age children. Result: Totally 23 791 questionnaires were handed out, while 22 018 were collected. The children had an average age of (8.8±1.8) years, within which 10 869 were male, and 11 021 were female. The risk ratios of ADHD were 2.197 (95%CI: 1.823-2.648) and 3.150 (95%CI: 2.082-4.760) in children with single allergic disease and combined allergic diseases separately. There was no significant difference after adjusting for the factor of sleep habits, as the risk ratios were 2.055 (95%CI: 1.683-2.508) and 3.140 (95%CI: 2.061-4.784) in children with single and combined allergic airway disease separately. Conclusion: Allergic rhinitis and bronchial asthma increased the risk of ADHD, not depending on sleep habits. Hence, allergic airway diseases could be independent risk factors of ADHD.

Natural history of serum HBV-RNA in chronic HBV infection

Virus-like particles encapsulating HBV-RNA represent a serum biomarker for assessing viral replication activity in clinical practice. However, baseline levels of serum HBV-RNA and their associations with viral replicative intermediates and liver disease in phases of chronic hepatitis B remain unknown. In this cross-sectional study, 102 patients were categorized into immune-tolerant (IT), HBeAg-positive immune active (HBeAg+IA), inactive carrier (IC) and HBeAg-negative immune active (HBeAg-IA) phases. HBV-RNA in serum samples and in 66 paired liver biopsies were quantified and correlated with serum ALT levels, histopathological scores and the levels of other viral replicative intermediates. Mean levels of serum HBV-RNA differed among phases, with the highest levels among IT (6.78 ± 0.83 log₁₀ copies mL^-1 ) patients, followed by HBeAg+IA (5.73 ± 1.16 log₁₀ copies mL^-1 ), HBeAg-IA (4.52 ± 1.25 log₁₀ copies mL^-1 ) and IC (2.96 ± 0.40 log₁₀ copies mL^-1 ) patients. Serum HBV-RNA levels correlated with HBV DNA in all phases, although correlations with other viral replicative intermediates weakened or disappeared when cases were stratified into phases. Distinct compositions of viral products were found among phases: the ratio of HBsAg to serum HBV-RNA was highest in IC patients, while the ratio of serum HBV-RNA to intrahepatic HBV-RNA and the ratio of intrahepatic HBV-DNA to intrahepatic HBV-RNA were significantly higher in IT patients. In conclusion, baseline levels of HBV-RNA and the composition of viral replicative intermediates differ significantly across the natural course of chronic HBV infection. These findings shed light on the nature of viral replication and pathogenesis of disease among different phases of chronic HBV infection.

Depressive symptoms and untreated coronal dental caries among adults ages 21-64 years, NHANES 2013-2014

BACKGROUND

Depression has been linked to poor oral health among patients seeking dental care. However, systematic research on the relationship between depressive symptoms and oral health is limited.

OBJECTIVE

To examine the association of depressive symptoms with untreated dental caries among adults aged 21-64 years.

BASIC RESEARCH DESIGN

Cross-sectional secondary analysis.

SETTING

The data were extracted national data collected in the United States (2013-2014 National Health Nutrition and Examination Survey).

PARTICIPANTS

The sample consisted of 3,127 non-institutionalized civilians.

MAIN OUTCOME MEASURE

Untreated coronal dental caries (yes, no) was the key outcome variable. Depressive symptom categories (none, moderate, and severe) were derived from the Patient Health Questionnaire-9 Depression Scale.

RESULTS

In the study sample, 33.4% of adults had untreated coronal dental caries. Most participants (77.9%) did not report depressive symptoms; 13.9% had mild and 8.2% had moderate or severe depressive symptoms. In unadjusted analyses, individuals with mild (Odds Ratio = 1.62 [95% CI: 1.26, 2.08] and moderate/severe depressive symptoms (Odds Ratio = 2.70 [95% CI: 1.81, 4.02]) were more likely to have untreated coronal caries as compared with individuals without depressive symptoms. When sex, race, age, education, family income-to-poverty ratio, dental visits, history of previous dental restorations, health insurance, and smoking were included into the model, the associations were no longer statistically significant (1.27 [95% CI: 0.96, 1.69] and 1.61 [95% CI: 0.95, 2.73], respectively).

CONCLUSION

The relationship between depressive symptoms and untreated coronal dental caries failed to remain significant after the addition of tobacco usage in the analysis.

A prospective study of the hypertriglyceridemic waist phenotype and risk of incident ischemic stroke in a Chinese rural population

OBJECTIVES

The hypertriglyceridemic waist phenotype has been reported as a practical tool to screen people with an increased risk of coronary artery disease and type 2 diabetes. The aim of this study was to investigate the relationship between the phenotype and ischemic stroke in a rural population in south China.

MATERIALS AND METHODS

A total of 4081 participants aged over 35 years old without a stroke history were surveyed in 2009 and followed up from May 2014 to January 2016. The hypertriglyceridemic waist phenotype was defined as a waist circumference ≥90 cm and a triglyceride level ≥2.0 mmol/L in males, and a waist circumference ≥85 cm and a triglyceride level ≥1.5 mmol/L in females. A Cox regression model was used to estimate the association of the phenotype and ischemic stroke.

RESULTS

After a mean of 5.16 years of follow-up, 138 individuals developed ischemic stroke. The hypertriglyceridemic waist phenotype was significantly associated with an increased risk of ischemic stroke before and after adjustment for confounding factors; the hazard ratios and 95% confidence intervals were 1.94 (1.27-2.96) and 1.71 (1.05-2.78), respectively. Further stratified analysis confirmed the associations in females (2.37 [1.09-5.14]) and smokers (3.20 [1.30-7.92]). A significant association of the phenotype and ischemic stroke risk was observed in subjects with normal glucose levels (2.94 [1.58-5.47]) but not in subjects with impaired fasting glucose and diabetes.

CONCLUSIONS

The hypertriglyceridemic waist phenotype is associated with an increased risk of ischemic stroke and might be a simple tool to screen individuals with a high risk for ischemic stroke.

Identifying metabolic elements that contribute to productivity of 1-propanol bioproduction using metabolomic analysis

INTRODUCTION

Previously constructed Escherichia coli strains that produce 1-propanol use the native threonine pathway, or a heterologous citramalate pathway. However, based on the energy and cofactor requirements of each pathway, a combination of the two pathways produces synergistic effects that increase the theoretical maximum yield with a simultaneous unexplained increase in productivity.

OBJECTIVE

Identification of key factors that contribute to synergistic effect leading to 1-propanol yield and productivity improvement in E. coli with native threonine pathway and heterologous citramalate pathway.

METHOD

A combination of snapshot metabolomic profiling and dynamic metabolic turnover analysis were used to identify system-wide perturbations that contribute to the productivity improvement.

RESULT AND CONCLUSION

In the presence of both pathways, increased glucose consumption and elevated levels of glycolytic intermediates are attributed to an elevated phosphoenolpyruvate (PEP)/pyruvate ratio that is known to increase the function of the native phosphotransferase. Turnover analysis of nitrogen containing byproducts reveals that ammonia assimilation, required for the threonine pathway, is streamlined when provided with an NAD(P)H surplus in the presence of the citramalate pathway. Our study illustrates the application of metabolomics in identification of factors that alter cellular physiology for improvement of 1-propanol bioproduction.

Genetic association between the NLRP3 gene and acne vulgaris in a Chinese population

BACKGROUND

Acne vulgaris is a common chronic skin disease. Inflammation is an important pathogenetic mechanism of acne, and NLRP3 polymorphisms have been reported to be involved in the mediation and occurrence of the inflammation. However, only a few studies on NLRP3 and acne have been reported, and the mechanism remains unclear.

AIM

To investigate two SNPs in the NLRP3 gene in patients with acne vulgaris (AV) and healthy controls (HCs) in a Chinese population.

METHODS

A case-control study was performed with 428 patients with AV and 384 (HCs). The SNPs rs10754558 and rs4612666 of the NLRP3 gene were genotyped using PCR with sequence-specific primers. A dual luciferase reporter assay was performed to determine whether the SNP rs10754558 might be responsible for the altered NLRP3 gene expression in AV by disrupting the interaction between micro-RNA (miR)-4273 and NLRP3 mRNA. Additionally, the mRNA level of NLRP3 was measured by PCR in the two groups.

RESULTS

The frequencies of the G allele of rs10754558 were 0.54 in patients and 0.49 in HCs (P < 0.05). No significant difference was observed for SNP rs4612666. Dual luciferase reporter assay revealed that luciferase activity was downregulated by about 40% when the G allele of rs10754558 coexisted with miRNA-4273, indicating that the G allele might interfere with miR-4273 function and alter NLRP3 expression. The level of NLRP3 mRNA in patients with AV was significantly higher than that in HCs.

CONCLUSIONS

Our study suggests that the NLRP3 SNP rs10754558 is associated with the incidence of AV. The G allele might be a genetic risk factor for AV in the Chinese population.