Wildfire particulate exposure and risks of preterm birth and low birth weight in the Southwestern United States

OBJECTIVES

Wildfire air pollution is a growing concern on human health. The study aims to assess the associations between wildfire air pollution and pregnancy outcomes in the Southwestern United States.

STUDY DESIGN

This was a retrospective cohort study.

METHODS

Birth records of 627,404 singleton deliveries in 2018 were obtained in eight states of the Southwestern United States and were linked to wildfire-sourced fine particulate matter (PM2.5) and their constituents (black carbon [BC] and organic carbon [OC]) during the entire gestational period. A double-robust logistic regression model was used to assess the associations of wildfire-sourced PM2.5 exposures and preterm birth and term low birth weight, adjusting for non-fire-sourced PM2.5 exposure and individual- and area-level confounder variables.

RESULTS

Wildfire-sourced PM2.5 contributed on average 15% of the ambient total PM2.5 concentrations. For preterm birth, the strongest association was observed in the second trimester (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.05-1.07 for PM2.5; 1.06, 95% CI: 1.05-1.07 for BC; 1.04, 95% CI: 1.03-1.05 for OC, per interquartile range increment of exposure), with higher risks identified among non-smokers or those with low socio-economic status. For term low birth weight, the associations with wildfire-sourced PM2.5 exposures were consistently elevated for all trimesters except for the exposure averaged over the entire gestational period. Overall, the associations between wildfire-sourced PM2.5 and pregnancy outcomes were stronger than those with total PM2.5.

CONCLUSIONS

Wildfire-sourced PM2.5 and its constituents are linked to higher risks of preterm birth and term low birth weight among a significant US population than the effects of ambient total PM2.5.

Pretreatment synthetic MRI features for triple-negative breast cancer

AIM

To evaluate the quantitative parameters derived from synthetic magnetic resonance imaging (SyMRI) for predicting triple-negative breast cancer (TNBC).

MATERIALS AND METHODS

This prospective study enrolled participants with invasive ductal breast carcinoma (IDBC) and separated them into a TNBC group and a Non-TNBC group. Preoperative breast MRI included both the SyMRI and conventional MRI sequences. The quantitative parameters derived from the SyMRI included T1 and T2 relaxation times, proton density (PD), and their standard deviations (SD). Clinicopathological characteristics, conventional MRI findings, and quantitative synthetic parameters were assessed for all participants. Multivariable logistic regression analysis was performed to determine the potential independent imaging predictors for TNBC preoperatively. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of these parameters.

RESULTS

A total of 231 participants with histopathological proven IDBC were included in this study (n=46 in the TNBC group and n=185 in the Non-TNBC group). The TNBC group had significantly larger tumour size (p=0.011) and more frequent intratumoural cystic or necrotic lesions (p<0.001) as compared to the Non-TNBC group. The univariate analysis showed that the TNBC tumours had significantly higher T1 (p=0.006) and T2 (p<0.001) values than Non-TNBC tumours. Subsequent multivariable analysis indicated that T2 values and the presence of cystic or necrotic lesions were the independent predictors for TNBC.

CONCLUSION

The T2 from synthetic imaging and the presence of cystic degeneration or necrosis within the breast cancer may serve as potential imaging biomarkers for preoperative differentiation of TNBC from Non-TNBC.

Prevalence and influencing factors of anaemia among pregnant women in rural areas of Northwestern China

OBJECTIVES

Anaemia during pregnancy is a significant public health problem that adversely impacts both the mother and foetus. However, the factors influencing maternal anaemia in deprived areas of Northwestern China have not yet been thoroughly investigated. This study aimed to describe the prevalence and potential influencing factors of anaemia among expectant mothers in rural areas of Northwestern China.

STUDY DESIGN

This was a cross-sectional survey.

METHODS

A cross-sectional survey of 586 expectant mothers was conducted to investigate the prevalence of anaemia, prenatal healthcare coverage, dietary diversity and nutrient supplementation intake. The study population was selected from the sample areas using a random sampling method. Data were collected through a questionnaire, and haemoglobin concentrations were measured by a capillary blood test.

RESULTS

The results show that 34.8% of the study population were anaemic, with 13% having moderate-to-severe anaemia. The results of the regression analysis showed that diet was not significantly associated with haemoglobin concentrations or the prevalence of anaemia. However, regular prenatal healthcare attendance was found to be an important influencing factor for both haemoglobin concentration (β = 3.67, P = 0.002) and the prevalence of anaemia (odds ratio = 0.59, P = 0.011).

CONCLUSIONS

Pregnant women receiving regular prenatal care were less likely to be anaemic; thus, it is essential to implement strategies to improve attendance at maternal public health services to reduce the prevalence of maternal anaemia.

Correlation between primary family caregiver identity and maternal depression risk in poor rural China

INTRODUCTION

Prenatal and postpartum depression are important public health challenges because of their long-term adverse impacts on maternal and neonatal health. This study investigated the risk of maternal depression among pregnant and postpartum women in poor rural China, along with the correlation between primary family caregiver identity and maternal depression risk.

METHODS

Pregnant women and new mothers were randomly selected from poor rural villages in the Qinba Mountains area in Shaanxi. Basic demographic information was collected regarding the women and their primary family caregivers. The Edinburgh Postnatal Depression Scale was used to identify women at risk of depression, and the Perceived Social Support Scale was used to evaluate perceived family support.

RESULTS

This study included 220 pregnant women and 473 new mothers. The mean proportions of women at risk of prenatal and postpartum depression were 19.5% and 18.6%, respectively. Regression analysis showed that identification of the baby's grandmother as the primary family caregiver was negatively correlated with maternal depression risk (β=-0.979, 95% confidence interval [CI]=-1.946 to -0.012, P=0.047). However, the husband's involvement in that role was not significantly correlated with maternal depression risk (β=-0.499, 95% CI=-1.579 to 0.581, P=0.363). Identification of the baby's grandmother as the primary family caregiver was positively correlated with family support score (β=0.967, 95% CI=-0.062 to 1.996, P=0.065).

CONCLUSION

Prenatal and postpartum depression are prevalent in poor rural China. The involvement of the baby's grandmother as the primary family caregiver may reduce maternal depression risk, but the husband's involvement in that role has no effect.

Utilisation of village clinics in Southwest China: evidence from Yunnan Province

INTRODUCTION

Primary healthcare in rural China is underutilised, especially in village clinics in Southwest China. The aim of this study was to explore any relationships among the ethnicity of the healthcare provider, the clinical competence of the healthcare provider, and the utilisation of village clinics in Southwest China.

METHODS

This cross-sectional survey study involved 330 village healthcare providers from three prefectures in Yunnan Province in 2017. Multiple logistic regressions were adopted to investigate the utilisation of primary healthcare among different ethnic healthcare providers.

RESULTS

Primary healthcare utilisation was higher in village clinics where healthcare providers were Han Chinese than those where healthcare providers were ethnic minority (151 vs 101, P=0.008). The logistic regression analysis showed that clinical competence was positively associated with the utilisation of primary healthcare (odds ratio [OR]=1.49, 95% confidence interval [CI]=1.12-2.00; P=0.007) and that inadequate clinical competence of ethnic minority health workers may lead to a lag in the utilisation of primary healthcare (OR=0.45, 95% CI=0.23-0.89; P=0.022).

CONCLUSION

Our results confirm differences in the utilisation of primary healthcare in rural Yunnan Province among healthcare providers of different ethnicities. Appropriate enhancements of clinical competence could be conducive to improving the utilisation of primary healthcare, especially among ethnic minority healthcare providers.

Anthropometric measures and breast cancer risk among Hispanic women in Puerto Rico

INTRODUCTION

Increased risk of postmenopausal breast cancer associated with anthropometric measures including Body Mass Index (BMI), adult weight gain, and waist circumference has been observed in North American and European populations, but little evidence is available for Hispanic women. Breast cancer is the leading type of cancer, and leading cause of cancer-related deaths among Hispanic women in Puerto Rico (PR). However, compared with the United States, breast cancer incidence rates are lower but increasing more rapidly.

PURPOSE

To examine associations between anthropometric characteristics and breast cancer risk in Hispanic women in PR.

METHODS

Data from a population-based case-control study in the San Juan metropolitan region (cases = 315; controls = 348) were used to examine associations between anthropometric measures and breast cancer risk, also considering menopausal status and hormone therapy (HT).

RESULTS

Among premenopausal participants, there was a significant trend for lower odds of breast cancer with higher BMI and borderline significant with higher waist to height ratio (WHtR). For postmenopausal participants, a significant trend for lower odds of breast cancer was observed with higher WHtR, and waist to hip ratio (WHR), borderline significant with higher BMI, and higher odds with height. Among postmenopausal participants using HT, a significant trend for lower odds of breast cancer was observed with higher waist circumference, WHtR, WHR, and body shape index.

CONCLUSION

Our study provides evidence of anthropometric differences in relation to breast cancer risk in PR compared to previous studies. Future studies should include analyses of fat and lean mass distribution, and hormone receptor status to further understand anthropometry and breast cancer risk among Hispanic women.

[Association between tea consumption and all-cause mortality in Chinese adults]

Objective: To investigate the association between tea consumption and the risk of all-cause and cause-specific mortality among Chinese adults. Methods: This study was based on China Kadoorie Biobank (CKB). Tea consumption information was self-reported by participants at baseline. Death was mainly identified by linkage to the death registry system. Cox proportional hazard regression models estimated HR and 95%CI. Results: With a median follow-up of 11.1 years, there were 34 661 deaths in 438 443 participants. Compared with those who never drink tea, all-cause mortality HR(95%CI) were 0.89(0.86-0.91) and 0.92(0.88-0.95) for non-daily tea drinkers and daily tea drinkers, respectively. A statistically significant difference was found in the association of tea consumption and the risk of all-cause mortality between men and women(interaction P<0.05). The protective effect was mainly seen in men. Compared with those who never drink tea, daily tea drinkers had a reduced risk of death from ischemic heart disease, ischemic stroke, hemorrhagic stroke, cancer, respiration diseases and other causes of death, and the corresponding HR(95%CI) were 0.83(0.76-0.92), 0.82(0.69-0.97), 0.86(0.78-0.94), 1.03(0.97-1.09), 1.00(0.87-1.16), 0.84(0.78-0.90). Among never smokers and non-excessive drinkers, there was no statistically significant association between daily tea drinking and the risk of death from cancer. While smokers and excessive drinkers had an increased risk of death from cancer (interaction P<0.001). Conclusions: Tea consumers had reduced risks of all-cause mortality and partial cause-specific mortality, but not for the risk of death from cancer. On the contrary, daily tea drinkers with smoking habits and excessive alcohol drinking had an increased risk of death from cancer.

Relations of Variety and Quantity of Dietary Proteins Intake from Different Sources with Mortality Risk: A Nationwide Population-Based Cohort

OBJECTIVES

The relations of variety and quantity of dietary proteins intake from different sources with mortality risk were still controversial. We aimed to examine the associations of variety and quantity of different sourced proteins with all-cause mortality risk in adults and older adults.

MATERIALS AND METHODS

17,310 participants (mean age was 44.0 [SD: 15.9] years and 51.0% were females) with utilizable data from the China Health and Nutrition Survey were included. Dietary intake was collected using three consecutive 24-h dietary recalls combined with a household food inventory. The variety score of protein sources was defined as the number of proteins consumed at the appropriate level, accounting for both types and quantity of proteins. The primary outcome was all-cause mortality.

RESULTS

Over a median follow-up of 9.0 years, 1324 (7.6%) death cases were reported. There were reversed J-shaped relationships of percentages energy from total protein, and protein from legume with all-cause mortality; U-shaped relationships of proteins from unprocessed red meat, processed red meat, poultry and whole grain with all-cause mortality; L-shaped relationships of proteins from egg and fish with all-cause mortality; and a reversed L-shaped relationship of protein from refined grain with all-cause mortality (all P values for nonlinearity < 0.001). Moreover, there was a significant inverse association between the variety score of protein sources with overall mortality risk (per score increment, HR, 0.69; 95%CI, 0.66-0.72).

CONCLUSIONS

Greater variety of proteins with appropriate quantity from different food sources was associated with significantly lower risk of mortality in Chinese adults and older adults.

Long-term repetitive exposure to excess iodine induces mitochondrial apoptosis, and alters monoamine neurotransmitters in hippocampus of rats of different genders

The influence of excess iodine on human health has been paid more and more attention. Although numerous studies have reported that excess iodine may cause deleterious effects, the mental damage and its mechanism is yet to be identified. Using Sprague-Dawley rats exposed to excess iodine from pregnancy to 6 months post-delivery as in vivo model, this study explored the impacts of long-term repetitive excess iodine administration on the hippocampus of offspring rats, focusing on mitochondrial apoptosis pathway, with changes in monoamine neurotransmitters. The results showed that excess iodine could increase urinary iodine and brain organ coefficient in offspring of both genders, change the hippocampal cell structure, and damage the spatial learning and memory capacities. Poly ADP-ribose polymerase (PARP), P53, Cleaved Caspase-3, and cytochrome C proteins expression increased and Bcl2 protein expression decreased in hippocampus of excess iodine-treated offspring, indicating that excess iodine could activate the mitochondrial apoptosis pathway. Besides, excess iodine showed different effects on monoamine neurotransmitter in different gender. Collectively, our experimental data indicated that the learning and memory impairment induced by excess iodine may be mediated via mitochondrial apoptotic pathway. Long-term repetitive excess iodine exposure affected monoamine neurotransmitters in hippocampus of offspring rats.

Single-cell transcriptomics reveals the heterogeneity of the decidual endothelial cells that participate in labor onset

OBJECTIVE

To investigate the heterogeneity of decidual endothelial cells and their changes during delivery.

PATIENTS AND METHODS

Single-cell RNA sequencing was used to characterize the transcriptomes of decidual endothelial cells before and after the onset of labor.

RESULTS

Decidual endothelial cells (9748 cells) were divided into five subgroups with different functions according to differences in the transcriptome. The functions of cluster 5 were enriched in vascular development and response to growth factors. After the onset of labor, the activities of each cluster were different, including the interleukin 17 pathway and regulation of ERK1 and ERK2 cascade. The downregulated genes were related to scavenger receptor (cluster 5), which may reflect the process of endothelial activation. In terms of genetic changes, cluster 5 may be more actively involved in labor than the other clusters.

CONCLUSIONS

Peripartum decidual endothelial cells are heterogeneous and participate in labor to varying degrees. One of the five subtypes of endothelial cells may be more actively involved in labor onset. Our findings may enable the assessment of decidual endothelial cells and labor onset.

Communication skills of providers at primary healthcare facilities in rural China

INTRODUCTION

Effective provider-patient communication has been confirmed to improve diagnosis, treatment planning, health outcomes, patient satisfaction, and treatment compliance. Few studies have measured the effectiveness of communication between patients and rural providers in China. To fill this gap in the literature, the present study describes the communication skills of providers at primary healthcare facilities in rural China and investigates the provider- and facility-level factors underlying these communication skills.

METHODS

The standardised patients successfully completed 504 interactions across two tiers of China's rural health system and engaged with providers at village clinics and township health centres. We assessed providers' communication skills based on recorded interactions between the providers and the standardised patients using the SEGUE Framework, which contains the following five dimensions: 'Set the stage', 'Elicit information', 'Give information', 'Understand the patient's perspective', and 'End the encounter'.

RESULTS

The providers' overall average score was 50.6% on the SEGUE communication tasks. They did well in 'Set the stage' (54.4%) and 'Elicit information' (56.2%) but performed poorly in 'End the encounter' (24.5%) and 'Understand the patient's perspective' (44.0%). Female and younger providers scored 0.75 (P<0.05) and 0.04 (P<0.01) points higher than their male and older counterparts on total SEGUE score, respectively.

CONCLUSION

Providers in rural China had relatively poor communication skills overall, especially in terms of their demonstration of care for patients and inviting them to participate in the interaction. Gender and age were significantly associated with providers' level of communication skills in rural China.

Clostridium butyricum promotes intestinal motility by regulation of TLR2 in interstitial cells of Cajal

OBJECTIVE

Clostridium butyricum (C. butyricum) as a probiotic has been reported to have an important role in the pathogenesis of gastrointestinal diseases. However, the effects of C. butyricum on regulation of intestinal motility of ulcerative colitis (UC) remain unclear. Our study aimed to explore the cross-regulation effect of C. butyricum and toll-like receptor 2 (TLR-2) on UC.

MATERIALS AND METHODS

Interstitial cells of Cajal (ICCs) were treated by C. butyricum for 2 h, the mRNA and protein levels of TLR-2, IL-6, and IL-8 were detected by RT-qPCR and Western blot. Then, TLR2-specific small interfering RNA (si-TLR2) was transfected into ICCs, and the relative expressions of IL-6 and IL-8, SCF, cell viability, ghrelin, SP, and ET were measured by RT-qPCR, Western blot, CCK-8, and ELISA. Besides, the signal pathways of NF-κB and JNK were determined by Western blot.

RESULTS

C. butyricum significantly increased TLR2, IL-6, and IL-8 expressions in ICCs. However, TLR2 silence alleviated C. butyricum-induced IL-6 and IL-8 expressions. Moreover, TLR2 silence significantly inhibited C. butyricum-induced cell viability in ICCs. Additionally, C. butyricum significantly increased SCF expression and promoted the secretion of ghrelin and SP. However, a significant reduction in the levels of SCF, ghrelin, and SP was evident in the silence of TLR2 expression. Besides, TLR2 silence reduced C. butyricum-activation NF-κB and JNK signal pathways in ICCs.

CONCLUSIONS

These findings revealed that C. butyricum promoted intestinal motility by regulation of TLR2 in ICCs, which contributed to understand the molecular mechanisms of C. butyricum on UC.

Quercetin reduces atherosclerotic lesions by altering the gut microbiota and reducing atherogenic lipid metabolites

AIMS

Epidemiological studies have correlated cardiovascular disease and atherosclerosis with lifestyle factors such as sedentary behaviour and a high-calorie diet. Recent studies of pathogenesis have highlighted the significance of the intestinal microbiota and chronic inflammation with respect to both the onset and development of atherosclerosis. This study examined the hypothesis that the oral administration of quercetin to low-density lipoprotein receptor-null (Ldlr^-/- ) mice would improve gut health by altering the gut microbiota and controlling the levels of atherogenic lipid metabolites and proinflammatory mediators in the intestine and serum.

METHODS AND RESULTS

Mice were maintained on a high-fat diet with or without oral quercetin administration for 12 weeks. Quercetin treatment suppressed body weight gains and reduced the extent of atherosclerotic lesions in the aortic sinus. Reduced malondialdehyde and increased interleukin 6 levels further indicated the protective effect of quercetin against immune/inflammatory responses and oxidative stress. Furthermore, quercetin led to decreased intestinal levels of cholesterol, lysophosphatidic acids and atherogenic lysophosphatidylcholine (LPC 18:1) and an increased level of coprostanol. A phylum-level microbial analysis revealed that quercetin treatment reduced the abundance of Verrocomicrobia and increased microbiome diversity and the abundances of Actinobacteria, Cyanobacteria and Firmicutes. A Spearman analysis revealed negative correlations of Actinobacteria with intestinal and plasma LPC 18:1 and caecal cholesterol levels and of Firmicutes and Cyanobacteria with the plasma LPC 18:1 level.

CONCLUSIONS

This study demonstrated the ability of quercetin treatment to reduce lipid levels, as well as the areas of atherosclerotic lesions and sizes of plaques. This treatment also altered the composition of the gut microbiota and decreased the levels of atherogenic lipid metabolites.

SIGNIFICANCE AND IMPACT OF THE STUDY

Oral quercetin treatment may represent a new approach to mitigating the onset and development of atherosclerosis.

P2637Hypertension as a risk factor for all-cause and cardiovascular mortality in women compared with men: a systematic review and meta-analysis of prospective cohort studies

Background

What is more, some recent meta-analysis have demonstrated the sex difference between smoking, diabetes, and atrial fibrillation, and the risk of CVD mortality. Whether and to what extent the excess risk of cause-specific mortality from CVD death conferred by hypertension differs among women and men remain unclear.

Objective

A systematic review with meta-analysis was performed to explore whether and to what extent the excess risk of cause-specific mortality from CVD death conferred by hypertension differs among women and men.

Methods

PubMed and EMBASE was systematically searched for prospective cohort studies published from inception to 7 October 2017. Eligible studies reported sex-specific relative risk (RR) estimates for mortality of all-cause, CVD, coronary heart disease (CHD) and stroke associated with hypertension. The data were pooled using random effects models with inverse variance weighting, and estimates of the women-to-men ratio of RRs (RRR) for each outcomes were derived.

Results

Twenty-four studies with 2,939,659 participants were included in this meta-analysis. The RR for CHD mortality associated with hypertension compared with no hypertension was 2.24 (95% CI 2.03–2.46) in women and 1. 72 (1.61–1.84) in men. The multiple-adjusted RRR for CHD mortality was 22% greater in women with hypertension than in men with hypertension (RRR 1.22, 95% CI 1.03–1.44) with no significant heterogencity between studies (I2=45%, P=0.11, Figure 1). No evidence was observed sex difference in the relationship between hypertension and the mortality from all-cause, CVD and stroke. Furthermore, the subgroup analyses showed that the pooled RRR for all-cause mortality, CVD and stroke mortality were not significantly associated with cohort region, the duration of follow-up, mean age of participants and the publication year of studies.

Conclusions

Hypertension is a major risk factor for all-cause, CVD, CHD and stroke among women and men. Moreover, women with hypertension have more than a 22% higher risk of CHD mortality compared with men with hypertension. Further studies need to identify the biological and/or lifestyle mechanisms involved in sex differences driving these associations.

P5495Sex differences in marital status and risk of cardiovascular disease, cancer, and all-cause mortality: a systematic review and meta-analysis of 7,881,040 individuals

Background

Marital status has been identified as an important social factor associated with mortality. In current epidemiologic research, being unmarried was observed to be a suboptimal health status in the global population. The growing number of unmarried people has health implications, in light of evidence suggesting that it is associated with an increase in the incidence of various diseases and high mortality. Few attempts have been made to produce an overall estimate and sufficiently clarified of the sex difference between unmarried status and mortality risks, this is still a matter of debate.

Purpose

To ascertain whether sex differences exist in the relationship between marital status and cardiovascular disease (CVD), cancer, all-cause mortality in the general population and to explore the potential effect of age, location, the duration of follow-up and publication years on these outcomes.

Methods

A systematic search was performed in PubMed and EMBASE from inception through to April 2018 and review of references. We used the sex-specific RRs (relative risk) to derive the women-to-men ratio of RRs (RRR) and 95% CIs from each study. Subsequently, the RRR for each outcome was pooled with random effects meta-analysis weighted by the inverse of the variances of the log RRRs.

Results

Twenty-one studies with 7,881,040 individuals were included for meta-analysis. Compared with married individuals, being unmarried was significantly associated with all-cause mortality, cancer mortality, CVD mortality and coronary heart disease (CHD) mortality, especially for singles, for both sexes (Figure 1). However, the association with death from all-cause and CVD was significantly stronger in men. Compared with women who were divorced/separated, divorced/separated men had significantly higher risk of all-cause mortality, cancer mortality and CVD mortality. Moreover, never married men had 31% and 9% higher excess risk of stroke mortality and all-cause mortality, respectively, compared with never married women. No sex differences were observed concerning the impact of any unmarried status on CHD mortality.

Conclusions

Being unmarried (widowed, divorced/separated or never married) conferred higher excess risk of stroke mortality and all-cause mortality for men than women. Moreover, divorced/separated men had significantly higher risk of cancer mortality and CVD mortality. Further studies are warranted to clarify the biological, behavioral, and/or social mechanisms involved in sex differences driving these associations.

[Determination of seven urinary metabolites of benzene, toluene and xylene by ultra-high performance liquid chromatography-triple quadrupole mass spectrometry]

Objective: To develop a method using ultra-high performance liquid chromatography-triple quadrupole mass spectrometry to determine the urinary metabolites of benzene, toluene and xylene. The selected metabolites are S-phenylmercapturic acid (S-PMA) , trans, trans-muconic acid (t, t-MA) , 8-hydroxy-2 deoxyguanosine (8-OHdG) , hippuric acid (HA) , 2-methylhippuric acid (2-MHA) , 3-methylhippuric acid (3-MHA) and 4-methylhippuric acid (4-MHA) . Methods: The urine sample was pretreated using methanol to precipitate the proteins. HSS T3 chromatographic column was used to separate the metabolites. The mass spectrometric acquisition was carried out using multiple reaction monitoring (MRM) after ionization with ESI source. External standard method was used for quantification. Results: All the standard curves showed good linear relation, and r of the seven metabolites was all above 0.999. The detection limits and quantitative limits of the seven metabolites were 0.01-500 ng/ml and 0.02-1 000 ng/ml (based on the actual dilution ratio) , respectively. The average spiked recoveries of four loadings ranged from 85.8% to 109.9%. The intra-day and inter-day precisions were 0.2%-4.5% and 0.6%-9.5%, respectively. The samples can be kept for at least 14 days at both 4 ℃ and -20 ℃. Conclusion: This method is simple, rapid and highly sensitive with low cost, and its accuracy, precision and stability can meet the daily test requirements. It can be applied for the determination of urinary S-PMA, t, t-MA, 8-OHdG, HA, 2-MHA, 3-MHA and 4-MHA for the occupational population exposed to benzene, toluene and xylene.

Dopamine receptor D2 gene polymorphism, urine fluoride, and intelligence impairment of children in China: A school-based cross-sectional study

OBJECTIVE

We aimed to study the association of urine fluoride with intelligence quotient (IQ) in children with a careful consideration of up to 30 potential confounding factors as well as possible heterogeneity of the relation between urine fluoride levels and IQ scores across children with different dopamine receptor-2 (DRD2) Taq 1A genotypes (CC, CT, and TT).

METHODS

A school-based cross-sectional study design was applied. A total of 323 children (2014-2015, 7-12 years old) were enrolled from four schools in both historical endemic and non-endemic areas of fluorosis in Tianjin of China using a cluster sampling method. Urine fluoride levels and age-specific IQ scores in children were measured at the enrollment. Polymerase chain reaction-restriction fragment length polymorphism methods were used to genotype DRD2 Taq 1A polymorphism with genomic DNA isolated from whole blood collected at the enrollment. Multiple linear regression models were applied to evaluate the relationship between urine fluoride levels and IQ scores overall and within the DRD2 Taq 1A SNP = CC/CT and TT subgroups. Model robustness was tested through bootstrap, sensitivity analysis, and cross-validation techniques. A safety threshold of urine fluoride levels for IQ impairment was determined in the subgroup TT.

RESULTS

In overall participants, the DRD2 Taq 1A polymorphism itself was not related to IQ scores in children who had a high level of urine fluoride. In the CC/CT subgroup, urine fluoride levels and IQ scores in children were unrelated (adjusted β (95% confidence interval (CI)) = - 1.59 (- 4.24, 1.05), p = 0.236). Among the participants carrying the TT genotype, there was a strong and robust negative linear relationship between log-urine fluoride and IQ scores in children (adjusted β (95% CI) = - 12.31 (- 18.69, - 5.94), p < 0.001). Urine fluoride levels had a stronger association with IQ in children carrying the TT genotype (adjusted β = - 12.31, bootstrapped standard error (SE) = 1.28), compared to that in overall participants (adjusted β = - 2.47, bootstrapped SE = 3.75) (Z = 2.483 and bootstrapped p = 0.007). The safety threshold of urine fluoride levels in the subgroup TT was 1.73 mg/L (95% CI = (1.51, 1.97) (mg/L)).

CONCLUSIONS

There is heterogeneity in the relation between urine fluoride and IQ across children carrying different DRD2 Taq 1A genotypes. Large-scale epidemiological studies are needed to confirm our findings.

Influence of Shrinkage and Viscosity of Flowable Composite Liners on Cervical Microleakage of Class II Restorations: A Micro-CT Analysis

This study determined the influence of shrinkage and viscosity of flowable composite liners on the cervical microleakage of Class II restorations using micro-CT. Seven composites of varying viscosities were selected and included five giomers (Shofu Beautifil II [BF], Flow Plus F00 and F03 [F00 and F03], Flow F02 and F10 [F02 and F10]) and 2 nano-filled composites (3M-ESPE Filtek Z350 [Z350] and Filtek Z350 Flowable [Z350F]). Polymerization shrinkage (n=7) was assessed with the Acuvol volumetric shrinkage analyzer while complex viscosity was determined with the advanced rheometric expansion system at 25°C. Standardized Class II restorations incorporating 1-mm horizontal layers of different flowable liners and 3-mm oblique layers of BF or Z350 were subjected to a silver nitrate test for 24 hours and examined using micro-CT. Microleakage was determined at 0.1-mm intervals from the buccal to lingual surfaces providing 30 sites per specimen and scored accordingly. Statistical analysis was performed with the one-way ANOVA, Kruskal-Wallis test, and Spearman's rho correlation at a significance level of p<0.05. Mean volumetric shrinkage ranged from 5.33±0.17% to 2.35±0.02% for F02 to Z350, respectively. The flowable materials had significantly higher shrinkage than did their sculptable counterparts (BF and Z350). Complex viscosities ranged from 9.65 to 4.20 (Z350 and F10, respectively) at a frequency of 10 rad/s and from 8.16 to 3.28 (Z350 and F03, respectively) for 100 rad/s. Giomer restorations had significantly less leakage than did those restored with nano-filled composites. No microleakage was observed with restorations lined with F02 or F10. The use of flowable liners reduced cervical microleakage of Class II restorations. Interfacial integrity of Class II restorations was significantly correlated with liner viscosity, filler volume, and shrinkage.

New insights into the plasmonic enhancement for photocatalytic H2 production by Cu–TiO2 upon visible light illumination

Cu nanoparticles were deposited on the surface of commercial TiO₂ nanoparticles (Cu–TiO₂) using different methods aiming at the production of highly efficient visible light photocatalysts.

Autophagy regulates high concentrations of iodide-induced apoptosis in SH-SY5Y cells

To date, there are many people residing in areas with high levels of iodide in water. Our previous epidemiological study showed that exposure to high iodine in drinking water significantly reduced the intelligence of children although the mechanisms remain unclear. To explore whether high concentrations of iodide may cause cytotoxic effect and the role of autophagy in the high iodide-induced apoptosis, human neuroblastoma cells (SH-SY5Y cells) were exposed to high concentrations of iodide. Morphological phenotypes, cell viability, Hoechst 33258 staining, the expression levels of apoptosis and autophagy-related proteins were detected. A possible effect of an inhibitor (3-methyladenine, 3-MA) or an inducer (rapamycin) of autophagy on high iodide-induced apoptosis also was examined. Results indicated that high iodide changed cellular morphology, decreased cell viability and increased the protein's expression level of apoptosis and autophagy. In addition, high iodide-induced apoptosis was enhanced by inhibition of autophagy and inhibited by activation of autophagy in SH-SY5Y cells. Collectively, high concentrations of iodide are toxic to SH-SY5Y cells, as well as induce apoptosis and autophagy. Furthermore, autophagy plays a regulatory role in high concentrations of iodide-induced apoptosis in SH-SY5Y cells.

Vitamin D Status and Prevalent Early Age-Related Macular Degeneration in African Americans and Caucasians: The Atherosclerosis Risk in Communities (ARIC) Study

OBJECTIVES

Vitamin D status has been hypothesized to protect against development of early age-related macular degeneration (AMD) via its anti-inflammatory properties and its possible beneficial influence on blood pressure control. We investigated the association between vitamin D status and prevalent early AMD in a community-based cohort.

DESIGN

This was a cross-sectional study.

SETTING

This was a secondary data analysis of already existing data from the Atherosclerosis Risk in Communities Study (ARIC) cohort collected from 1990 to 1995.

PARTICIPANTS

There were 9,734 (7,779 Caucasians, 1,955 African American) ARIC participants (aged 46 to 70 at visit 2 [1990-1992]) with 25(OH)D data available at visit 2, AMD assessment at visit 3 (1993-1995), and complete covariate data.

MEASUREMENTS

Vitamin D status was assessed with serum 25-hydroxyvitamin D (25(OH)D) concentrations from bloods drawn at visit 2. Prevalent, early AMD (n=511) was assessed at visit 3 (1993-95) with nonmydriatic retinal photographs of one randomly chosen eye. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for early AMD by categories of 25(OH)D in nmol/L (deficient <30, inadequate 30-<50, and two categories of adequate status: 50-<75 and ≥75). Linear trend was estimated using continuous 25(OH)D concentrations. ORs were adjusted for age, race, and smoking status. We further adjusted for hypertension status to examine if vitamin D status influenced early AMD via its effects on blood pressure. Exploratory analyses of effect modification by age, sex, race and high risk genotypes [Y402H complement factor H (CFH) rs1061170 and the A69S age-related maculopathy susceptibility 2 (ARMS2) rs10490924 polymorphisms] were conducted.

RESULTS

The prevalence of early AMD was 5%, and 5% of participants were vitamin D deficient. The adjusted OR (95% CIs) for early AMD among those with adequate (≥75 nmol/L) compared to deficient (<30 nmol/L) vitamin D status was 0.94 (0.59-1.50), p-trend=0.86. Further adjustment for hypertension status did not influence results (OR [95% CI]=0.95 [0.59-1.52], p-trend=0.84). Results did not vary significantly by age, race, sex, early AMD subtype (soft drusen or retinal pigment epithelium depigmentation), or ARMS2 genotype. Results did not vary significantly by CFH genotype in African Americans. The p for multiplicative interaction between 25(OH)D and CFH genotype was 0.06 in Caucasians, but OR [95% CIs] for AMD by vitamin D status were similar in each CFH genotype and not statistically significant.

CONCLUSIONS

Vitamin D status was not associated with early AMD in this cohort sample.

[The characteristics of a mouse model with nasal polyp established by lipopolysaccharide]

Objective:To explore the effect of lipopolysaccharide(LPS) on the formation of nasal polyps in mice and its mechanism.Method:Five or ten μg of LPS were dropped into the nasal cavities of six to eight-week C57BL/6J mice in order to establish animal models with nasal polyps.Buried food pellets experiment was used to assess olfactory function of mice.Hematoxylin-eosin staining,olfactory marker protein(OMP),and myeloperoxidase(MPO) for neutrophil immunohistochemistry were used to observe histopathological changes in the nasal mucosa.The expression levels of cytokines,such as interferon(IFN)-γ,tumor necrosis factor(TNF)-α,IL-6 in the nasal lavage fluid,were detected by ELISA.Result:Compared to the control group,mice in the LPS groups showed significant nasal polyp formation,olfactory dysfunction,more MPO⁺ cells while less OMP⁺ cells in the nasal mucosa,as well as increased significantly levels of IFN-γ,TNF-α,and IL-6 in the nasal lavage fluids(all P<0.05).Conclusion:LPS from Gram negative bacteria alone can induce the formation of nasal polyps in mice,characterized by more neutrophils,olfactory dysfunction,and increasing Th1 cytokine.Therefore,this model is commensurate with the characteristics of primary nasal polyps found in China and other major Asian.The current study suggests that LPS may be one of the important pathogenesis of gram negative bacteria in the nasal polyps.

Role of endoplasmic reticulum stress-induced apoptosis in rat thyroid toxicity caused by excess fluoride and/or iodide

Excess fluoride and iodide coexist in drinking water in many regions, but few studies have investigated the single or interactive effects on thyroid in vivo. In our study, Wistar rats were exposed to excess fluoride and/or iodide through drinking water for 2 or 8 months. The structure and function of the thyroid, cells apoptosis and the expression of inositol-requiring enzyme 1 (IRE1) pathway-related factors were analyzed. Results demonstrated that excess fluoride and/or iodide could change thyroid follicular morphology and alter thyroid hormone levels in rats. After 8 months treatment, both single and co-exposure of the two microelements could raise the thyroid cells apoptosis. However, the expressions of IRE1-related factors were only increased in fluoride-alone and the combined groups. In conclusion, thyroid structure and thyroid function were both affected by excess fluoride and/or iodide. IRE1-induced apoptosis were involved in this cytotoxic process caused by fluoride or the combination of two microelements.

[Association between adverse experiences in childhood and risk of chronic diseases in adulthood]

OBJECTIVE

To analyze the prevalence and characteristics of childhood adverse experiences among adults aged 18-59 years and understand the association between childhood adverse experiences and risk of chronic diseases in adulthood.

METHODS

A cross-sectional study was conducted with a questionnaire among adults aged 18-59 years selected through cluster random sampling from 3 communities in Macheng, Hubei province. Uinivariate and multivariate logistic regression analyses were conducted to evaluate the association between adverse experiences in childhood and the risk of chronic diseases in adulthood.

RESULTS

A total of 1 767 adults aged 18-59 years were surveyed and 1 501 valid questionnaires were returned. The average age was (36.32± 10.20) years for males and (35.72±9.08) years for females. The prevalence rate of childhood adverse experiences was 66.22%. The risk of chronic disease in adults increased with the increase of the score indicating childhood adverse experiences (Z=-5.902 1, P<0.000 1). Multivariate logistic regression analysis showed that being physically abused (OR=1.93, 95% CI: 1.41-2.64), substance abuse in family (OR=2.82, 95% CI: 1.16-6.80), being bullied (OR=2.59, 95% CI: 1.39-4.80) and parents separation/divorce (OR=1.51, 95% CI: 1.09-2.09) were significantly associated with risk of chronic diseases in adulthood.

CONCLUSION

The prevalence of adverse childhood experiences was high in adults aged 18-59 years, which was significantly associated with the risk of chronic diseases in adulthood. Early prevention of chronic diseases should be conducted in childhood.

[Micro-CT observations of the adaptation at gingival wall in Class II restorations with different dental restorative materials]

OBJECTIVE

To evaluate the adaptation of different materials for gingival layer in Class II restorations using Micro-CT.

METHODS

Eighteen extracted human premolars were selected, and Class II cavities were prepared. The teeth were randomly divided into six groups and restored using layering technique. Six materials were used for gingival layer, including four injectable materials: Beautifil Flow Plus F00 (F00), Beautifil Flow F10 (F10), Filtek Z350 Flowable (Z350F), FujiII LC CAPSULE (Fuji), and two packable materials: BeautifilII (BF), Filtek Z350 (Z350). The restored teeth were scanned with micro-CT and the images were 3D reconstructed to evaluate the volumes and the distribution of the voids on the restoration-tooth interface of the gingival layer. The volume of the voids were statistically analyzed using nonparametric Jonckheere-Terpstra tests.

RESULTS

The volumes (mm(3)) of the voids on the restoration-tooth interface were: Z350F (0.000 15), F10 (0.000 39), F00 (0.012), Fuji (0.070), Z350 (0.16) and BF (0.20). There were significant differences between Z350F/F10 and Fuji/Z350/BF (P < 0.05). Most of the voids were found on the point-line angles of the cavities.

CONCLUSION

The voids on the restoration-tooth interface were mainly on the point-line angles of the cavities. Injectable materials with high flowablility could reduce the restoration-tooth interface voids significantly when used for the gingival layer in Class II restorations.

Impact of exercise intensity on cardiac function in adolescent runners

BACKGROUND

Prolonged exercise may induce a transient reduction in the left ventricular (LV) function (exercise-induced cardiac fatigue) in adults. However, data related to the cardiovascular consequences of prolonged exercise in adolescents are extremely limited. This study examined the impact of exercise intensity adopted in routine long-distance run training on LV function in trained adolescent runners in a laboratory-based setting.

METHODS

Twelve male adolescent runners (14.5 ± 1.5 years) performed two 90-min treadmill runs with intensity set at the running speeds that corresponded to either 80% (T1) or 100% (T2) ventilatory threshold. LV function was examined echocardiographically pre- and post-exercise.

RESULTS

The two-factor repeated-measures ANOVA revealed no significant (P>0.05) main effects for the intensity and the interaction of intensityÍ pre- and postexercise in ejection fraction (EF), systolic blood pressure/end systolic volume ratio (SBP/ESV) and early to atrial diastolic flow velocity ratio (E:A). Nevertheless, the main effect for time course in EF was significant (P<0.05). Pre-exercise EF in T1 (74 ± 5 vs. 70 ± 5%, P<0.05), but not in T2 (75 ± 4 vs. 72 ± 7%, P>0.05), decreased significantly post-exercise, yet this did not reach clinical levels. Further, no difference (P>0.05) was found between pre- and post-exercise in SBP/ESV (T1: 3.9 ± 0.9 vs. 3.7 ± 1.1; T2: 4.0 ± 0.7 vs. 4.6 ± 1.9 mmHg·ml⁻¹) and E:A (T1: 1.87 ± 0.11 vs. 1.87 ± 0.11; T2: 1.83 ± 0.11 vs. 1.87 ± 0.09) in both trials.

CONCLUSION

These findings suggest that the training intensities adopted in routine long-distance run training in the adolescent runners do not seem to induce cardiac fatigue. Adolescent hearts appear to cope well with prolonged run performed on training.

Rapid reuptake of granzyme B leads to emperitosis: an apoptotic cell-in-cell death of immune killer cells inside tumor cells

A cell-in-cell process refers to the invasion of one living cell into another homotypic or heterotypic cell. Different from non-apoptotic death processes of internalized cells termed entosis or cannibalism, we previously reported an apoptotic cell-in-cell death occurring during heterotypic cell-in-cell formation. In this study, we further demonstrated that the apoptotic cell-in-cell death occurred only in internalized immune killer cells expressing granzyme B (GzmB). Vacuole wrapping around the internalized cells inside the target cells was the common hallmark during the early stage of all cell-in-cell processes, which resulted in the accumulation of reactive oxygen species and subsequent mitochondrial injury of encapsulated killer or non-cytotoxic immune cells. However, internalized killer cells mediated rapid bubbling of the vacuoles with the subsequent degranulation of GzmB inside the vacuole of the target cells and underwent the reuptake of GzmB by killer cells themselves. The confinement of GzmB inside the vacuole surpassed the lysosome-mediated cell death occurring in heterotypic or homotypic entosis processes, resulting in a GzmB-triggered caspase-dependent apoptotic cell-in-cell death of internalized killer cells. On the contrary, internalized killer cells from GzmB-deficient mice underwent a typical non-apoptotic entotic cell-in-cell death similar to that of non-cytotoxic immune cells or tumor cells. Our results thus demonstrated the critical involvement of immune cells with cytotoxic property in apoptotic cell-in-cell death, which we termed as emperitosis taken from emperipolesis and apoptosis. Whereas entosis or cannibalism may serve as a feed-on mechanism to exacerbate and nourish tumor cells, emperitosis of immune killer cells inside tumor cells may serve as an in-cell danger sensation model to prevent the killing of target cells from inside, implying a unique mechanism for tumor cells to escape from immune surveillance.

Microenvironment-dependent homeostasis and differentiation of epidermal basal undifferentiated keratinocytes and their clinical applications in skin repair

Skin homeostasis is maintained by controlling the balance between proliferation and differentiation of epidermal stem cells. The microenvironment, including extrinsic stresses, growth factors, soluble molecules, cell-ECM and cell-cell communications, plays an important role in cell fate determination in vivo and in vitro. In response to external signals, keratinocytes cooperate with other cell types to modulate and facilitate the wound microenvironment during wound healing; however, the aberrant signals or conjunctions in the environment will lead to pathologic abnormalities. In addition, despite some drawbacks, the epidermal stem-cellbased bioengineered skin substitutes have greatly improved the quality of cutaneous repair. Thus, exploring the characteristics and regulation mechanisms of microenvironment-dependent homeostasis and differentiation of epidermal basal undifferentiated keratinocytes is necessary to understand skin development and wound repair and to design novel therapeutic strategies for skin wound healing.