[Epidemic characteristics and trend analysis of major injuries deaths among children and adolescents in Jiangsu Province from 2012 to 2021]

Objective: To understand the situation and epidemic characteristics of injury deaths among children aged 5 to 24 years in Jiangsu Province from 2012 to 2021 and the trend of annual changes. Methods: The main injury mortality data of children and adolescents was collected, and the crude and standardized mortality rates of road traffic accidents, drowning, suicide, and accidental falls among children and adolescents over a decade and the annual average percentage of change (AAPC) were calculated. The main injury mortality characteristics and trends of children and adolescents of different age groups and genders were analyzed. Results: The total number of injury deaths among 5 to 24 adolescents in Jiangsu Province was 16 052, with a standardized mortality rate of 9.58/100 000. There was no significant trend in the overall standardized mortality rate of injuries (AAPC=-3.450%, P=0.055). The standardized mortality rate of road traffic injuries among children and adolescents showed a decreasing trend over the past decade, with statistical significance (AAPC=-9.406%, P<0.001). The standardized suicide mortality rate showed an upward trend over the past decade, with statistical significance (AAPC=9.000%, P=0.001). The overall injury mortality rate showed an upward trend with age. Suicide rates in males and females were on the rise and both have statistical significance (AAPC=9.420% and AAPC=9.607%, both P<0.05). The standardized mortality rates of female traffic accidents, drowning, and male traffic accidents showed a decreasing trend and were statistically significant (AAPC for female traffic accidents=-7.364%, AAPC for female drowning=-5.352%, and AAPC for male traffic accidents=-10.242%, all P<0.05). The standardized mortality rate of urban and rural traffic accidents showed a decreasing trend and was statistically significant(AAPC=-7.899% and AAPC=-9.421%, both P<0.001). The standardized suicide mortality rate showed an upward trend and statistical significance (AAPC=11.009% and AAPC=7.528%, both P<0.05). Conclusions: The overall injury situation of children and adolescents in Jiangsu Province improved in the past decade from 2012 to 2021, but the suicide mortality rate was on the rise. It is necessary to focus on the mental health issues of this age group and to strengthen the prevention and control of suicide among children and adolescents, in Jiangsu.

Risk factors and their interactive effects on severe acute pancreatitis complicated with acute gastrointestinal injury

BACKGROUND

There are many risk factors for severe acute pancreatitis (SAP) complicated with acute gastrointestinal injury (AGI), but few reports on the interaction between these risk factors.

AIM

To analyze the risk factors for SAP complicated with AGI and their interactive effects.

METHODS

We selected 168 SAP patients admitted to our hospital between December 2019 and June 2022. They were divided into AGI group and non-AGI group according to whether AGI was present. Demographic data and laboratory test data were compared between the two groups. The risk factors for SAP with concomitant AGI were analyzed using multifactorial logistic regression, and an analysis of the interaction of the risk factors was performed.

RESULTS

The percentage of patients with multiple organ dysfunction syndrome, acute physiological and chronic health scoring system II (APACHE II) score, white blood cell count and creatinine (CRE) level was higher in the AGI group than in the non-AGI group. There was a statistically significant difference between the two groups (P < 0.05). Logistic regression analysis indicated that an APACHE II score > 15 and CRE > 100 µmol/L were risk factors for SAP complicating AGI. The interaction index of APACHE II score and CRE level was 3.123.

CONCLUSION

An APACHE II score > 15 and CRE level > 100 µmol/L are independent risk factors for SAP complicated with AGI, and there is a positive interaction between them.

[Epidemiological characteristics of falls in the elderly in Jiangsu from 2006 to 2021]

Objective: To understand the epidemiological characteristics and influencing factors of elderly unintentional fall-related injuries (EUFI) in Jiangsu from 2006 to 2021 and provide a scientific basis for the prevention of falls in the elderly and the formulation of related policies. Methods: Data on EUFI was collected from the first diagnosed cases in the injury surveillance hospitals in Jiangsu from 2006 to 2021, and epidemiological characteristics of injuries were analyzed. logistic regression was performed to identify the risk factors for EUFI. Results: The number of EUFI increased from 2006 to 2021, ranked as the first cause of elderly unintentional injuries during these years. The proportion of EUFI among elderly unintentional injuries increased in the same period. The male-to-female ratio is 1∶1.4. Falls mainly occurred during 8:00-10:00 am (32.7%). The most common place where falls occurred was at home (63.6%). From 2006 to 2014, leisure activities (62.1%), housework/study (23.1%), and work (5.2%) were the top three activities when injuries occurred. During 2015-2021, leisure activities (41.7%), housework/study (22.6%) and walking (20.5%) were the top three activities when injuries occurred. The major fall-related injuries were fractures (39.9%), with the injured parts at low limbs (32.5%), of which most were mild injuries (60.3%), and the primary outcome was hospitalization after treatment (74.1%). logistic regression showed that the risk factors of EUFI were female, old age, immigrants, winter, public residence, housework/study, and leisure activities. Higher education, occupation of household and production and transportation equipment operators were protective factors (all P<0.05). Conclusions: Fall is the leading cause of unintentional injuries in the elderly in Jiangsu, especially the elderly female population. Corresponding measures should be taken to prevent and intervene in falls in the elderly in the community according to the distribution characteristics.

Identification of the Microbial Transformation Products of Secoisolariciresinol Using an Untargeted Metabolomics Approach and Evaluation of the Osteogenic Activities of the Metabolites

Secoisolariciresinol (SECO) is one of the major lignans occurring in various grains, seeds, fruits, and vegetables. The gut microbiota plays an important role in the biotransformation of dietary lignans into enterolignans, which might exhibit more potent bioactivities than the precursor lignans. This study aimed to identify, synthesize, and evaluate the microbial metabolites of SECO and to develop efficient lead compounds from the metabolites for the treatment of osteoporosis. SECO was fermented with human gut microbiota in anaerobic or micro-aerobic environments at different time points. Samples derived from microbial transformation were analyzed using an untargeted metabolomics approach for metabolite identification. Nine metabolites were identified and synthesized. Their effects on cell viability, osteoblastic differentiation, and gene expression were examined. The results showed that five of the microbial metabolites exerted potential osteogenic effects similar to those of SECO or better. The results suggested that the enterolignans might account for the osteoporotic effects of SECO in vivo. Thus, the presence of the gut microbiota could offer a good way to form diverse enterolignans with bone-protective effects. The current study improves our understanding of the microbial transformation products of SECO and provides new approaches for new candidate identification in the treatment of osteoporosis.

[Analysis of 18 cases of malignant rhabdoid tumor in children]

Objective: To investigate the clinical characteristics, treatment and prognosis of malignant rhabdoid tumor (MRT) in children. Methods: Clinical data total of 18 children with MRT treated in the Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University between June 2015 to June 2021 were analyzed retrospectively. The patients were grouped according to age, gender, tumor type, clinical stage and other factors.Progression free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method, survival differences among different groups were compared by Log-rank test, and prognostic factors were analyzed by Cox regression model. Results: Among the 18 patients, there were 5 males and 13 females. The age of disease onset was 30.5 (12.0, 75.0) months, the tumor diameter was (80±29) mm, and no integrase interactor 1 (INI-1) expression was detected by immunohistochemistry. There were 7 cases of malignant rhabdoid tumor of the kidney (MRTK), 6 cases of atypical teratoid rhabdoid tumor (ATRT) and 5 cases of extrarenal extracranial rhabdoid tumor (EERT). At the time of early diagnosis, 12 patients were clinically stage Ⅲ-Ⅳ, 11 patients had local or distant metastasis, and 4 patients had metastasis during treatment. Surgical excision is the preferred treatment. There were 3 cases with preoperative puncture biopsy, 13 cases with complete resection, 4 cases with partial resection, and 1 case without operation. Thirteen patients were treated with the domestic conventional chemotherapy regimen for Wilms' tumor, medulloblastoma and rhabdomyosarcoma, and 5 patients were treated with the international conventional chemotherapy regimen. Nine patients received radiotherapy, including 1 case of MRTK, 4 cases of ATRT and 4 cases of EERT. By the end of follow-up in January 2022, 7 patients survived and 11 patients died. The 3-year PFS and OS rates were (8±8) % and (14±12) %. Log-rank test showed that the 5-year OS of EERT group was higher than ATRT and MRTK groups (χ²=16.31, P<0.001), the tumor diameter <80 mm group was higher than that of the ≥80 mm group (χ²=4.49, P=0.034), and the radiotherapy group was higher than no radiotherapy group (χ²=3.97, P=0.046). The differences were statistically significant. There was no significant difference in the influence of tumor type, age, tumor diameter, radiotherapy and chemotherapy on OS by Cox regression model (all P>0.05). Log-rank test showed that the 3-year PFS of EERT group was higher than ATRT and MRTK groups (χ²=11.14, P=0.004),>3 years group was higher than ≤3 years group (χ²=10.10, P=0.001), the differences were statistically significant. Tumor type, clinical stage, tumor diameter, age, tumor rupture and radiotherapy were included in the Cox regression model, and the results showed that clinical stage (HR=0.49, 95%CI 0.26-0.94, P=0.031), tumor diameter (HR=8.67, 95%CI 1.84-40.89, P=0.006), age (HR=0.01, 95%CI 0.00-0.15, P=0.001) had statistical significance on PFS. Conclusions: MRT is one of the most aggressive and fatal cancers in early childhood and infancy. There is no standard treatment and the prognosis is extremely poor. Clinical stage, tumor size and age are risk factors for disease progression.

[Analysis of developmental coordination disorder in Chinese children]

Objective: To investigate the prevalence of children's developmental coordination disorder (DCD) and its distribution based on different family socioeconomic characteristics in China, in order to provide a theoretical basis for early prevention, diagnosis, and intervention for DCD. Methods: From June to October, 2016, 1 887 children aged 3-10 years from 20 kindergartens and 10 elementary schools from 8 cities in seven geographic areas of China using a stratified cluster sampling method were recruited. With a cross-sectional design, parents were asked to report on their basic information. Children' s motor ability was assessed using the movement assessment battery for children-second edition (MABC-2). Children were grouped by age, sex, body mass index (BMI), one-child status, and family structure. Chi-square test and one-way ANOVA were used to compare family socioeconomic characteristics of children between different groups. Results: Among the 1 887 children, there were 1 110 (58.8%) preschool children (3-6 years of age) and 777 (41.2%) school-aged children (7-10 years of age). There were 982 males (52.0%) and 905 females (48.0%). A total of 5.5% (104 cases) children were diagnosed with DCD, 10.4% (197 cases) with suspected DCD, and 84.1% (1 586 cases) as typical motor developing children. There were no significant differences in prevalence of diagnosed and suspected DCD among different regions (χ²=17.342 and 4.877, P=0.173 and 0.560), total motor coordination score (F=2.759, P<0.05), and the scores of all dimensions (manual dexterity, positioning and grabbing, balance: F=9.276, 5.277, 3.706, all P<0.01). The prevalence of DCD in preschool children was significantly higher than that in school-age children (χ²=11.891, P<0.01). Girls were significantly better than boys in total motor coordination, manual dexterity, and balance (all P<0.01). Boys were significantly better than girls in positioning and grabbing (P<0.01). The prevalence of DCD in boys was significantly higher than that in girls (70 boys (7.1%) and 34 girls (3.8%), χ²=28.508, P<0.01). The total motor coordination ability, manual dexterity and balance of children who are overweighted (BMI>18 kg/m²) were significantly lower than those of children of normal weight (BMI≤18 kg/m²) (all P<0.01). The prevalence of suspected DCD children who are overweighted was significantly higher than that of children of normal weight (χ²=4.369, P<0.05). The difference of total motor coordination ability (F=6.811, P<0.01) and the prevalence of DCD (χ²=14.902, P<0.01) among different family structures were statistically significant. The total motor coordination ability and balance ability of children from multi-child family were better than those of children from one-child family (both P<0.05). Conclusion: The motor coordination ability of Chinese children is well-developed, with differences among different regions, gender, age, BMI, and family structure.

[Prevalence and influencing factors of carotid plaque in population at high-risk for cardiovascular disease in Jiangsu province]

Objective: To understand the prevalence of carotid plaque (CP) in population at high-risk for cardiovascular disease (CVD) in Jiangsu province and identify related influencing factors. Methods: Based on the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project from 2015 to 2016, a total of 11 392 persons at high-risk for CVD were selected from six project areas in Jiangsu province for the questionnaire survey, physical measurement, laboratory test and bilateral ultrasound examination of carotid arteries. The prevalence of CP and influencing factors of abnormal carotid arteries, CP and plaque burden (CP≥2) were analyzed. Results: Among the persons surveyed, 4 821 (42.3%) were males. The age of the persons surveyed was (59.4±8.9) years. There were 5 971 abnormal carotid arteries cases (52.4%), including 1 782 carotid intima-media thickness thickening cases (15.6%), 3 811 CP cases (33.5%) and 378 carotid stenosis cases (3.3%). Older age (OR=2.253, 95%CI: 2.127-2.386), urban residence (OR=2.622, 95%CI: 2.375-2.895), hypertension (OR=1.439, 95%CI: 1.195-1.732), smoking (OR=1.441, 95%CI: 1.259- 1.650), pulse pressure difference (OR=1.270, 95%CI: 1.198-1.347), fasting plasma glucose (FPG) (OR=1.109, 95%CI: 1.059-1.161) and LDL-C/HDL-C (OR=1.225, 95%CI: 1.164-1.288) were possible risk factors of CP in population at high risk for CVD. Being women (OR=0.558, 95%CI: 0.494-0.630), high BMI (OR=0.948, 95%CI: 0.904-0.994), higher levels of education (OR=0.708, 95%CI: 0.531-0.945), and higher annual household income (OR=0.773, 95%CI: 0.669-0.894) were the possible protective factors. Conclusions: Over half of the population at high-risk for CVD in Jiangsu showed abnormal carotid arteries. High blood pressure, high blood glucose, high blood lipids and smoking were the main factors that could be changed.

Transcriptome Reveals the Rice Response to Elevated Free Air CO2 Concentration and TiO2 Nanoparticles

Increasing CO₂ levels are speculated to change the effects of engineered nanomaterials in soil and on plant growth. How plants will respond to a combination of elevated CO₂ and nanomaterials stress has rarely been investigated, and the underlying mechanism remains largely unknown. Here, we conducted a field experiment to investigate the rice (Oryza sativa L. cv. IIyou) response to TiO₂ nanoparticles (nano-TiO₂, 0 and 200 mg kg^-1) using a free-air CO₂ enrichment system with different CO₂ levels (ambient ∼370 μmol mol^-1 and elevated ∼570 μmol mol^-1). The results showed that elevated CO₂ or nano-TiO₂ alone did not significantly affect rice chlorophyll content and antioxidant enzyme activities. However, in the presence of nano-TiO₂, elevated CO₂ significantly enhanced the rice height, shoot biomass, and panicle biomass (by 9.4%, 12.8%, and 15.8%, respectively). Furthermore, the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis revealed that genes involved in photosynthesis were up-regulated while most genes associated with secondary metabolite biosynthesis were down-regulated in combination-treated rice. This indicated that elevated CO₂ and nano-TiO₂ might stimulate rice growth by adjusting resource allocation between photosynthesis and metabolism. This study provides novel insights into rice responses to increasing contamination under climate change.

[Prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province]

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions: The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.

Oxidative stress, defense response, and early biomarkers for lead-contaminated soil in Vicia faba seedlings

Chemical analyses and biological measurements were investigated in leaves of Vicia faba seedlings exposed to extraneous lead (Pb) at 0 to 2,000 mg/kg of soil for a month. The results showed that superoxide radical (O*(2)(-)) production, increased along with total Pb in leaves and available Pb in soil, resulted in enhancement of malondialdehyde and carbonyl groups. Antioxidant enzymes, including corresponding isoenzymes and heat shock protein 70 (hsp 70), were also enhanced to some extent. Significant changes were detected in the patterns and intensities of guaiacol peroxidase isoenzymes, while superoxide dismutase, catalase, and ascorbate peroxidase isoenzymes only changed intensities. Superoxide dismutase activities increased with the increase of extraneous Pb at 0 to 500 mg/kg of soil and tended to decline thereafter, which might be responsible for the decrease of hydrogen peroxide and accumulation of O*(2)(-). Guaiacol peroxidase and ascorbate peroxidase enzymes were upregulated to become major scavengers of excess hydrogen peroxide on the condition of decreased catalase activities. Levels of hsp 70 were well correlated with Pb contents in leaves (r=0.777), O*(2)(-) accumulation (r = 0.985, p<0.01), and carbonyl groups (r=0.920, p<0.01) under extraneous Pb at 0 to 250 mg/kg of soil, suggesting that hsp 70 induced by O*(2)(-) was possibly involved in disposal of denatured proteins. The results showed that O*(2)(-), hsp 70, and guaiacol peroxidase isoenzymes had the most sensitive responses in the seedlings and these parameters could be potential early biomarkers of soil Pb contamination.