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The role of alkali metals in the development of neural tube defects (NTDs) is little known. We examined the associations between placental concentrations of lithium (Li), sodium (Na), potassium (K), rubidium (Rb), and cesium (Cs), and the occurrence of NTDs in fetuses.408 women who had NTD-affected pregnancies and 593 women who delivered healthy infants were included. Logistic regression, weight quantile sum regression (WQSR), and Bayesian kernel machine regression (BKMR) were applied to assess whether these metals are associated with the occurrence of NTDs.Cs showed an inverse association with the odds of NTDs [adjusted odds ratio (aOR): 0.58, 95% confidence interval (CI): 0.36-0.91] in single-metal logistic model. Estimates did not change much in the multiple-metal logistic model. In WQSR, the WQS index was inversely associated with the odds of NTDs (aOR: 0.62, 95%CI: 0.51-0.75), in which Cs (weighted 0.45) had the highest weight. In BKMR, the odds of NTDs decreased with the levels of the five-metal mixtures. Cs was associated with decreased odds of NTDs when the remaining four metals were fixed at their 25A high concentration of Cs and Na in placental tissue was respectively associated with decreased and increased odds of NTDs. In addition, the occurrence of NTDs decreased with the levels of the five-metal mixtures.

Exposure to copper, silver, and titanium has been reported to be associated with a variety of adverse effects on humans, but it is little focused on the fetus. We investigated the associations between prenatal exposure to the three metals (copper, silver, and titanium) and risk for fetal neural tube defects (NTDs). Placental samples from 408 women with pregnancies affected by NTDs and 593 women with normal pregnancies were collected from 2003 to 2016 in Pingding, Xiyang, Shouyang, Taigu, and Zezhou counties of China. Multilevel mixed-effects logistic regression and Bayesian kernel machine regression (BKMR) were used to evaluate the single and joint effects of the metals on NTDs. Silver was associated with an increased risk for NTDs in a dose-response fashion in single-metal logistic regression, with adjusted odds ratios (95% confidence intervals) of 1.78 (1.04-3.06) and 1.92 (1.11-3.32) in the second and third tertiles, respectively, compared to the lowest tertile. BKMR revealed toxic effects of silver on NTDs and the association appeared to be linear. No interaction of silver with any of the other two metals was observed. Besides, silver concentration was positively correlated with maternal certain dietary intakes. Placental high silver concentrations are associated with an elevated risk for NTDs. Maternal diet may be a source of silver exposure.

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Previous epidemiological studies have shown that prenatal exposure to organochlorine pesticides (OCPs) entails a variety of adverse impacts on fetal health, but it is not yet known whether it is associated with risk for orofacial clefts (OFCs). This study of 103 fetuses or newborns with a diagnosis of OFCs (cases) and 103 healthy newborns without malformations (controls) examined whether prenatal exposure to OCPs, as indicated by their concentrations in placental tissue, is a risk factor for OFCs. No differences were found in the median concentrations of OCPs between cases and controls, with exception of o,p'-dichlorodiphenyldichloroethylene, o,p'-dichlorodiphenyldichloroethane, and total o,p'-dichlorodiphenyltrichloroethane (DDTs), whose concentrations were higher in controls than in cases (Ps 0.05). Although higher concentrations of placental δhexachlorocyclohexane and isodrin were found to be associated with decreased risk for OFCs in logistic regression, no association was observed in the Bayesian kernel machine regression, a novel statistical model in analyzing exposure mixtures. Women who reported periconceptional folic acid supplementation had lower placental concentrations of DDTs than women who did not. In conclusion, no association between levels of OCPs in placental tissue and risk for OFCs was observed in this population. Supplementation with folic acid may help decrease the levels of DDTs in placental tissue, but further studies are needed to confirm this unexpected finding.

Background: Exposure to copper, silver, and titanium has been reported to be associated with a variety of adverse effects on humans. However, few studies have focused on the fetus, which is vulnerable to environmental insults. We investigated the associations between prenatal exposure to the three metals and risk for fetal neural tube defects (NTDs).Methods: Placental samples from 408 women with pregnancies affected by NTDs and 593 women with normal pregnancies were collected from 2003 to 2016 in an NTD high-risk area in northern China. Placental metal concentrations were quantified and used as prenatal exposure markers. Multilevel mixed-effects logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the association between metal concentrations and risk for NTDs. Single and joint effects of the metals on NTDs were evaluated with Bayesian kernel machine regression (BKMR), which can account for correlation, nonlinearity, and interaction between metals.Results: NTDs had higher concentrations of copper (4.16 μg/g) and silver (0.96 ng/g) than controls (copper: 3.91 μg/g; silver: 0.96 ng/g). Silver was associated with an increased risk for NTDs in a dose-response fashion in single-metal logistic regression, with adjusted ORs (95% CIs) of 1.78 (1.04–3.06) and 1.92 (1.11–3.32) in the second and third tertiles, respectively, compared to the lowest tertile. BKMR revealed toxic effects of silver on NTDs when the concentrations of copper and titanium were fixed at their 25th, 50th, and 75th percentiles, and the association appeared to be linear. No interaction of silver with any of the other two metals was observed. Besides, silver concentration was positively correlated with maternal certain dietary intakes, such as meat or fish, during the periconceptional period.Conclusions: High silver concentrations in placental tissue are associated with an elevated risk for NTDs in offspring. Maternal diet may be a source of silver exposure.

Growing evidence suggests that essential trace element imbalance during pregnancy may contribute to fetal malformations, but the role of essential trace elements in the occurrence of orofacial clefts (OFCs) is unknown. We aimed to examine the association between concentrations of zinc (Zn), manganese (Mn), selenium (Se), cobalt (Co), molybdenum (Mo), and nickel (Ni) in placental tissues and the risk for OFCs in offspring in a rural population in northern China with a high prevalence of OFCs.The case-control study subjects were 103 OFC infants and 206 non-malformed infants. The concentrations of selected trace elements in placental tissues were determined using inductively coupled plasma-mass spectrometry. Sociodemographic information was collected from the mothers through face-to-face interviews using a structured questionnaire. The risk for OFCs in association with higher concentrations of the trace elements was estimated using the odds ratio (OR) with its 95% confidence interval (95% CI).The placental median concentrations of Se and Ni were significantly lower, but those of Mo were significantly higher in OFC cases than in controls (all P 0.05). A Se concentration above the median of all subjects was associated with a 58% reduced risk for OFCs (adjusted OR 0.42, 95% CI 0.23, 0.77) after adjusting for potential confounding factors. The risk for OFCs decreased with increases in placental Se concentrations, with adjusted ORs of 0.45 (95% CI 0.22, 0.92) for the second tertile and 0.22 (95% CI 0.10, 0.49) for the top tertile of Se concentration, with the lowest tertile concentration as the referent (PThe concentration of Se in placental tissues was dose-dependently associated with decreased risk for OFCs in offspring. This finding suggests that maternal Se intake during pregnancy may protect against OFCs in offspring.

Uranium and thorium are common radioactive elements that exist in the environment. However, few environmental epidemiological studies have focused on their possible effects on congenital malformations. Here, we explored the association between uranium and thorium concentrations in maternal scalp hair grown from 3 months before to 3 months after conception, namely during the periconceptional period and the risk of orofacial clefts (OFCs) in offspring. Our study included 153 women whose pregnancies were affected by OFCs (cases) and 601 women who delivered infants without birth defects (controls) from four provinces in China. Face-to-face interviews were used to collect sociodemographic characteristics with a structured questionnaire. Concentrations of uranium and thorium in maternal scalp hair grown during the periconceptional period were detected using inductively coupled plasma-mass spectrometry. The risk of OFCs in association with higher concentrations of the two radioactive elements was estimated using odds ratios (ORs) and 95% confidence intervals (CIs) while adjusting for potential confounding factors. The levels of uranium and thorium in maternal hair were in agreement with the published literature. After adjusting for several confounders, the ORs of thorium in the highest, upper, and lower quartile versus the lowest quartile were 2.63 (95% CI, 1.41-4.92), 1.98 (95% CI, 1.03-3.79), and 2.73 (95% CI, 1.46-5.12), respectively. No association was found between levels of uranium and the risk of OFCs. Maternal periconceptional exposure to thorium may be a risk factor for OFCs in offspring.

Herein, combined with the outstanding adsorption ability of flower-like MoS2 with ultra-thin nanosheets and the good electrical conductivity of reduced graphene oxide (rGO), a sensitive and anti-interference electrochemical sensing interface for the analysis of Pb(II) was constructed by using MoS2/rGO nanocomposite modified glassy carbon electrode (MoS2/rGO-GCE). The stripping behavior of Pb(II) was estimated using square wave anodic stripping voltammetry (SWASV), a high sensitivity of 50.80 μA μM−1 was achieved, and the limit of detection (LOD) was determined to be 0.005 μM (3σ method). The reasons for the excellent electrochemical performance of MoS2/rGO-GCE toward Pb(II) is that the excellent adsorption capacity and electrical conductivity, and the redox reaction of Pb(II) occurs directly on the surface of the MoS2/rGO nanocomposite. Moreover, series interference experiments were systematically conducted, the sensitivity of Pb(II) has no obvious change in the presence of other coexist heavy metal ions. In addition, an intriguing interference phenomenon between Pb(II) and Cu(II) was found. When Cu(II) exists in the solution, two stripping peaks of Pb(II) were observed, this phenomenon can be explained that the form of Pb Cu alloy or intermetallic compounds during the preconcentration process. Further experiments indicated that the proposed method has good stability and reproducibility. Finally, the accurate detection result of Pb(II) in wastewater sample gathered from Wangxiaoying wastewater treatment plant were obtained.

Natural exposure to and increasing use of barium and aluminum in various products, such as plastics, rubber, and food additives, raise concerns for their potential health impacts on pregnant women and vulnerable fetuses. We investigated whether there are associations between barium and aluminum concentrations in placental tissues and the risk for orofacial clefts (OFCs) in offspring. In this case-control study, we recruited 103 women with OFC-affected pregnancies and 206 women who delivered healthy newborns. Concentrations of barium and aluminum in placental tissues were measured using inductively coupled plasma-mass spectrometry. Information on maternal sociodemographic characteristics and diet was collected via face-to-face interviews using a structured questionnaire. Aluminum concentrations in placental tissues were not associated with OFC risk. However, a higher concentration of barium in placental tissues was associated with an increased risk for OFCs, with an adjusted odds ratio (OR) of 2.42 (95% confidence interval [95% CI] 1.34–4.40) for total cleft lip with or without cleft palate (CL ± P), and 1.90 (95% CI 1.03–3.50) for isolated CL ± P. There was a positive dose–response relationship between placental barium concentrations and OFC risk. Maternal exposure to barium may increase the risk for OFCs in offspring.

Aluminum (Al)1 is ubiquitously present in the environment, and human exposure to Al is common. Al has been reported to be involved in various human diseases and adverse pregnancy outcomes, including neural tube defects (NTDs). This study aimed to examine the association between prenatal Al exposure and the risk for NTDs using Al concentrations in maternal serum and placental tissue. The subjects were recruited from six counties/cities in the Shanxi province of northern China from 2003 to 2016. Al concentrations in both types of specimens were assessed using inductively coupled plasma-mass spectrometry. In the maternal serum cohort (200 cases and 400 controls), compared to the lowest tertile concentration of Al, the highest Al tertile was associated with 2.42-fold (95% confidence interval, 1.23-4.87) increased risk after adjustment for confounding factors. In the placental tissue cohort (408 cases and 593 controls), the highest tertile of Al also tended to be associated with an elevated risk for NTDs [adjusted odds ratio, 1.60 (0.94-2.70)]. When analyzed by NTD subtypes, the highest Al tertile was associated with an increased risk for anencephaly in both cohorts after adjustment for confounders [odds ratio, 1.97 (1.15-3.48) in the maternal serum cohort; odds ratio, 4.75 (2.01-12.00) in the placental tissue cohort]. Taken together, using concentrations of Al in maternal serum and placental tissue as exposure markers, we found that prenatal exposure to higher levels of Al is a risk factor for fetal NTDs, especially for the anencephaly subtype.

Background Epigenetic dysregulation is one of the postulated underlying mechanisms of neural tube defects (NTDs). Polycyclic aromatic hydrocarbons (PAHs), a group of environmental pollutants that are reported as a risk factor of NTDs, may cause decreased genome-wide DNA methylation. With DNA extracted from neural tissues, this study identified gene(s) whose hypomethylation was related to elevated risk for NTDs and examined whether its hypomethylation is related to PAH exposure. Results Using data profiled by Infinium HumanMethylation450 BeadChip array from 10 NTD cases and eight controls, ZIC4, CASP8, RAB32, RARA, and TRAF6 were identified to be the top five genes in NTD-related hypomethylated gene families. Among all identified genes, ZIC4 had the largest number of differently methylated CpG sites (n = 13) in the promoter region and 5′ UTR. Significantly decreased methylation in the ZIC4 promoter region and 5′ UTR was verified in an independent cohort of 80 cases and 32 controls (p < 0.001) utilizing the Sequenom EpiTYPER platform. Hypomethylation of ZIC4 was associated with a higher risk of NTDs [adjusted OR = 1.08; 95% confidence interval (CI): 1.03, 1.13] in a logistic regression model. Mean methylation levels in the promoter region and 5′ UTR of ZIC4 tended to be inversely associated with levels of high-molecular-weight PAHs in fetal liver among NTD fetuses (β [95% CI]: −0.045 [−0.091, 0.001], p = 0.054). Six and three CpG sites in the ZIC4 promoter region and 5′ UTR were inversely correlated with antioxidant indicators and protein oxidation markers (ρ: −0.45 to −0.75, p < 0.05) in fetal neural tissues, respectively. In a whole-embryo cultured mouse model, hypomethylation of the Zic4 promoter region and 5′ UTR and upregulation of Zic4 were observed, coupled with increased NTD rates after BaP exposure. The antioxidant N-acetyl-L-cysteine normalized the changes observed in the BaP exposure group. Conclusion Hypomethylation of the ZIC4 promoter region and 5′ UTR may increase the risk for NTDs; oxidative stress is likely to play a role in the methylation change of Zic4 in response to PAH exposure in NTD formation.

Background To examine whether exposure to secondhand smoke (SHS) during the periconceptional period among nonsmoking women is associated with an increased risk for orofacial clefts (OFCs) in offspring in a population with low rates of maternal active smoking but high rates of SHS exposure. Methods We recruited 240 women with OFC-affected pregnancies and 1420 women who delivered healthy infants from a population-based case-control study in northern China during 2002 and 2016. Data including self-reported SHS exposure were collected by trained health care workers through face-to-face interviews. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were used to estimate the association between SHS exposure and OFC risk. Results The unadjusted ORs for OFCs and cleft lip with or without cleft palate (CL±P) in association with SHS exposure were both 1.6 (95% CI 1.2, 2.1). After adjusting for maternal fever or flu, farming occupation, infant sex, and history of pregnancy affected by birth defects, the adjusted ORs were both 1.6 (95% CI 1.2, 2.2). Frequent SHS exposure (>6 times/week) was associated with an even higher risk for OFCs (adjusted OR 2.6, 95% CI 1.8, 3.8) and for CL±P (adjusted OR 2.5, 95% CI 1.7, 3.7). Conclusions Maternal SHS exposure during the periconceptional period increases the risk for OFCs in offspring among nonsmoking mothers.

Rare earth elements (REEs) are ubiquitous in the environment. Animal experiments have shown that many REEs have adverse impacts on the health of fetuses. However, data from humans are scarce. In this study, we examined the associations between concentrations of 10 REEs in maternal serum and the risk for fetal neural tube defects (NTDs). The study included 200 pregnant women with pregnancies affected by NTDs and 400 pregnant women with healthy fetuses/infants. Fifteen REEs in maternal serum were assessed; 10 of them were detectable in over 60% of samples and were included in statistical analyses, including lanthanum (La), cerium (Ce), praseodymium (Pr), neodymium (Nd), samarium (Sm), europium (Eu), terbium (Tb), dysprosium (Dy), lutetium (Lu), and yttrium (Y). When the elements were considered individually with the use of Logistic regression model, the risk for NTDs increased by 2.78-fold (1.25–6.17) and 4.31-fold (1.93–9.62) for La, and 1.52-fold (0.70–3.31) and 4.73-fold (2.08–10.76) for Ce, in the second and third tertiles, respectively, compared to the lowest concentration tertile. When Bayesian kernel machine regression was used to examine the joint effect of exposure to all 10 REEs, the risk for NTDs increased with overall levels of these REEs and the association between La and NTD risk remained when other nine elements were taken into consideration simultaneously. Taken together, this study shows that the risk for NTDs increases with La concentrations when single REEs are considered and with concentrations of all 10 REEs when these REEs are considered as a co-exposure mixture. Keywords: Rare earth element, Neural tube defect, Serum, Pregnancy, Bayesian kernel machine regression

Neural tube defects (NTDs) have a complex etiology. Few studies have assessed alkaline earth metals exposures and occurrence of NTDs. We examined the association between prenatal exposure to magnesium (Mg), calcium (Ca), strontium (Sr) and barium (Ba) and risk for NTDs in a case-control study, and assessed the teratogenic effects of Ba on mice. Placentas were collected from 408 women with NTD-affected pregnancies and 593 women who delivered healthy infants, and concentrations of these metals were determined as prenatal exposure markers. The single effect of individual exposure and joint effect of coexposure to these metals were evaluated with logistic regression and Bayesian kernel machine regression (BKMR), respectively. Barium chloride (BaCl2) was intragastrically administered to pregnant ICR mice and fetal mice were examined for NTDs. Median concentrations of Mg and Ba were higher in NTD cases than in controls (Pall

Previous studies examining the impact of the unethical behavior of a group of colleagues on an individuals unethical behavior have typically employed social learning theory as a theoretical foundation. In this research, we extend these rich yet defective examinations by addressing the largely ignored relationship perspective. Drawing on the social network perspective, we posit that the structure of relationships significantly influences the process of unethical behavior diffusion. Consistent with the theoretically derived hypotheses, our agent-based model simulation results provide general support for our theoretical model: colleagues unethical behaviors positively affect an individuals unethical behaviors, and this influence is positively moderated by group network density, group network closeness centrality and group size. This paper also discusses theoretical contributions, practical values, limitations and directions for future research.

Orofacial clefts (OFCs) have multifactorial etiologies. Prenatal exposure to heavy metals can induce OFCs in animal models, but evidence from studies of human subjects is scarce. We examined whether concentrations of mercury (Hg), cadmium (Cd), lead (Pb), and arsenic (As) in placental tissues are associated with risk for OFCs in offspring. This population-based case-control study included 103 newborns affected by OFCs with available placental tissues and 206 controls randomly selected from 509 non-malformed newborns with available placenta samples, recruited in five rural counties in northern China. Sociodemographic information was collected using a structured questionnaire in face-to-face interviews. The concentrations of Hg, Cd, Pb, and As in placental tissues were analyzed using an inductively coupled plasma-mass spectrometry in helium mode. The median concentrations of Hg (7.4 ng/g), Cd (57.1 ng/g), and Pb (96.1 ng/g) were all statistically significantly higher in OFC cases than in controls (Hg 5.5 ng/g, Cd 38.6 ng/g, and Pb 67.9 ng/g, respectively); no differences were observed between the two groups in median concentrations of As. Concentrations above the median for all subjects were associated with a 2.33-fold (95% confidence interval [CI] 1.33–2.09) increased OFC risk for Cd and a 3.08-fold (95% CI 1.74–5.47) increased risk for Pb. The risk for OFCs increased with concentration tertiles, with an adjusted odds ratio of 3.06 (95% CI 1.36–6.88) for the second tertile and 8.18 (95% CI 6.64–18.37) for the highest tertile of Cd, and 3.88 (95% CI 1.78–8.42) for the second tertile and 5.17 (95% CI 2.37–11.29) for the highest tertile of Pb. The association between Hg concentration and OFC risk was borderline nonsignificant after adjusting for confounding factors. Prenatal exposure to Cd and Pb, as reflected by their concentrations in placental tissues, is associated with an increased risk for neonatal OFCs.

Urinary volatile organic compounds (VOCs) profiling has recently received considerable attention because it can be obtained noninvasively and conveniently while it can be successfully used in a variety of diseases and can provide unique biomarkers. The aim of current study was to investigate potential biomarkers between minimal change type nephrotic syndrome (MCNS) and normal. Urinary samples were collected from 38 minimal change type nephrotic syndrome patients and 15 healthy controls. Solid phase microextraction (SPME) and chromatography- mass spectrometry (GC-MS) were used to analysis the urinary metabolites. To deal with the final data, the statistical methods principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLSDA) were performed. Six specific VOC biomarkers were present at abnormal levels in the urine of MCNS patients. These VOCs included trans-2,2-dimethyl-4-decene; pyrrole; carbamic acid, monoammonium salt; 1-butyne, 3,3-dimethyl-; diisopropylamine; and 4-heptanone. These biomarkers may be useful as a new diagnostic method and for monitoring the prognosis for MCNS patients.

Background Breath analysis of propofol is a potential noninvasive method for approximating the plasma propofol concentration. There have been various reported techniques for measuring the exhaled propofol concentration at steady state; however, the propofol concentration undergoes marked changes during clinical anesthesia. Therefore, this study investigated the use of membrane inlet-ion mobility spectrometry (MI-IMS) to monitor exhaled propofol discontinuously and continuously during propofol anesthesia. Methods The study included 19 patients of American Society of Anesthesiologists physical status I or II. In experiment I (discontinuous study), breath and blood samples were collected discontinuously, with stable target propofol concentrations of 2.8 μg/ml, 3.2 μg/ml, 3.5 μg/ml, and 3.8 μg/ml. In experiment II (continuous study), propofol concentration was maintained at 3.5 μg/ml after induction, and exhaled breath was collected continuously every 3 min during propofol infusion. Relationships of the exhaled propofol concentration with the plasma propofol concentration, measured by high-performance liquid chromatography and the continuously measured bispectral (BIS) index were investigated. Results Comparison of the exhaled and plasma propofol concentrations revealed a bias ± precision of 2.1% ± 14.6% (95% limits of agreement: − 26.5–30.7%) in experiment I and − 10.4% ± 13.2 (− 36.3–15.4%) in experiment II. In both experiments, exhaled propofol concentrations measured by MI-IMS were consistent with, the propofol effect represented by the BIS index. Conclusions MI-IMS may be a suitable method to predict plasma propofol concentration online during propofol anesthesia. Monitoring exhaled propofol may improve the safety of propofol anesthesia.

(90−x)TeO2–xZnO–10Bi2O3 (x = 15, 17.5, 20 and 22.5, in mol%) and 70TeO2–20ZnO–(10−y)Bi2O3−yNa2O (y = 1, 3, 5, 7, and 10, in mol%) glasses, and the corresponding Ag paste were prepared in order to prove that the Te-based glass frit could be applied to Ag pastes to fabricate Ag electrode. The relationship between structure and properties of the glasses was analyzed. The effects of glass frit on the microstructure, adhesion force, and resistivity of the Ag electrode were studied. The microstructure of Ag electrodes and the phase analysis of interface between Ag electrodes and the Si wafer were investigated using SEM and XRD. Finally, the 70TeO2–20ZnO–5Bi2O3–5Na2O glass showed better performance in the paste. What is more, Ag crystallites could be found on the Si wafer. These results suggested that the Te-based glass frit could react with SiN x anti-reflecting coating and Si to serve as a medium for forming Ag crystallites.

In order to prove that the Te-based glass frit could be applied to Ag pastes to fabricate Ag electrode and elucidate the reactions among Ag, the frit, and the Si wafer, the Te-based glass and Ag pastes with different contents of glass frit (0 wt%, 1 wt%, 3 wt%, 5 wt%, and 7 wt%) were prepared. The microstructures of Ag electrodes and the phase analysis of interface between Ag electrodes and the Si wafer were investigated using scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD). When the content of glass frit is 3 wt%, the Ag electrode has good adhesion with Si wafer. What’s more, Ag crystallites and metallic Te could be found on the Si wafer. These results suggest that the TeO2 in the glass frit could react with SiN x anti-reflecting coating (ARC) and Si to serve as a medium for forming Ag crystallites.

Amyotrophic lateral sclerosis (ALS) is an incurable neurological degenerative disease. It can cause irreversible neurological damage to motor neurons; typical symptoms include muscle weakness and atrophy, bulbar paralysis and pyramidal tract signs. The ALS-mimicking disease cervical spondylotic myelopathy (CSM) presents similar symptoms, but analysis of breath volatile organic compounds (VOCs) can potentially be used to distinguish ALS from CSM. In this study, breath samples were collected from 28 ALS and 13 CSM patients. Subsequently, gas chromatography/mass spectrometry (GCMS) was used to analyze breath VOCs. Principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLSDA) were the statistical methods used to process the final data. We identified 4 compounds with significantly decreased levels in ALS patients compared with CSM controls: (1) carbamic acid, monoammonium salt; (2) 1-alanine ethylamide, (S)-; (3) guanidine, N,N-dimethyl-; and (4) phosphonic acid, (p-hydroxyphenyl)-. Currently, the metabolic origin of the VOCs remains unclear; however, several pathways might explain the decreasing trends observed. The results of this study demonstrate that there are specific VOC profiles associated with ALS and CSM patients that can be used to differentiate between the two. In addition, these metabolites could contribute to a better understanding of the underlying pathophysiological mechanisms of ALS.

Currently, there is no adequate, sensitive, reproducible, specific and noninvasive biomarker that can reliably be used to detect renal cell carcinoma (RCC). Previous studies have elucidated the urinary non-volatile metabolic profile of RCC. However, whether urinary volatile organic compound (VOC) profiles are able to identify RCC remains to be elucidated. In the present study, urine was collected from 22 patients with RCC and 25 healthy subjects. Principal component analysis and orthogonal partial least square discriminant analysis were used to compare the data of patients and healthy subjects, and preoperative and postoperative patients undergoing radical nephrectomy. In total, 11 VOC biomarkers were elevated in the RCC patients compared to the healthy subjects, which were phenol; decanal; 1,6-dioxacyclododecane-7,12-dione; 1-bromo-1-(3-methyl-1-pentenylidene)-2,2,3,3-tetramethyl-cyclopropane; nonanal; 3-ethyl-3-methylheptane; isolongifolene-5-ol; 2,5-cyclohexadiene-1,4-dione, 2,6-bis(1,1-dimethylethyl); tetradecane; aniline; and 2,6,10,14-tetramethyl-pentadecane. Three biomarkers were decreased in RCC patients: styrene, 4-heptanone and dimethylsilanediol. In preoperative patients, 2-ethyl-1-hexanol and cyclohexanone were elevated, while 6-t-butyl-2,2,9,9-tetramethyl-3,5-decadien-7-yne were decreased when compared to postoperative patients. Compared with the healthy subjects, RCC has a unique VOC profile, suggesting that VOC profiles may be a useful diagnostic assay for RCC.

Identifying and explaining the property of Chinese Materia Medica (CMM) is an important and urgent mission in recent CMM researches. In the present work, we built a combination system for predicting the cold/hot property of CMM based on chemical material basis. A novel strategy, weight center treatment, was used to solve the problem that the chemical description was unable to be applied to CMM. As the results of prediction, the accuracy of 83.3% and 81.0% for the training and the test set, respectively, indicates that this system is a useful tool to predict the property of unidentified folk herbs and foreign herbs. It will characterize these herbs with traditional Chinese medicine properties so as to design new CMM formulas for better therapeutics. Moreover, we found some interesting explanation about the property of CMM based on chemical information by using the selected descriptors. It will give new insight into the CMM property from the standpoint of chemistry.

We have investigated the feedback control of the cooperative dynamics of two coupled electrochemical oscillators that is induced merely by external noise. The interacting electrochemical cells are modeled with parameter values at which no autonomous oscillations occur, and each unit is forced by its own source of random fluctuations. Application of delayed feedback to only one of two subsystems is shown to be able to change the coherence and time scales of noise-induced oscillations either in the given subsystem or globally. It can also induce or suppress stochastic resonance under the certain conditions.

To identify the best lung ventilation strategy for acute respiratory distress syndrome (ARDS), we performed a network meta-analysis. The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, CINAHL and the Web of Science were searched and 36 eligible articles were included. Compared with higher tidal volumes with FiO2-guided lower positive end-expiratory pressure [PEEP], the hazard ratios (HRs) for mortality were 0.624 (95% confidence interval (CI) 0.419–0.98) for lower tidal volumes with FiO2-guided lower PEEP and prone positioning and 0.572 (0.34–0.968) for pressure-controlled ventilation with FiO2-guided lower PEEP. Lower tidal volumes with FiO2-guided higher PEEP and prone positioning had the greatest potential to reduce mortality and the possibility of receiving the first ranking was 61.6%. Permissive hypercapnia, recruitment maneuver and low airway pressures were most likely to be the worst in terms of all-cause mortality. Compared with higher tidal volumes with FiO2-guided lower PEEP, pressure-controlled ventilation with FiO2-guided lower PEEP and lower tidal volumes with FiO2-guided lower PEEP and prone positioning ventilation are associated with lower mortality in ARDS patients. Lower tidal volumes with FiO2-guided higher PEEP and prone positioning ventilation and lower tidal volumes with pressure-volume (P–V) static curve-guided individual PEEP are potential optimal strategies for ARDS patients.

Exhaled nitric oxide (eNO) has been suggested to be a marker of small airway injury. We investigated the effects of different ventilation strategies on eNO. Sixty-nine patients who received elective open abdominal surgery under general anesthesia with more than 2 h of surgery duration were randomly divided into three groups: high tidal volume of 10-12 ml kg(-1) predicted body weight (PBW) with zero end-expiratory pressure (ZEEP) (high VT + ZEEP group); low tidal volume of 6-8 ml kg(-1) PBW with 8 cm H2O positive end-expiratory pressure (PEEP) (low VT + PEEP group); and low tidal volume of 6-8 ml kg(-1) PBW with 8 cm H2O PEEP and recruitment maneuvers (low VT + PEEP + RMs group). eNO, respiratory system compliance (Crs), oxygenation index, inflammatory mediators tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), IL-8, prostaglandin E2 (PGE2) and PGF2a as well as pulmonary function were measured during the perioperative period. The postoperative eNO decreased in 78.3% of patients in the high VT + ZEEP group and low VT + PEEP group, and increased in 56.5% of patients in the low VT + PEEP + RMs group (P = 0.016). The Crs level in the high VT + ZEEP group significantly decreased with time but significantly increased in the low VT + PEEP + RMs group (P 0.05). The oxygenation index, inflammatory mediators and pulmonary function did not statistically differ among the three groups. Compared with the low VT + PEEP + RMs group, the decreasing rate of postoperative eNO in the high VT + ZEEP and low VT + PEEP groups was higher, which may imply small airway injury during geriatric abdominal surgery.

The potentially harmful effects of short-term mechanical ventilation during surgery have been examined in recent years. An optimal strategy for mechanical ventilation of patients during non-laparoscopic abdominal surgery must be devised. A total of 63 patients undergoing elective open abdominal surgery with more than 2 h of ventilation time were selected for this randomized, open-label, clinical study. They were divided into three ventilation groups: high volume of 9 ml/kg IBW (ideal body weight) with ZEEP (zero end-expiratory pressure); low volume of 7 ml/kg IBW with 8 cm H2O PEEP (positive end expiratory pressure); and low volume of 7 ml/kg IBW with 8 cm H2O PEEP and recruitment. Intraoperative PaO2/FiO2 ratio and pulmonary compliance and postoperative pulmonary function were measured. There were no significant differences in intraoperative PaO2/FiO2 ratio among the three groups (P=0.31). The pulmonary compliance of three groups showed different changes over time (group effect over time P=0.0006). There were no significant differences in FEV1 or FVC among the three groups (P=0.32 and 0.09, respectively), but both of these measurements showed different changes over time (group effect over time P0.001). On the first postoperative day, the low volume with high PEEP and recruitment group had significantly higher FEV1 than the other two groups (mean ± SD): 1.52 ± 0.37 versus 0.95 ± 0.38 (P0.001) and 1.52 ± 0.37 versus 0.95 ± 0.34 (P0.001), respectively. Low tidal volume with PEEP and recruitment showed advantages in maintaining the pulmonary compliance and expediting the recovery of the 1(st) postoperative day's pulmonary function in patients undergoing non-laparoscopic abdominal surgery.

To study formulation of self-microemulsifying drug delivery system (SMEDDS) of mangiferin phospholipid complex and improve dissolution and bioavailability of mangiferin.Ternary phase diagram was applied to optimize the prescription of self-microemulsifying drug delivery system of mangiferin phospholipid complex, and the best recipe was selected by comprehensive evaluation of the speed of microemulsifying, microemulsion size and electric potential.The optimum formulation of SMEDDS was composed of IPM-Cremphor EL35-labrasol = 2 : 4.8 : 3.2.Self-microemulsifying drug delivery system of mangiferin phospholipid complex can effectively improve the dissolution of Mangiferin.

To investigate the distribution and drainage of lymphatic vessels of tongue, and to provide anatomical evidence for treatment of tongue cancer.Indirect lymphatic injection was employed, combined with clearing method with winter green oil and corrosive cast technique, to study the distribution of lymphatic vessels of tongue. Anatomical methods were used to detect the sentinel lymph nodes in different region of tongue.The lymphatic vessels of dorsal mucosa composed of lymphocapillary vessels and anstomosing side branches were present by superficial and deep capillary networks. The distribution of lymphatic networks extend from tip to base and from one board to another, and was not influenced by the sulcus tenninalis and median lingual sulcus. Lymphatic vessels in the muscular portion communicated with lymphocapillary network of dorsal and ventral mucosa, which made the lymphatic vessels of tongue to be an integrity network structure. These characters of distribution influenced the lymphatic drainage of tongue. The results showed principal sentinel lymph nodes (SLNs) for anterior part of tongue were submental lymph nodes, submandibular lymph nodes and juguloomohyoid lymph nodes, for lateral part and middle part of tongue were submandibular lymph nodes, jugulodigastric lymph nodes and thyroid lymph nodes, and for root part of tongue were jugulodigastric lymph nodes. SLNs for every injection region were all presented at bilatral neck, but the frequency of stained SLNs at homolateral neck was more than that at contralateral neck.The lymphatic vessels of tongue arranged like a network, which made the lymphatic drainage at various ways and made the distribution of sentinel lymph nodes to be bilateral and dispersive.