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Objective The aim of the present study is to investigate the association of trace elements and the risk of type 2 diabetes mellitus. Design and methods The 1837 participants (637 men and 1200 women) aged 40–70 were from a cross-sectional community-based study performed in downtown Shanghai. All the participants without diabetes mellitus history underwent a 75-g OGTT. The participants with diabetes mellitus took 100 g steamed bread as the substitute. The fasting and OGTT 2 h or postprandial 2 h venous blood samples were collected. Blood glucose levels, fasting serum insulin concentrations, lipid profiles, HbA1C and 19 trace elements including magnesium, copper, zinc and selenium and so on were assayed. Results Of all the 1837 studied subjects, 510 subjects had diabetes mellitus (191 male, 319 female). Serum magnesium levels were decreased statistically (p < 0.05), but serum copper, zinc and selenium levels were significantly increased in subjects with diabetes mellitus compared to non-diabetic subjects (p < 0.01 for copper, p < 0.001 for zinc and selenium). Logistic regression analysis showed that serum magnesium was negatively associated with diabetes (p < 0.05) and serum copper, zinc, and selenium were all positively associated with diabetes (p < 0.05 for copper, p < 0.001 for both zinc and selenium). Correlation analysis showed a remarkable correlation between blood glucose, HbA1C and serum magnesium, copper, zinc, and selenium (p < 0.01 for zinc, p < 0.001 for copper, zinc and selenium). Conclusions Serum magnesium levels are decreased and serum copper, zinc and selenium levels are elevated in patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

To assess associations of single and combined exposures to lead and stress during different stages of pregnancy with offspring neurodevelopment. We measured prenatal lead (maternal blood-lead in early-pregnancy and umbilical-cord-blood-lead) and maternal stress levels in Shanghai-Birth-Cohort from 2013 to 2016. Maternal stress was assessed using Center-for-Epidemiological-Studies-Depression-Scale and Self-Rating-Anxiety-Scale during mid-pregnancy. The Ages-Stages-Questionnaires-3 (at 6/12-months-of-age) and Bayley-III (at 24-months-of-age) were both used to assess neurodevelopment. A total of 2132 mother-child pairs with both prenatal lead and stress measurements were included. The geometric-means of blood-lead in early-pregnancy and cord-blood-lead were 1.46 μg/dL and 1.33 μg/dL, respectively. Among the study women, 1.89 % and 0.14 % were screened positive for depression and anxiety. Adjusting for related confounders, the combined exposures had stronger adverse associations with offspring social-emotional skills than single exposures; and the combined exposure in early-pregnancy was associated with greater neurodevelopmental differences than combined exposure around-birth, especially in social-emotion at 24 months-of-age [β (95 %CI): − 10.48(−17.42, −3.54) vs. − 5.95(−11.53, −0.36)]. Both single and combined prenatal exposures to lead/stress impaired infant neuro-development, and the effects of combined exposure may be more profound than single exposures. Combined exposure in early-pregnancy may be associated with worse neurodevelopmental outcomes than combined exposure around-birth, especially in social-emotional development. • Effects of prenatal single and combined exposure to lead and stress were investigated using a large-scale birth cohort. • The overall levels of prenatal exposures to lead/stress were relatively low in the Shanghai study women. • Adverse effects of prenatal combined exposure on offspring neurodevelopment may be more profound than single exposure. • The impaired neurodevelopment domains in the offspring mainly include social-emotional development. • Higher levels of impairments were induced when the combined exposure occurred in an earlier stage of pregnancy. [ABSTRACT FROM AUTHOR]

Abstract: Methylmercury (MeHg) is a potent environmental neurotoxin that shows toxicity to developing central nervous system (CNS), causing brain damage in children even at low exposure levels. However, the mechanisms for its effect on CNS are not well understood. In current study, primary cultures of progenitor cells from embryonic cerebral cortex were used as a model system to study the potential effect and the underlying mechanism of MeHg on neural progenitor cells. Results showed that, in cultured cortical progenitor cells, 48-h exposure to low-level of MeHg (at 2.5nM, 5nM and 50nM, respectively) caused G1/S cell cycle arrest in a dose-dependent manner without inducing cell death. Interestingly, the expression of cyclin E, which promotes G1/S transition, but not cyclin D1 and CDK2, was selectively downregulated by exposure of MeHg. In addition, low-level of MeHg inhibited the maintenance of ERK1/2 phosphorylation, possibly by abolishing the late phase ERK1/2 activation induced by bFGF. Thus, MeHg may induce proliferation inhibition and cell cycle arrest of neural progenitor cells via regulating cyclin E expression and perturbing a pathway that involves ERK1/2. [Copyright &y& Elsevier]

Objective: To examine the relationship between sleep and obesity in children 3 to 4 years old in Shanghai, China. Study design: A total of 1311 Chinese children from 10 kindergarten classes in Shanghai, aged 3 to 4 years, who were participating in the kindergarten entrance health examination in 2000, were included in the study. Body weight and height were measured, and a questionnaire was given to the children''s parents about sleep and physical and social characteristics of the children and their family. The main outcome measure was obesity, defined as body mass index (kg/m2) ≥95th percentile for the children. Results: Compared with children reporting ≥11 hours of sleep per night, the odds ratio for childhood obesity was 4.76 (95% CI, 1.28-17.69) for children with <9 hours of sleep, and 3.42 (95% CI, 1.12-10.46) for children with 9.0 to 9.4 hours of sleep, after adjustment for age, sex, and other risk factors. Children with caregivers who slept less, who had mothers with higher education, or who co-slept with caregivers had less nighttime sleep than other children. Conclusion: Short sleep duration is positively associated with obesity in preschool children, and short nighttime sleep duration is significantly related to bedtime and co-sleeping with caregivers. [Copyright &y& Elsevier]

Although abundant evidence has suggested that early-life antibiotic exposure was associated with adipogenesis later in life, limited data were available on the effect of intrauterine antibiotic exposure on infant growth and growth speed. Additionally, few studies have investigated the role of the neonatal gut microbiota in the above association. In this study, we examined the association between intrauterine cumulative antibiotic exposure and infant growth and explored the potential role of the neonatal gut microbiota in the association. 295 mother-child pairs from the Shanghai Maternal-Child Pairs Cohort (MCPC) study were included, and meconium samples and infant growth measurements were assessed. Z-scores of length-for-age, weight-for-age (weight-for-age), and body mass index (BMI)-for-age (BMI-for-age) were calculated. Eighteen common antibiotics were measured in meconium. Multivariable linear regression models were applied to test the interrelationships between antibiotic exposure, diversity indicators, and the relative abundance of selected bacterial taxa from phylum to genus levels from least absolute shrinkage and selection operator (LASSO) and infant growth indicators. The detection rates of the 18 antibiotics, except for chlortetracycline, penicillin, and chloramphenicol, were below 10 %. Penicillin was found to be positively associated with infant growth at birth and with growth speed from 2 to 6 months. The Pielou and Simpson indexes were negatively associated with meconium penicillin. Nominally significant associations between penicillin and the relative abundances of several bacterial taxa from the phyla Proteobacteria, Bacteroidetes, and Firmicutes were found. The Pielou and Simpson indexes were also found to be negatively associated with infant growth. Among taxa selected from LASSO regression, the relative abundances of the phyla Actinobacteria and Firmicutes and order Bifidobacteriales were found to be significantly associated with weight and BMI growth speeds from 2 to 6 months. In conclusion, intrauterine antibiotic exposure can affect infant growth. The neonatal gut microbiota might play a role in the abovementioned association. [Display omitted] • Intrauterine penicillin exposure was positively associated with growth indicators at birth. • Even low intrauterine penicillin exposure can be linked to growth speed during infant periods. • Altered neonatal gut microbiota may be attributed to intrauterine penicillin exposure. • Altered neonatal gut microbiota was associated with growth indicators at birth and infant growth speed. • Targeting interfered neonatal gut microbiota under penicillin could help reduce its adverse effect. Intrauterine antibiotic exposure could decrease the diversity of neonatal gut microbiota and disturb the growth of infants. [ABSTRACT FROM AUTHOR]

At the end of 2019, a novel coronavirus, designated as SARS-CoV-2, emerged in Wuhan, China and was identified as the causal pathogen of COVID-19. The epidemic scale of COVID-19 has increased dramatically, with confirmed cases increasing across China and globally. Understanding the potential affecting factors involved in COVID-19 transmission will be of great significance in containing the spread of the epidemic. Environmental and meteorological factors might impact the occurrence of COVID-19, as these have been linked to various diseases, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), whose causative pathogens belong to the same virus family as SARS-CoV-2. We collected daily data of COVID-19 confirmed cases, air quality and meteorological variables of 33 locations in China for the outbreak period of 29 January 2020 to 15 February 2020. The association between air quality index (AQI) and confirmed cases was estimated through a Poisson regression model, and the effects of temperature and humidity on the AQI-confirmed cases association were analyzed. The results show that the effect of AQI on confirmed cases associated with an increase in each unit of AQI was statistically significant in several cities. The lag effect of AQI on the confirmed cases was statistically significant on lag day 1 (relative risk (RR) = 1.0009, 95% confidence interval (CI): 1.0004, 1.0013), day 2 (RR = 1.0007, 95% CI: 1.0003, 1.0012) and day 3 (RR = 1.0008, 95% CI: 1.0003, 1.0012). The AQI effect on the confirmed cases might be stronger in the temperature range of 10 °C ≤ T < 20 °C than in other temperature ranges, while the RR of COVID-19 transmission associated with AQI was higher in the relative humidity (RH) range of 10% ≤ RH < 20%. Results may suggest an enhanced impact of AQI on the COVID-19 spread under low RH. Unlabelled Image • AQI - COVID-19-confirmed cases association is statistically significant in some cities. • Lag effect of AQI on confirmed cases is statistically significant on lag 1–3 days. • AQI effect on the confirmed cases in temperature range of 10–20 °C may be stronger. • Impact of AQI on the spread of COVID-19 may be enhanced under low relative humidity. [ABSTRACT FROM AUTHOR]

Abstract: The relationship between prenatal stress (PS) exposure and neurodevelopmental deficits remains inconclusive, especially when assessing the role of PS duration and timing and sex-dependent effects. This study explored a sex-specific association between the duration and timing of exposure and the outcomes of PS-induced neurotoxicity in hippocampal microstructure, synaptophysin expression, and neurobehavioral performance in rats. Pregnant rats were randomly assigned to control, PS-ML (exposed to prenatal restraint stress in the mid-to-late period of pregnancy), or PS-L (exposed in the late period of pregnancy) groups, and offspring in each group were divided into two subgroups by sex. Surface-righting reflex test, cliff avoidance test and Morris water maze test showed that neurodevelopmental levels were reduced in PS-treated pups but without significant sex differences. On postnatal day 22, hippocampal microstructure was examined by electron microscopy, and the expression of hippocampal synaptophysin was assessed by western blot. Abnormal ultrastructural appearance of hippocampal neurons and myelin sheaths, more degenerating neurons and higher G-ratios were found in young PS-ML and PS-L rats as well as reduced expression of hippocampal synaptophysin, although PS-ML pups were more greatly affected than PS-L, with males showing slightly greater impairments than females. These findings suggest that hippocampal hypo-myelination and decreased synaptophysin expression in neurodevelopment may be a duration and time-dependent effect of prenatal stress exposure, modified slightly by sex. [Copyright &y& Elsevier]

Chinese children are exposed to broad environmental risks ranging from well-known hazards, such as pesticides and heavy metals, to emerging threats including many new man-made chemicals. Although anecdotal evidence suggests that the exposure levels in Chinese children are substantially higher than those of children in developed countries, a systematic assessment is lacking. Further, while these exposures have been linked to a variety of childhood diseases, such as respiratory, endocrine, neurological, behavioral, and malignant disorders, the magnitude of the associations is often unclear. This review provides a current epidemiologic overview of commonly reported environmental contaminants and their potential impact on children's health in China. We found that despite a large volume of studies on various topics, there is a need for more high-quality research and better-coordinated regional and national data collection. Moreover, prevention of such diseases will depend not only on training of environmental health professionals and enhanced research programs, but also on public education, legislation, and networking. [ABSTRACT FROM AUTHOR]

Abstract Background The extent to which low-level, in utero mercury exposure affects child neurobehavioral development during early childhood has been inconclusive. In addition, the effects of sex and docosahexaenoic acid (DHA) on these relationships remain unclear and controversial. Objectives This study aimed to explore the associations between prenatal low-level mercury exposure and child neurobehavioral development during the neonatal and toddler periods and to examine the potential confounding or interactive effects of sex and DHA status on these relationships. Methods This longitudinal study included 286 mother-child pairs in Shanghai, China, whose cord blood samples were analyzed for total mercury, DHA, other nutrients and coexposure contaminants possibly due to maternal consumption of seafood. Children's neurobehavioral development was assessed with the Neonatal Behavioral Neurological Assessment (NBNA) three days after birth and the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) at 18 months of age. Results Cord blood mercury concentration, with geometric mean of 2.00 μg/l, was related to poorer NBNA performance but unrelated to BSID-III scores with adjustment for DHA and other covariates. Cord serum DHA was positively associated with motor development assessed by the BSID-III. The interaction was found between mercury and DHA on the NBNA score, and the inverse relation of cord blood mercury with NBNA was significant only among the children with lower DHA levels (<45.54 μg/ml). Additional adjustment for DHA didn't change the associations between cord blood mercury and neurodevelopmental outcomes substantially. The mercury by sex interaction for language of BSID-III was borderline significant. Conclusions Our research provides initial evidence for the negative effects of prenatal low-level mercury exposure on neonates' neurobehavioral development. Prenatal DHA status may modify the relationship between cord blood mercury level and neonatal neurobehavioral development, but the confounding effects of DHA were not observed. Further studies are warranted before the causality of the observed associations can be determined. Highlights • Prenatal low-level Hg exposure had negative effects on neonatal neurodevelopment. • Cord serum DHA levels were positively associated with toddlers' motor development. • Prenatal DHA status may modify the effects of Hg on neonatal neurodevelopment. [ABSTRACT FROM AUTHOR]

Abstract Background and objective Mounting evidence showed that lead exposure increased the risk of child attention-deficit-hyperactivity disorder (ADHD). Epidemiologic studies have typically used the blood-lead as a biomarker of lead exposure; blood-lead levels mostly reflect recent lead exposure. However, few studies have examined the relationship between bone-lead, a biomarker of cumulative exposure, and ADHD. Therefore, we aimed to compare the associations of bone-lead vs blood-lead levels with child ADHD symptoms and comorbidities. Methods A total of 164 children aged 3–15 years were enrolled during 2014–2015. The Vanderbilt-ADHD-Diagnostic-Parent-Rating Scale (VADPRS) was used to evaluate the children's ADHD symptoms and comorbidities. Children's blood and bone lead concentrations were assessed, the latter using a non-invasive K-X-ray-fluorescence technique. According to blood-lead levels, children were classified into high (blood-lead ≥ 10.0 μg/dL) and low (blood-lead < 10.0 μg/dL) blood-lead groups. According to bone-lead levels, children were classified into high (bone-lead ≥ 2.66 μg/g) and low (bone-lead < 2.66 μg/g) bone-lead groups. We associated blood/bone lead with VADPRS data using multi-variable binary logistic regression models. Results Children in the high blood-lead group had higher hyperactivity/impulsivity (P = 0.02) scores than the corresponding low blood-lead group. Children in the high bone-lead group had higher hyperactivity/impulsivity (P = 0.02) and oppositional-defiant-disorder (ODD) (P = 0.03) scores than the corresponding low bone-lead group. After adjusting for relevant confounders, children in the high bone-lead group were more likely to have ODD-behavior than the low group (OR = 6.7, 95%CI: 1.2–36.5). However, no adjusted association was observed between blood-lead and any ADHD-domain score. Conclusion High levels of cumulative lead exposure in children may be an independent risk factor of ODD-behavior. Graphical abstract Unlabelled Image Highlights • High cumulative lead exposure was reported to associate with high past exposure to lead. • Limited studies explored the association of bone lead with child ADHD-like behavior. • Bone lead levels represent levels of cumulative lead exposure. • High levels of cumulative lead exposure are independently associated with oppositional-defiant-disorder in children. [ABSTRACT FROM AUTHOR]

Objective: Sleep dysfunction has been speculated to be involved in the pathological mechanism of nocturnal enuresis (NE). However, results obtained from previous studies were conflicting. This study evaluated and compared the sleep patterns and problems between children with and without nocturnal enuresis (NE) across different age and gender groups in a large epidemiological study.Methods: A multi-center, cross-sectional, epidemiological study was carried out in which 21,439 primary school children (10,655 boys and 10,784 girls aged 5.1-12.9 years) and their parents participated. Chinese versions of the Children's Sleep Habits Questionnaire and the General Condition Questionnaire were used to identify nocturnal enuresis, sociodemographic characteristics, sleep patterns, and sleep problems in children. The sleep patterns and problems were compared between children with and without NE while controlling for a number of confounding factors in different age and gender groups.Results: It was observed that children with NE (especially boys aged 11-12 years with severe NE) slept for a shorter period and were more likely to have sleep problems such as bedtime resistance, sleep duration disorder, night awakening, sleep anxiety, sleep-disordered breathing, and daytime sleepiness than those without NE. Girls with NE were more likely to suffer from other types of parasomnias.Conclusion: Children with NE, especially older boys with severe NE, were more sleep compromised than those without NE. Our findings warrant further research on the mechanism of NE and may have clinical implications for the treatment of childhood sleep problems and NE. [ABSTRACT FROM AUTHOR]

Background We investigated the clinical characteristics of a 3-month-old infant with acute mercury vapor poisoning. Clinical symptoms of acute mercury poisoning in infants include acute onset, rapid progression, severe illness with respiratory symptoms that may result in pneumothoraces and aspiration pneumonias. Case presentation A 3-month-old girl presented with pneumothoraces and respiratory failure to the hospital. Two days before hospitalization, the girl had stayed in a room containing mercury vapor for several hours. She was hospitalized for acute mercury poisoning. We used sodium dimercaptosulphonate (DMPS) for treatment. Conclusion Pulmonary disease was mainly induced by the inhalation of mercury vapor. The disease was characterized by acute respiratory distress, pneumothorax and acute chemical pneumonitis. It responded to chelation therapy with the agent DMPS. [ABSTRACT FROM AUTHOR]

To investigate prenatal exposure to arsenic and its effect on birth size, we conducted a cross-sectional study in Wujiang City, Jiangsu, China, from June 2009 to June 2010. A total of 1722 mother-infant pairs were included in the study. A questionnaire was administered to the pregnant women and umbilical cord blood(UCB) samples were collected. Arsenic concentration in UCB was detected by inductively coupled plasma emission mass spectroscopy (ICP-MS). The birth size included birth weight, birth body length and head circumference of the newborns. The effects of arsenic exposure on birth size were assessed by multiple linear regression analysis. Arsenic concentrations in UCB ranged from 0.11 to 30.36 μg/L, the median was 1.71 μg/L. In this range of exposure, arsenic concentration was significantly negatively associated with birth weight, especially among male infants. Our results showed that prenatal exposure to arsenic level was low in Wujiang City, China. However, low prenatal arsenic exposure could have negative effects on birth weight. Our research provided evidence for the adverse effects of prenatal low-level arsenic exposure on the intrauterine growth of the fetus. [Display omitted] • The levels of prenatal exposure to arsenic were relatively low in Wujiang City, China. • Low-level arsenic exposure was shown to be correlated with reduced birth weight in newborns. • The effects of arsenic exposure during pregnancy on birth outcomes may be gender-specific. [ABSTRACT FROM AUTHOR]

Abstract: The hippocampus, a major component of the brain, is one of the target nervous organs in lead poisoning. In this work, a rat’s hippocampal injury caused by lead was studied. The lead concentrations in blood, bone and hippocampus collected from rats subject to lead poisoning were quantified by Inductively Coupled Plasma Mass Spectrometry while morphological information and elemental distributions in the hippocampus were obtained with synchrotron radiation X-ray phase contrast imaging and synchrotron radiation micro-beam X-ray fluorescence, respectively. For comparison, identical characterization of the specimens from the rats in the control group was done in parallel. Results show that the ratios between the lead content in the treated group and that in the control group of the hippocampus, bone, and blood are about 2.66, 236, and 39.6, respectively. Analysis also revealed that some health elements such as S, K, Cl and P increase in the regions with high lead content in the treated hippocampus. Morphological differences between the normal and lead-exposed hippocampus specimens in some local areas were observed. Explicitly, the structure of the lead-exposed hippocampus was tortuous and irregular, and the density of the neurons in the Dentate Gyrus was significantly lower than that from the control group. The study shows that the synchrotron radiation methods are very powerful for investigating structural injury caused by heavy metals in the nervous system. [ABSTRACT FROM AUTHOR]

Abstract: Cancer risk is modulated by gene–environment interactions between toxic exposure and genetic variation in carcinogen metabolism. Our objective was to assess interactions between exposure to industrial pollutants and polymorphisms affecting cytochrome P450s (CYP1A1 and CYP2E1) and glutathione S-transferases (GSTP1 and GSTT) in childhood acute leukemia (AL). A case-only design was conducted in 123 Chinese children with sporadic AL. Industrial plants in the vicinity were recorded and, if present, their size and proximity to the usual place of residence of AL children was evaluated. Unconditional logistic regression analysis was performed across the AL study group adjusting for age, gender, parental education, occupation and smoking, indoor and outdoor pesticide use, presence of television sets, refrigerators, microwave ovens and furniture material in children''s rooms, and electric transformers, power lines, and telecommunication transmitters within 500m. This analysis revealed an interaction between the GSTT null allele and industrial plants within 500m of the residences of childhood AL patients (interaction odds ratio, COR=2.96, 95% CI: 1.09–8.01). Furthermore, the COR for the interaction between GSTT null and industrial plants within 50m was 5.99 (95% CI: 1.41–25.45). Our results suggest an association between proximity to industrial plants and the GSTT null allele in patients with childhood AL. [Copyright &y& Elsevier]

Non-optimal weather conditions and air pollution pose a significant threat to children's health. However, the relative impact of different environmental exposures on childhood allergic diseases remains unclear. This study aimed to quantify the relative impact of meteorological factors and air pollutants on childhood allergic diseases in Shanghai, China. Data on clinical visits due to childhood asthma, allergic rhinitis (AR) and atopic dermatitis (AD) from 2007 to 2017 in Shanghai were collected from Shanghai Children's Medical Center and Xinhua Hospital. The meteorological data (i.e. daily mean temperature, temperature difference, air pressure, air pressure difference, precipitation, relative humidity, sunshine and wind speed) for the same period were obtained from the Shanghai Meteorological Center. Air pollution data (PM 10 , PM 2.5 , NO 2 , SO 2 and O 3) were provided by the Shanghai Environmental Protection Agency. Quasi-Poisson regression with distributed lag non-linear models and Poisson regression combined with generalized linear models were used to assess the relative impact of meteorological factors and air pollutants on childhood allergic diseases. There were a total of 2,410,392 cases of childhood allergic diseases, including 975,771 asthma, 646,975 AR and 787,646 AD. Most of environmental factors were significantly associated with childhood allergic diseases. Daily mean temperature (standard β : −0.076 (95% confidence interval (CI): −0.086, −0.067)) and air pressure (standard β : 0.075 (95% CI: 0.068, 0.082)) seemed to play more important roles than other environmental factors in the occurrence of these allergic diseases. The numbers of these allergic diseases attributable to an interquartile range (IQR) change in meteorological factors also appeared to be greater than those attributable to an IQR change in air pollutants. Both climatic variation and air pollution were associated with childhood allergic diseases, but the former appeared to play a more important role in the occurrence of these diseases. These findings may have significant implications for the development of tailored strategies to prevent these rapidly-increasing diseases worldwide. Unlabelled Image • First study to examine the relative impact of meteorological factors and air pollutants on childhood allergic diseases. • The relationships between environmental factors and allergic diseases were quantified using 11-year time-series data. • Meteorological factors played a more important role than air pollutant in the occurrence of these diseases in Shanghai. [ABSTRACT FROM AUTHOR]