Search

Background Triclosan (TCS) has been widely detected in pregnant women. The reproductive endocrine-disrupting effects of TCS have been observed in humans and animals. Little is known about the potential impact of prenatal TCS exposure on fetal reproductive development as well as its potential mechanism. Objectives We investigated the potential effect of prenatal TCS exposure on fetal reproductive hormones in cord blood and its potential mechanism in relation to placental steroidogenic enzymes. Methods Urinary TCS was detected among 537 healthy pregnant women from a prospective cohort in China. Four reproductive hormones in cord blood, namely E 2 (n = 430), T (n = 424), LH (n = 428) and FSH (n = 373), and three steroidogenic enzymes in placenta, namely P450arom (n = 233), 3β-HSD (n = 227) and 17β-HSD (n = 222), were measured. Results Prenatal TCS exposure was associated with increased testosterone concentrations in cord blood in a dose-dependent manner. Infants with prenatal TCS levels > 0.6 μg/L had, on average, a 0.23 ng/mL (95% CI: 0.05, 0.45, p = 0.02) higher testosterone concentrations in cord blood compared to those with prenatal TCS levels < 0.1 μg/L. Of note, prenatal TCS exposure was associated with increased testosterone and decreased E 2 concentrations in cord blood among male infants. Adverse associations were found between the prenatal TCS exposure and concentrations of three placental steroidogenic enzymes. 3β-HSD and P450arom demonstrated mediating effects in the association between prenatal TCS exposure and testosterone concentrations in cord blood. Conclusions Our findings suggested potential impacts of prenatal TCS exposure on reproductive hormones in cord blood mediated by steroidogenic enzymes, and male infants were more vulnerable. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of and risk factors for IAD among different ethnicity groups was unknown. Our aim was to investigate the prevalence of and risk factors for IAD among Han, Uygur and Kazakh ethnicities in Xinjiang. China. Methods: In total, 14,618 adult participants (7,799 males and 6,819 females) were recruited from the Cardiovascular Risk Survey. A 4-stage stratified cluster random sampling method was used. The participants’ personal information and medical history were assessed by questionnaire. IAD was diagnosed by a noninvasive arteriosclerosis analyzer. Results: The prevalence of abnormal IAD among the general population was 14.3%, with 12.5% in the Han, 14.9% in the Uygur, and 16.4% in the Kazakh populations. The prevalence of abnormal IAD among the hypertensive population was 19.4%, with 17.0% in the Han, 18.1% in the Uygur, and 22.7% in the Kazakh populations. The prevalence of abnormal IAD increased with age (all P < 0.01) but was not significantly different between the genders (all P> 0.05). Multivariate logistic regression analysis showed that age more than 45 years, obesity and hypertriglyceridemia were significantly associated with a higher prevalence of IAD. There were different risk factors for abnormal IAD in different ethnicities. Middle or old age, obesity, ABI and diabetes mellitus were risk factors for the Han population, smoking was a risk factor in the Uygur population, and obesity and PAD were risk factors in the Kazakh population. Conclusion: The prevalence of abnormal IAD in the Kazakh participants was higher than that in the Han and Uygur populations among both the general population and the hypertensive population in Xinjiang, China. The main risk factors of IAD were age, obesity, and triglyceride levels. Different ethnicities had different kinds of risk factors for IAD. [ABSTRACT FROM AUTHOR]

Background and Objectives: Dietary protein intake has been associated with reduced risk of stroke. This study aimed to examine the relationship between premorbid dietary intake of protein and both stroke severity and neurological outcomes in patients with acute ischemic stroke.Methods and Study Design: Consecutive patients with first-ever ischemic stroke in Jinling Hospital were screened for eligibility of participation. A validated foodfrequency questionnaire (FFQ) was performed to collect necessary data for calculating pre-stroke dietary intakes. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) at baseline. Neurological outcomes were assessed by the modified Rankin scale (mRS) 90 days after stroke onset. Multivariable logistical regression was applied to analyze the impacts of dietary protein intake on stroke severity or neurological outcomes.Results: Of the 201 enrolled patients, 110 (54.7%) were classified as minor (NIHSS ≤5) and 91 (45.3%) as major stroke (NIHSS ≥6). After adjusting for potential confounders, multivariable logistic regression did not detect significant association between total (odds ratio (OR)=0.98, p=0.15), animal (OR=1.01, p=0.87) or plant protein intake (OR=0.96, p=0.07) and stroke severity. According to the 90-day mRS, 127 patients (63.2%) were determined with good (mRS ≤2), and 74 (36.8%) with poor outcomes (mR 3-6). Multivariable logistic regression detected that premorbid dietary intake of total protein was positively associated with good neurological outcomes (OR=1.05, p=0.04).Conclusions: Higher level of premorbid protein intake may be associated with favorable neurological outcomes independent of stroke severity. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is no evidence on the most effective nutritional screening tool for hospitalized children. The objective of this study was to develop and validate a pediatric nutritional screening tool to assess undernutrition risk upon hospital admission.Methods and Study Design: The study had a two-phase prospective observational design. A novel pediatric nutritional screening score (PNSS) was developed and sensitivity, specificity, and reliability were evaluated by comparing with a complete dietetic assessment. Length of hospital stay, weight loss, disease complications, and nutritional support were recorded.Results: PNSS consisted of three elements: disease with malnutrition risks, changes in food intake, and anthropometric measurements, with a score of 0-2 for each element. The optimal cut-off score to identify patients (n=96) at risk of undernutrition was two. The agreement between PNSS and the complete dietetic assessment was moderate (κ=0.435, 95% CI=0.373-0.498). Sensitivity and specificity values of PNSS were 82% (95% CI=76%-87%) and 71% (95% CI=67%-74%), respectively. Inter-rater agreement had a κ value of 0.596 (95% CI=0.529-0.664, p<0.001). The percentage of children with undernutrition risk was 44.9%. Children with oncologic, gastrointestinal, and cardiac diseases were most likely to be at risk of undernutrition. The at-risk group was associated significantly with longer length of hospital stay and higher percentage of weight loss compared with the not-at-risk group.Conclusion: PNSS is the first nutritional screening tool developed for hospitalized children and validated in a large population of patients in China. [ABSTRACT FROM AUTHOR]

Acromioclavicular dislocation (ACD) is a common injury. According to the Rockwood classification, ACD is classified into six types (type I-VI); however, for type III injuries, it remains controversial whether or not operative treatment should be applied. Numerous studies have advocated early surgical treatment to ensure early rehabilitation activities. Thus, the present study aimed to investigate a modified closed-loop double-endobutton technique (MCDT), that may be used to repair Rockwood type III ACD. In the current study, 61 patients with Rockwood type III ACD were enrolled during a period of 5 years at the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. Patients were divided into three groups according to the surgical method used, the MCDT group (n=20), the common closed-loop double-endobutton technique (CCDT) group (n=21), and the clavicular hook plate fixation (CHPF) group (n=20). Preoperative and intraoperative information were recorded. Furthermore, the functional scores of injured shoulder were evaluated prior to surgery and following surgery with a 1-year follow-up. Among the three groups, postoperative functional scores were significantly more improved compared with those prior to surgery (P<0.05), and no significant difference was observed regarding the coracoclavicular interval with the 1-year follow-up (P>0.05). Postoperative functional scores in the MCDT and CCDT groups were significantly more improved compared those in the CHPF group (P<0.05). In addition, the duration of surgery in the MCDT group was significantly shorter compared with that in the CCDT group (P<0.05). Furthermore, compared with the CHPF group, the incision length was significantly shorter with reduced hemorrhage in the MCDT group (P<0.05). In conclusion, the results of the current study suggest that MCDT is more simple, convenient and efficient compared with CCDT, and is worth popularizing. [ABSTRACT FROM AUTHOR]

The fifth epidemic wave of avian influenza A(H7N9) virus in China during 2016-2017 demonstrated a geographic range expansion and caused more human cases than any previous wave. The factors that may explain the recent range expansion and surge in incidence remain unknown. We investigated the effect of anthropogenic, poultry, and wetland variables on all epidemic waves. Poultry predictor variables became much more important in the last 2 epidemic waves than they were previously, supporting the assumption of much wider H7N9 transmission in the chicken reservoir. We show that the future range expansion of H7N9 to northern China may increase the risk of H7N9 epidemic peaks coinciding in time and space with those of seasonal influenza, leading to a higher risk of reassortments than before, although the risk is still low so far. [ABSTRACT FROM AUTHOR]

Liver cancer ranks the sixth in cancer incidence and the second in tumor related mortality worldwide, with over half of the new cases and deaths occur in China. Because of difficulties in early diagnosis, rapid progression and lack of targeted drugs, the survival rate of liver cancer is extremely low. The existence of extraordinary heterogeneity has greatly limited the progress in early detection, molecular classification and targeted therapy of live cancer, owing to its varied risk factors, genetic susceptibilities, morphological diversity and microenvironmental discrepancies. Based on the heterogeneity of individual patients, precision medicine brings a new dimension to cancer personalized diagnosis and more-targeted treatment, and even give us access to pre-clinical screening of tumors in high risk populations. The present review article will provide progresses in precision diagnosis, molecular classification, signaling disregulation, preclinical models and personalized treatment of liver cancer in China. [ABSTRACT FROM AUTHOR]

This essay explores the ways in which Lu Gwei-djen (1904–91) served as a gatekeeper for interpreting medicine in China in the second half of the twentieth century. After retiring from science in 1956, Lu set out to write one of the first comprehensive English-language histories of medicine in China. Through a close study of Lu's work notes and marginalia from later in her life, this essay examines how she carefully articulated the material characteristics of a "Chinese" medicine that gave rise to jingluo , or therapeutic paths often known as "meridians." I argue that at the heart of this uneasy comparison was the difficult process of translating across multiple expressions of physiology. By placing Lu Gwei-djen at the center of a feminist intellectual history of medicine, this essay further shows how Lu's translations were influenced by the social hierarchies in which she was embedded, including cultural, gender, and temporal dualities. [ABSTRACT FROM AUTHOR]

Objective: To assess the association between long-term exposures to smoky coal, environmental tobacco smoke (ETS) and lung cancer incidence in China.Methods: A meta-analysis was performed on literature searched through Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases. Odds ratio (OR) with 95% confidence intervals (CIs) was used to assess the strength of association between air pollution and lung cancer in China.Results: Twenty-eight studies were included in the meta-analysis. Stratification by ETS exposure source, amount, and gender found a variation in effect. The pooled OR (95% CI) for exposure to spousal, parents, and work ETS was 1.153 (1.000-1.329), 2.117 (1.626-2.755), and 1.454 (1.307-1.618), respectively. The OR (95% CI) values related to childhood exposure was 1.297 (1.142-1.473), adulthood exposure 1.102 (0.937-1.296), exposure lower than 20 cigarette/day 1.088 (0.809-1.464), higher than 20 cigarette/day 1.776 (1.392-2.267), male 1.555 (1.304-1.855), female 1.487 (1.265-1.748), and coal use 1.490 (1.330-1.669).Conclusion: The meta-analysis provided evidence that indoor coal use and ETS were significantly associated with lung cancer in China. [ABSTRACT FROM AUTHOR]

Background Currently, there is no dedicated equation to estimate glomerular filtration rate (GFR) for transplanted kidneys. This study aimed to compare the performance of serum creatinine (Scr)- and cystatin C (CysC)-based equations in Chinese renal transplant recipients. Methods A total of 252 stable renal transplant recipients were enrolled in this study. The plasma clearance of 99m Tc-DTPA (rGFR) was used as a reference standard. The Scr, CysC, and rGFR of the patients were measured on the same day. The bias, precision, accuracy (percentage of estimates within 10%, 30%, and 50% of rGFR), and agreements of 8 Scr and 5 CysC eGFR equations were assessed. The factors affecting the accuracy were also evaluated. Results Among the Scr-based equations, the Japanese Society of Nephrology-Chronic Kidney Disease Initiatives (JSN-CKDI) equation had the best overall performance with a bias of −6.2 mL/min/1.73 m 2 , and 96.1% of its estimates were within 30% of the rGFR. For the CysC-based equations, the Filler equation had the best performance with a bias of −3.9 mL/min/1.73 m 2 , and 93.7% of its estimates were within 30% of the rGFR. Overall, the CysC-based equations showed better performance than the Scr-based equations. In addition, significant differences were observed between bias and gender and between bias and rGFR value in some equations, whereas transplantation time and immunosuppressive regimens were not correlated with the bias. Conclusion The JSN-CKDI equation provides the best estimation of the GFR equations, and the CysC-based equations performed better than the Scr-based equations in this population. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to describe the patients’ reasons for encounter (RFE) and health problems managed by general practitioners (GPs) in the rural areas of Beijing to provide evidences for health services planning and GPs training. Methods: This study was conducted at 14 community health service centers (CHSCs) in 6 suburban districts of Beijing, using a multistage sampling method. A total of 100 GPs was selected from the study sites. A self-designed data collection form was developed on the basis of Subjective-Objective-Assessment-Plan (SOAP), including patient characteristics, RFEs, health problems, interventions, and consultation length. Each GP recorded and coded their 100 consecutive patients’ RFEs and health problems with the International Classification of Primary Care, 2nd version (ICPC-2). Descriptive statistics were employed to describe the distribution of RFE and health problems. Student t-test and analysis of variance were used to compare the differences of mean number of RFE or health problems per encounter by patient characteristics. Results: A total of 10,000 patient encounters with 13,705 RFEs and 15,460 health problems were recorded. The RFEs and health problems were mainly distributed in respiratory, circulatory, musculoskeletal, endocrine, metabolic and nutritional, and digestive systems. Cough and hypertension were the most common RFE and health problem, respectively. With increased ages, the mean number of RFEs decreased and the mean number of health problems increased. Patients with Beijing medical insurance had less RFEs and more health problems than those in other cities (p<0.001). Patients who had visited the CHSC previously and signed contracts with the GP team had more health problems than those who had not (p<0.001). Conclusions: These findings present a view of patients’ demands and work contents of GPs in Beijing rural areas and can provide reference for health services planning and GPs training. [ABSTRACT FROM AUTHOR]

Background: To assess socioeconomic inequality in periconceptional folic acid supplementation in China.Methods: We used data of periconceptional folic acid (FA) supplementation of rural Chinese women from the National Free Preconception Health Examination Project from 2010 to 2012 and socioeconomic level data from the National Bureau of Statistics. We used logistic models to assess the associations between the prevalence of taking FA and the sociodemographic characteristics of the participants, the couples, and the socioeconomic levels of their region of residence.Results: Of the 907,720 included women, 682,315 (75.62%) of the women reported taking FA. The prevalence of FA supplementation was significantly higher in participants aged 21-29 (75.87%) than in those women aged 40-49 (68.44%, p < 0.01). The prevalence of FA supplementation was significantly higher in the region with the highest Per Capita Gross Regional Product than in the regions with lower Per Capita Gross Regional Product (aOR = 12.20 [95% CI:9.54-15.61]). The higher the per capita net income of farmer households in the region, the higher the prevalence of FA supplementation (aOR = 1.95 [95% CI:1.74-2.18]).Conclusions: The rate of periconceptional FA supplementation among rural Chinese women has increased with the support of China's Health System Reform policy. However, socioeconomic disparities in periconceptional folic acid supplementation remain. [ABSTRACT FROM AUTHOR]

Equine hepacivirus (EqHV), equine pegivirus (EPgV) and Theiler’s disease-associated virus (TDAV) are three novel equine viruses in the family Flaviviridae. EqHV and EPgV have been identified to circulate in the equine population worldwide, whereas TDAV has not been detected in equines since the first reported case. To date, no studies have focused on investigating EqHV, EPgV and TDAV in commercial equine sera or equine blood products in China. Considering the potential threat of EqHV, EPgV and TDAV to biosecurity and considering their possible influences on research results, equine sera for cell culture propagation and pregnant mare serum gonadotropin (PMSG) were purchased from different companies in China and investigated for EqHV, EPgV and TDAV in this study. By performing nested PCR or two rounds of PCR targeting the viral NS3 gene, four serum samples were confirmed to be EqHV-, EPgV-, or TDAV-RNA positive; all of the PMSG samples were negative for these three viruses. Subsequent sequencing results indicated that the serum samples contained multiple viral variants of EqHV, EPgV or TDAV, and a genetic analysis based on the partial NS3 gene of the three equine viruses was performed. Our study is the first to confirm the presence of EqHV, EPgV and TDAV in equine sera for cell culture propagation that is commercially available in China and provides the first demonstration of the presence of TDAV in China. [ABSTRACT FROM AUTHOR]

Background: Our previous study found that B cell translocation gene 2 (BTG2) was hyper-methylated and down-regulated in side population (SP) cells of hepatocellular carcinoma (HCC) cell line. However, its clinical significances and biological impacts on HCC SP cells remained unclear.Aims: To investigate the prognostic value of BTG2 gene in HCC and its influences on cancer stem cells (CSCs)-like traits of HCC cell line SP cells.Methods: BTG2 expression in human HCC and adjacent non-cancerous tissues was detected by immunohistochemical staining and quantitative real-time PCR, and also obtained from GEO and TCGA data. Its prognostic values were assessed. Its biological influences on HCC cell line SP cells were evaluated using cell viability, cell cycle, plate clone-forming assay, and chemoresistance in vitro and tumorigenicity in vivo.Results: BTG2 expression was significantly suppressed in human HCC compared to adjacent non-cancerous tissues. BTG2 expression was correlated with TNM stage, tumor size and vascular invasion. Lower expression of BTG2 was associated with poorer overall survival and disease-free survival. In vitro, overexpression of BTG2 substantially suppressed cell proliferation and accumulation of HCC cell line SP cells in G0/G1 phase. Colony formation ability was markedly suppressed by BTG2 overexpression. Moreover, sensitivity of HCC cell line SP cells to 5-fluorouracil was substantially increased by overexpression of BTG2. Furthermore, tumorigenicity of HCC cell line SP cells transfected with BTG2 plasmids was significantly reduced in vivo.Conclusions: BTG2 gene could regulate the CSC-like traits of HCC cell line SP cells, and it represented as a molecular prognostic marker for HCC. [ABSTRACT FROM AUTHOR]

Rice straw return and green manure cultivation in winter fallow season are 2 effective ways of improving soil fertility in south China. Due to the relatively stable carbon to nitrogen ratio, either the rice straw return or green manure cultivation alone has its own limits in practice. Recently, the combined application of green manure and rice straw has been developed, while little is known about the impacts on crop yield and soil fertility. A field trial was conducted at an experimental station managed by National Engineering and Technology Research Center for Red Soil Improvement in Fengcheng, Jiangxi Province, China to explore effects of remaining high rice stubble, inter-planting green manure (Chinese milk vetch, Astragalus sinicus L.) and co-incorporation of rice straw and green manure on double rice and green manure yield and soil fertility. Field experiments were conducted in a rice-rice-winter fallow or rice-rice-Chinese milk vetch (MV) rotation system. A total of 5 treatments with different cultivation practices were included, (i) CK, rice-rice-winter fallow without rice straw return; (ii) RS, rice-rice-winter fallow with rice straw return; (iii) MV, rice-rice-MV without rice straw; (iv) MV+LRS, rice-rice-MV with return of low stubble (0 cm) of rice straw; (v) MV+HRS rice-rice-MV with return of high stubble (30 cm) of rice straw. The results showed that co-incorporation of RS and MV significantly increased fresh yield and nitrogen content of MV plants by 13.1% and 6.8% in MV+LRS and 32.2% and 5.2% in MV+HRS than those in MV alone, respectively. The average yield of double rice yield over the 4 years was significantly increased by 556.8 and 412.8 kg/hm2 in MV+HRS than in RS and MV, respectively. Compared to CK, the soil organic matter (SOM) content was significantly increased by 6.8% to 8.0% in RS and MV, the total nitrogen (TN) was marginally affected by the 2 treatments. Compared to CK, the soil inorganic N content was significantly decreased in treatments with RS and MV alone, while the available K was increased in RS. Different from soil inorganic nitrogen, manure treatments greatly improve available P content and the treatment of MV with HRS increased the available P by 18.0%. However, the treatments with rice straw could greatly increased soil available K by 8.0% (RS), 9.2%(MV+LRS) and 22.8%(MV+HRS), respectively. The soil microbial nitrogen were also significantly enhanced in the combinations than in MV or RS alone (P<0.05). The dissolved organic carbon and nitrogen were greater in the manure-rice straw combination treatments than CK. The treatments with rice straw enhanced the proportion of microbial biomass C in SOC and that of microbial biomass N in TN. Compared with the rice straw and manure alone, the co-incorporation of rice straw and manure increased the proportion of dissolved organic N in TN and inorganic N in TN. Collectively, the co- incorporation of rice straw and green manure could improve the rice yield and soil fertility in present conditions. The practice of keeping high stubble of rice straw standing in the field and returned together withgreen manure had the great promise to maintain and improve soil fertility and rice yield in south China. [ABSTRACT FROM AUTHOR]

Background: The meniscus is one of the most commonly injured parts of the body, and meniscal healing is difficult. Hypothesis: Kartogenin (KGN) induces tendon stem cells (TSCs) to differentiate into cartilage cells in vitro and form meniscus-like tissue in vivo. A damaged meniscus can be replaced with a KGN-treated autologous tendon graft. Study Design: Controlled laboratory study. Methods: In the in vitro experiments, TSCs were isolated from rabbit patellar tendons and cultured with various concentrations of KGN, from 0 to 1000 µM. The effect of KGN on the chondrogenesis of TSCs in vitro was investigated by histochemical staining and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). The in vivo experiments were carried out on 6 New Zealand White rabbits by removing a meniscus from the rabbit knee and implanting an autologous tendon graft treated with KGN or saline. The meniscus formation in vivo was examined by histological analysis and immune staining. Results: The proliferation of TSCs was promoted by KGN in a concentration-dependent manner. Both histochemical staining and qRT-PCR showed that the chondrogenic differentiation of TSCs was increased with KGN concentration. After 3 months of implantation, the tendon graft treated with KGN formed a meniscus-like tissue with a white and glistening appearance, while the saline-treated tendon graft retained tendon-like tissue and appeared yellowish and unhealthy. Histochemical staining showed that after 3 months of implantation, the KGN-treated tendon graft had a structure similar to that of normal meniscus. Many cartilage-like cells and fibrocartilage-like tissues were found in the KGN-treated tendon graft. However, no cartilage-like cells were found in the saline-treated tendon graft after 3 months of implantation. Furthermore, the KGN-treated tendon graft was positively stained by both anti–collagen type I and type II antibodies, but the saline-treated tendon graft was not stained by collagen type II. Conclusion: The findings indicated that KGN can induce the differentiation of TSCs into cartilage-like cells in vitro and in vivo. The results suggest that KGN-treated tendon graft may be a good substitute for meniscal repair and regeneration. Clinical Relevance: This study revealed the direct effects of KGN on the chondrogenic differentiation of TSCs in vitro and in vivo. A KGN-treated autologous tendon graft induced formation of a meniscus-like tissue in vivo. This study provides a new cartilage regenerating technology for the treatment of damaged meniscus. [ABSTRACT FROM AUTHOR]

The low methionine content in plant-based diets is a major limiting factor for feed utilization by animals. However, the molecular consequences triggered by methionine deficiency have not been well characterized, especially in fish species, whose metabolism is unique in many aspects and important for aquaculture industry. In the present study, the primary muscle cells of turbot (Scophthalmus maximus L.) were isolated and treated with or without methionine for 12 h in culture. The responses of nutrient sensing pathways, the proteomic profiling of metabolic processes, and the expressions of key metabolic molecules were systematically examined. Methionine deprivation (MD) suppressed target of rapamycin (TOR) signaling, activated AMP-activated protein kinase (AMPK) and amino acid response (AAR) pathways. Reduced cellular protein synthesis and increased protein degradation by MD led to increased intracellular free amino acid levels and degradations. MD also reduced glycolysis and lipogenesis while stimulated lipolysis, thus resulted in decreased intracellular lipid pool. MD significantly enhanced energy expenditure through stimulated tricarboxylic acid (TCA) cycle and oxidative phosphorylation. Collectively, our results identified a comprehensive set of transcriptional, proteomic, and signaling responses generated by MD and provided the molecular insight into the integration of cell homeostasis and metabolic controls in fish species. [ABSTRACT FROM AUTHOR]

Purpose. To quantify macular vascular density using optical coherence tomography angiography (OCTA) and to investigate its relationship with retinal thickness in myopic eyes of young adults. Methods. In this cross-sectional study, 268 myopic eyes without pathological changes were recruited and divided into three groups: mild myopia (n=81), moderate myopia (n=117), and high myopia (n=70). Macular vascular density was quantified by OCTA and compared among three groups. Average retinal thickness, central subfield thickness, and macular ganglion cell complex (mGCC) thickness were also evaluated and compared. Correlations among these variables were analyzed. Results. There was no statistical difference in superficial (62.3 ± 5.7% versus 62.7 ± 5.9% versus 63.8 ± 5.5%) and deep macular vascular densities (58.3 ± 9.6% versus 59.2 ± 9.3% versus 60.9 ± 7.9%) among mild-myopia, moderate-myopia, and high-myopia groups (both P>0.05). Superficial and deep macular vascular densities both had correlations with mean arterial pressure. Furthermore, superficial macular vascular density was significantly correlated with mGCC thickness. Conclusions. Varying degrees of myopia did not affect macular vascular density in young healthy adults. In addition, superficial macular vascular density, as an independent factor, was positively correlated with mGCC thickness. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the clinical and molecular epidemiology and biofilm formation of Staphylococcus aureus (SA) isolated from pediatricians in China.Methods: SA strains were isolated from Beijing Children's hospital from February 2016 to January 2017. Isolates were typed by multilocus sequence typing (MLST), spa and SCCmec typing (for Methicillin-resistant SA [MRSA] only). Antimicrobial susceptibility testing was performed by agar dilution method except sulphamethoxazole/trimethoprim (E-test method). Biofilm formation and biofilm associated genes were detected.Results: Totally 104 children (41 females and 63 males; median age, 5.2 months) were enrolled in this study, in which 60 patients suffered from MRSA infection. Among the 104 cases, 54.8% were categorized as community associated SA (CA-SA) infections. The children under 3 years were more likely to occur CA-SA infections compared with older ones (P = 0.0131). ST59-SCCmec IV-t437 (61.7%) was the most prevalent genotype of MRSA, and ST22-t309 (18.2%), ST5-t002 (9.1%), ST6-t701 (9.1%), ST188-t189 (9.1%) were the top four genotypes of methicillin-sensitive SA (MSSA). All the present isolates were susceptible to linezolid, vancomycin, trimethoprim-sulfamethoxazole, mupirocin, tigecyclin, fusidic acid. No erythromycin-susceptible isolate was determined, and only a few isolates (3.8%) were identified as susceptible to penicillin. Multi-drug resistant isolates were reponsible for 83.8% of the ST59-SCCmec IV-t437 isolates. The isolates with strong biofilm formation were found in 85% of MRSA and 53.2% of MSSA, and in 88.7% of ST59-SCCmec IV-t437 isolates. Biofilm formation ability varied not only between MRSA and MSSA (P = 0.0053), but also greatly among different genotypes (P < 0.0001). The prevalence of the biofilm associated genes among ST59-SCCmec IV-t437 clone was: icaA (100.0%), icaD (97.3%), fnbpA (100.0%), fnbpB (0), clfA (100%), clfB (100%), cna (2.7%), bbp (0), ebpS (88.5%), sdrC (78.4%), sdrD (5.4%), and sdrE (94.5%).Conclusions: These results indicated strong homology of the MRSA stains isolated from Chinese children, which was caused by spread of multiresistant ST59-SCCmec IV-t437 clone with strong biofilm formation ability. The MSSA strains, in contrast, were very heterogeneity, half of which could produce biofilm strongly. [ABSTRACT FROM AUTHOR]

Objective. Traumatic orbital apex syndrome (TOAS) is a rare disease characterized by the damage of cranial nerves (CNs) II, III, IV, and VI. The aim of our study was to analyze the functional recovery of CNs in TOAS and discuss the management of these patients. Methods. We retrospectively reviewed 28 patients with TOAS treated in the Department of Neurosurgery, Shanghai Changzheng Hospital from February 2006 to February 2016. Functional recovery of CNs was evaluated based on extraocular muscle movement and visual perception. Follow-up duration was at least 6 months. Results. There were 26 males and 2 females with a mean age of 35.3 years. The most common cause of TOAS was traffic accident. CN IV suffered the lightest injury among CNs III, IV, and VI. CN II achieved obvious improvement at 3-month follow-up, while other CNs enjoyed evident improvement at 6-month follow-up. There was no significant difference between conservative treatment and surgical decompression. Conclusion. CNs passing through orbital apex region might recover to different degrees several months after proper management. Clinical decision should be individualized and surgical decompression could be considered with evidence of fracture, hematoma, or deformation. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the laying performance, egg quality, and serum biochemistry of hens maintained in conventional cage rearing system (CRS), flat net-rearing system (NRS), and free range system (FRS) under summer conditions. Indigenous Xianju chickens (n = 540) were randomly allocated into cages or pens of rearing system groups, within each system there were 5 replicates with 36 hens in each replicate. The experiment lasted between 21 and 29 wk of age. Hen-day egg production (P = 0.00) and egg mass (P = 0.00) were higher in the CRS but were similar in the NRS and FRS. Lowest egg weight (P = 0.02), yolk weight (P = 0.00) and yolk ratio (P = 0.01), and feed intake (P = 0.01) were observed from the FRS, whereas lowest feed conversion ratio (FCR) was recorded from the CRS (P = 0.01). Rearing systems had negligible effect on egg quality. Serum Ca (P = 0.04) and total protein (P = 0.03) levels were found to be higher in the CRS but were lower in the FRS. Serum levels of glucose (P = 0.01), cholesterol (P = 0.00), and triglyceride (P = 0.00) in the CRS increased compared with the NRS and FRS groups, whereas serum levels of high density lipoprotein cholesterol (HDL-C; P = 0.01) in the CRS decreased. It can be concluded that under summer conditions, Xianju chickens from CRS had an advantage in terms of productivity parameters, but exhibited higher levels of serum lipids and glucose. [ABSTRACT FROM AUTHOR]

To develop a consensus on the definition and measurement of Internet gaming disorder (IGD), several recent studies have used the DSM-5's proposed criteria for IGD as the basis in scale construction. This study contributes to this emerging consensus by developing and validating a new Chinese Internet Gaming Disorder Scale (C-IGDS) based on the DSM-5 criteria. A representative sample of Hong Kong community adults (n=502, 50% men, mean age=37.1, age range=18-60) was recruited for a telephone survey with random digit dialing. Various statistical techniques were used to assess the psychometric properties of the C-IGDS. The C-IGDS had good reliability (Cronbach's α=0.91) and structural validity (CFA model fit: RMSEA=0.027, CFI=0.991, TLI=0.988) in our sample. Moderate to moderately strong correlations with depressive symptoms (r=0.617, p<0.001), social anxiety symptoms (r=0.366, p<0.001), and gaming hours (r=0.412, p<0.001) supported the criterion validity of the C-IGDS. In addition, the C-IGDS exhibited strict measurement invariance for sex and at least strong measurement invariance for age. In addition to providing the first Chinese scale for measuring IGD based on the DSM-5's proposed criteria, this study provides empirical support for the validity of these diagnostic criteria as the basis for a universal measure of IGD. Most important, this study is the first to reveal the criteria's measurement invariance, thereby indicating their suitability for use with diverse demographic groups. [ABSTRACT FROM AUTHOR]

Strain BO-07 was isolated from the root tissue ofBoesenbergia rotunda(L.) Mansf A. and identified asStreptomycessp. on the basis of morphology, chemotaxonomy and 16S rDNA sequencing. The fractionation of the crude extract from strain BO-07 cultures led to the isolation of two biphenyls: 3′-hydroxy-5-methoxy-3,4-methylenedioxybiphenyl (1) and 3′-hydroxy-5,5′-dimethoxy-3,4-methylenedioxybiphenyl (2); these compounds and the crude extract had potent antibacterial activity against Gram-positive bacteria, and antioxidant and anticancer activities. These compounds showed the highest activity againstStaphylococcus aureusATCC25932,Bacillus cereusATCC7064 andBacillus subtilisATCC6633 with a minimum inhibitory concentration value of 0.5 µg/ml and minimum bactericidal concentration of 2–8 µg/ml. Compounds1and2showed the highest (1, 1diphenyl-2-picryl hydrazyl) DPPH antioxidant activity with a scavenging concentration (SC50) value of 85.84 and 88.26 µg/ml, respectively, and also showed strong cytotoxicity against all the three cancer cell lines (HeLa, HepG2 and Huh7) at an IC50value of 3.04–20.30 μg/ml. Both the compounds were less toxic on normal cells (L929) than on the investigated cancer cell lines. [ABSTRACT FROM PUBLISHER]

In China, food safety problems have occurred frequently in the past ten years, causing great concern for the public. Adolescents, with higher exposure to problematic food, represent a unique target for interventions aimed at risk reduction. To understand their food safety knowledge, attitude and practice, a cross-sectional survey using paper questionnaire was carried out among 4,220 students (median age of 14 years, 50.3% females) from nine secondary schools in 3 districts of Beijing. The findings showed that the majority of respondents (42.0%) had a high knowledge level. Significant association was found between food safety knowledge score (median = 11, IQR:9–13) and demographic characteristics of region, school type, residence type, habit of smoking and alcohol use, academic record and parents’ education background. In terms of attitude and practice, only 17% of those surveyed regarded China’s food safety situation as good, 53.6% regarded it as worrying; almost all students (96.5%) did pay attention to food safety; 95.3% of the students had worried about the safety of the food provided by the small restaurants and street peddlers, but in reality, as many as 69.4% often or occasionally bought food from peddlers around their campuses and nearly half continued the consumption of such food in spite of worrying about its safety problems. Overall, the food safety knowledge among Beijing secondary school students was relatively good. They did not show much confidence in the country’s food safety situation, but many aware of the safety issues did not bother to change or take action. The study suggests that more systematic and targeted education on food safety is necessary for this age group. [ABSTRACT FROM AUTHOR]

Objectives: China has a high burden of drug-resistant tuberculosis (TB). As irrational use and inadequate dosing of anti-TB drugs may contribute to the epidemic of drug-resistant TB, we assessed the drug types and dosages prescribed in the treatment of TB cases in a representative sample of health care facilities in Yunnan. Methods: We applied multistage cluster sampling using probability proportion to size to select 28 counties in Yunnan. Consecutive pulmonary TB patients were enrolled from either the TB centers of Yunnan Center of Disease Control or designated TB hospitals. Outcomes of interest included the regimen used in the treatment of new and retreatment TB patients; and the proportion of patients treated with adequate dosing of anti-TB drugs. Furthermore, we assess whether there has been reduction in the use of fluoroquinolone and second line injectables in Tuberculosis Clinical Centre (TCC) after the training activity in late 2012. Results: Of 2390 TB patients enrolled, 582 (24.4%) were prescribed second line anti-TB drugs (18.0% in new cases and 60.9% in retreatment cases); 363(15.2%) prescribed a fluoroquinolone. General hospitals (adjusted odds ratio (adjOR) 1.97, 95% confidence interval (CI) 1.47–2.66), retreatment TB cases (adjOR 4.75, 95% CI 3.59–6.27), smear positive cases (adjOR 1.69, 95% CI 1.22–2.33), and extrapulmonary TB (adjOR 2.59, 95% CI 1.66–4.03) were significantly associated with the use of fluoroquinolones. The proportion of patients treated with fluoroquinolones decreased from 41.4% before 2013 to 13.5% after 2013 (adjOR 0.19, 95% CI 0.12–0.28) in TCC. The proportion of patients with correct, under and over dosages of isoniazid was 88.2%, 1.5%, and 10.4%, respectively; of rifampicin was 50.2%, 46.8%, and 2.9%; of pyrazinamide was 67.6%, 31.7% and 0.7%; and of ethambutol was 41.4%, 57.5%, and 1.0%. Conclusions: The prescribing practice of anti-TB drugs was not standardized, findings with significant programmatic implication. [ABSTRACT FROM AUTHOR]

Objective. To investigate the gut microbiota differences of obese children compared with the control healthy cohort to result in further understanding of the mechanism of obesity development. Methods. We evaluated the 16S rRNA gene, the enterotypes, and quantity of the gut microbiota among obese children and the control cohort and learned the differences of the gut microbiota during the process of weight reduction in obese children. Results. In the present study, we learned that the gut microbiota composition was significantly different between obese children and the healthy cohort. Next we found that functional changes, including the phosphotransferase system, ATP-binding cassette transporters, flagellar assembly, and bacterial chemotaxis were overrepresented, while glycan biosynthesis and metabolism were underrepresented in case samples. Moreover, we learned that the amount of Bifidobacterium and Lactobacillus increased among the obese children during the process of weight reduction. Conclusion. Our results might enrich the research between gut microbiota and obesity and further provide a clinical basis for therapy for obesity. We recommend that Bifidobacterium and Lactobacillus might be used as indicators of healthy conditions among obese children, as well as a kind of prebiotic and probiotic supplement in the diet to be an auxiliary treatment for obesity. [ABSTRACT FROM AUTHOR]

Background: Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China's health system-characterized by a movement toward "integrated care" and promotion of initial contact with grassroots providers-will affect the care of TB patients.Methods/findings: Unannounced standardized patients (SPs) presenting with classic pulmonary TB symptoms were deployed in 3 provinces of China in July 2015. The SPs successfully completed 274 interactions across all 3 tiers of China's rural health system, interacting with providers in 46 village clinics, 207 township health centers, and 21 county hospitals. Interactions between providers and standardized patients were assessed against international and national standards of TB care. Using a lenient definition of correct management as at least a referral, chest X-ray or sputum test, 41% (111 of 274) SPs were correctly managed. Although there were no cases of empirical anti-TB treatment, antibiotics unrelated to the treatment of TB were prescribed in 168 of 274 interactions or 61.3% (95% CI: 55%-67%). Correct management proportions significantly higher at county hospitals compared to township health centers (OR 0.06, 95% CI: 0.01-0.25, p < 0.001) and village clinics (OR 0.02, 95% CI: 0.0-0.17, p < 0.001). Correct management in tests of knowledge administered to the same 274 physicians for the same case was 45 percentage points (95% CI: 37%-53%) higher with 24 percentage points (95% CI: -33% to -15%) fewer antibiotic prescriptions. Relative to the current system, where patients can choose to bypass any level of care, simulations suggest that a system of managed referral with gatekeeping at the level of village clinics would reduce proportions of correct management from 41% to 16%, while gatekeeping at the level of the township hospital would retain correct management close to current levels at 37%. The main limitations of the study are 2-fold. First, we evaluate the management of a one-time new patient presenting with presumptive TB, which may not reflect how providers manage repeat patients or more complicated TB presentations. Second, simulations under alternate policies require behavioral and statistical assumptions that should be addressed in future applications of this method.Conclusions: There were significant quality deficits among village clinics and township health centers in the management of a classic case of presumptive TB, with higher proportions of correct case management in county hospitals. Poor clinical performance does not arise only from a lack of knowledge, a phenomenon known as the "know-do" gap. Given significant deficits in quality of care, reforms encouraging first contact with lower tiers of the health system can improve efficiency only with concomitant improvements in appropriate management of presumptive TB patients in village clinics and township health centers. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of acupuncture for patients with chronic tension-type headache (CTTH) is controversial. In this article, we report the protocol for a randomized controlled trial aiming to evaluate the long-term effect of acupuncture for CTTH, in comparison with superficial acupuncture.Design: A two-armed, parallel-design, patient-assessor blind, randomized controlled trial is underway in China. A total of 218 participants with CTTH will be randomly assigned to the treatment group or the control group in a 1:1 ratio. Participants in the treatment group and control group will receive acupuncture or superficial acupuncture treatments in a fixed prescription of acupoints respectively, for a total of 20 sessions over 8 weeks. The posttreatment follow-up period will be 24 weeks. The primary outcome will be the proportion of responders assessed at week 16 after randomization. The secondary outcomes will include the number of headache days, the mean intensity of headache, the reduction of medication intake, results from the 36-item short form health survey, the Hamilton Depression Scale and the Hamilton Anxiety Scale, the number of participants with adverse events, the expectation value of acupuncture treatment, and the intensity of deqi sensation. The first five secondary outcomes will be assessed or calculated at baseline, and at 4, 8, 12, 16, 20, 24, 28, and 32 weeks after randomization. Moreover, the expectation value will be collected at baseline and at week 8 after randomization, the intensity of deqi sensation will be assessed at 5 minutes after each treatment and adverse events will be summarized at the end of the follow-up period.Discussion: Results from this trial will provide evidence for the long-term effect of acupuncture for CTTH with a long follow-up period.Trial Registration: ClinicalTrial.gov NCT03133884 . Registered on 25 April 2017. [ABSTRACT FROM AUTHOR]

The properties of infant skin regarding its structure and stratum corneum (SC) properties during development compared to adult skin have been reported only for a few races and body sites. The aim of this study was to understand the developmental changes of skin properties in Chinese infants, focusing on SC ceramides and protein secondary structure, which are important for skin barrier function. Three body sites with distinct characteristics (cheeks, inner upper arms, and buttocks) were assessed. Sixty pairs of Chinese infants and their mothers were measured for SC hydration, transepidermal water loss, ceramide levels, sebum with an ester bond, and protein secondary structure of superficial SC. Skin hydration decreased with age at all body sites. TEWL was similar between the 2–12- and 13–24-month-old groups but was higher than the adult group at the buttocks and inner upper arms and was equal to the adult group at the cheeks. These differences coincided with differences in protein secondary structure. Ceramide and sebum levels were lower in the infant groups. We conclude that both the SC functions and the components of infant skin are still developing and are not fully adapted as in adult skin at each body site examined. [ABSTRACT FROM AUTHOR]

Primulina curvituba B. Pan, L.H. Yang & M. Kang, a new species of Primulina (Gesneriaceae) from Guangxi, China, is described and illustrated. This new species is mainly diagnosed by its strongly curved corolla tube, which is a rare character in Primulina. The morphological relationship and differences between this species and its related congeners are discussed. The conservation status of P. curvituba is assessed as 'Critically Endangered' (CR) according to IUCN. [ABSTRACT FROM AUTHOR]

We examined the mediating effect of regret in the relationship between rumination and depression in new employees in China. Newly employed staff members of 2 Chinese firms (N = 376) completed a survey to measure their rumination, regret, and depression. We used structural equation modeling to test the mediating effect of regret in this relationship, and bootstrapping methods to assess the magnitude of the direct and indirect effects. The results indicated that the direct effect of rumination on depression was significant. We also found a significant indirect effect of rumination on depression through the mediator of regret. The findings extend those of prior studies and shed light on how rumination affects depression among new employees in China, in that regret can partially mediate the effect of rumination on depression. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between progesterone-follicle number (P/F) ratio and live delivery rate in patients with normal ovarian reserve undergoing cleavage-stage embryo transfer with a long gonadotropin-releasing hormone agonist cycle.Methods: The present retrospective study included data from patients younger than 38 years with normal ovarian reserve who were undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer at Zhongnan Hospital, Wuhan University, China, between January 1, 2009 and December 31, 2015. Patients underwent cleavage-stage fresh embryo transfer with a long gonadotropin-releasing hormone agonist cycle, and associations between P/F ratios and fertility/pregnancy outcomes were analyzed.Results: Patients with a P/F ratio of 0.11 or above had higher serum progesterone levels (P<0.001) and lower serum estradiol levels (P<0.001) on the day of human chorionic gonadotropin administration in comparison with patients with lower P/F ratios; elevated P/F ratios were also associated with fewer follicles at least 14 mm in size (P<0.001) and lower live delivery rates (P<0.001). Multiple logistic regression confirmed that P/F ratio was an independent predictor of live delivery rate (P=0.001).Conclusion: A P/F ratio of at least 0.11 was associated with lower live delivery rates in women with normal ovarian reserve undergoing cleavage-stage embryo transfer with a long gonadotropin-releasing hormone agonist cycle. [ABSTRACT FROM AUTHOR]

Some reports have shown that nicotinamide N-methyltransferase (NNMT) is associated with the body mass index (BMI) and energy metabolism. Here we explored the association between NNMT gene polymorphisms and obesity. The subjects were recruited from male Chinese Han college student. 289 of them (19 ≤ body fat percentage (BF%)) were selected as the high body fat group (HBFG), 494 of them (3 ≤ BF% < 13.5) were selected as the low body fat group (LBFG), and then a case-control study (fat versus thin) was carried out to explore the association between the NNMT gene polymorphism and the body composition using tagSNPs method. A tagSNP (rs10891644) in NNMT gene was found significantly associated with the body composition (P<0.0026). At this locus, the BF% for the genotype GT, TT, and GG were 14.56±8.35, 13.47±8.11, and 12.42±7.50, respectively, and the differences between the GT and the GG + TT were highly significant (P<0.01); the ORadjusted value of the GT versus (GG + TT) was 1.716 (Padjusted=0.002, 95% CI = 1.240–2.235). Therefore, the variation of the tagSNP, rs10891644, is significantly associated with obesity and the GT carriers are the susceptible population. [ABSTRACT FROM AUTHOR]

Background: Stroke is the prime cause of morbidity and mortality in the general population, and hypertension will increase the recurrence and mortality of stroke. We report a protocol of a pragmatic randomized controlled trial (RCT) using blood pressure (BP)-lowering acupuncture add-on treatment to treat patients with hypertension and stroke.Methods: This is a large-scale, multicenter, subject-, assessor- and analyst-blinded, pragmatic RCT. A total of 480 patients with hypertension and ischemic stroke will be randomly assigned to two groups: an experimental group and a control group. The experimental group will receive "HuoXueSanFeng" acupuncture combined with one antihypertensive medication in addition to routine ischemic stroke treatment. The control group will only receive one antihypertensive medication and basic treatments for ischemic stroke. HuoXueSanFeng acupuncture will be given for six sessions weekly for the first 6 weeks and three times weekly for the next 6 weeks. A 9-month follow-up will, thereafter, be conducted. Antihypertensive medication will be adjusted based on BP levels. The primary outcome will be the recurrence of stroke. The secondary outcomes including 24-h ambulatory BP, the TCM syndrome score, the Short Form 36-item Health Survey (SF-36), the National Institute of Health Stroke Scale (NIHSS), as well as the Barthel Index (BI) scale will be assessed at baseline, 6 weeks and 12 weeks post initiating treatments; cardiac ultrasound, carotid artery ultrasound, transcranial Doppler, and lower extremity ultrasound will be evaluated at baseline and 12 weeks after treatment. The safety of acupuncture will also be assessed.Discussion: We aim to determine the clinical effects of controlling BP for secondary prevention of stroke with acupuncture add-on treatment.Trial Registration: ClinicalTrials.gov, ID: NCT02967484 . Registered on 13 February 2017; last updated on 27 June 2017. [ABSTRACT FROM AUTHOR]

Aim: Diabetes is a serious global health problem. A simple and effective screening tool should have substantial public health benefit. We investigated the performance of the latest American Diabetes Association diabetes screening methods in our aging Chinese population. Methods: Subjects without diabetes who returned for the 4th Hong Kong Cardiovascular Risk Factors Prevalence Study in 2010–2012 were evaluated for the probability of having diabetes with reference to the age- and body mass index-based screening criteria (screening criteria) and the diabetes risk test (risk test), and the conclusion drawn was compared to their measured glycaemic status. Diabetes was defined by fasting glucose ≥ 7 mmol/L or 2-hour post oral glucose tolerance test glucose ≥ 11.1 mmol/L. Results: 1415 subjects, aged 58.1±10.2, were evaluated. 95 (6.7%) had diabetes. The risk test showed good accuracy (area under the receiver operating curve 0.725) in screening for diabetes with an optimal cut-off score of five. Compared to the screening criteria, the risk test had significantly better specificity (0.57 vs. 0.41, p<0.001), positive predictive value (0.12 vs. 0.09, p<0.001) and positive diagnostic likelihood ratio (1.85 vs. 1.37, p<0.001). To diagnose one case of diabetes, fewer subjects (11 vs. 18) needed to be tested for blood glucose if the risk test was adopted. Conclusion: The risk test appears to be a more effective screening tool in our population. It is simple to use and can be adopted as a public health strategy for identifying people with undiagnosed diabetes for early intervention. [ABSTRACT FROM AUTHOR]

Background: Numerous school-based interventions for childhood obesity have been emerging in mainland China in recent decades, but little is known about the effectiveness of such interventions. This study aims to assess the effectiveness of school-based interventions for childhood obesity conducted in mainland China. Methods: A systematic search was undertaken in eight databases to identify both randomized and non-randomized controlled trials from January 1990 to December 2015 examining the effectiveness of school-based obesity interventions. A random effects meta-analysis was conducted assessing the impact of included interventions on (body mass index) BMI. The quality of each included studies were assessed using Effective Public Health Practice Project Quality Assessment Tool. A P value <0.05 (two-sided) was considered statistically significant. Result: Of the seventy-six included studies, we found physical activity and health education were the two most common components of interventions. More treatment studies were effective compared with prevention studies (85.0% vs. 58.3%). Comprehensive interventions involving physical activity and health education appeared more effective than the physical activity only interventions in both obesity treatment and prevention studies. The meta-analyses showed comprehensive interventions involving physical activity and health education had larger effect on the change of BMI than physical activity only interventions (treatment studies: -1.80 kg/m2 (95% CI: -2.15,-1.44) vs. -0.91 kg/m2 (95% CI: -1.15,-0.67); prevention studies: -0.19 kg/m2 (95% CI: -0.27, -0.11) vs. +0.05 kg/m2 (95% CI: -0.04, +0.15)). Conclusions: Comprehensive school-based interventions may assist in tackling the rising prevalence of childhood obesity in mainland China. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to assess the prevalence of overweight/obesity, abdominal obesity and obesity-related risk factors in southern China. Methods: A cross-sectional survey of 15,364 participants aged 15 years and older was conducted from November 2013 to August 2014 in Jiangxi Province, China, using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), body fat percentage (BFP) and visceral adipose index (VAI). Multivariate logistic regression analysis was performed to evaluate the risk factors for overweight/obesity and abdominal obesity. Results: The prevalence of overweight was 25.8% (25.9% in males and 25.7% in females), while that of obesity was 7.9% (8.4% in males and 7.6% in females). The prevalence of abdominal obesity was 10.2% (8.6% in males and 11.3% in females). The prevalence of overweight/obesity was 37.1% in urban residents and 30.2% in rural residents, and this difference was significant (P < 0.001). Urban residents had a significantly higher prevalence of abdominal obesity than rural residents (11.6% vs 8.7%, P < 0.001). Among the participants with an underweight/normal body mass index (BMI), 1.3% still had abdominal obesity, 16.1% had a high BFP and 1.0% had a high VAI. Moreover, among obese participants, 9.7% had a low /normal WC, 0.8% had a normal BFP and 15.9% had a normal VAI. Meanwhile, the partial correlation analysis indicated that the correlation coefficients between VAI and BMI, VAI and WC, and BMI and WC were 0.700, 0.666, and 0.721, respectively. A multivariate logistic regression analysis indicated that being female and having a high BFP and a high VAI were significantly associated with an increased risk of overweight/obesity and abdominal obesity. In addition, living in an urban area and older age correlated with overweight/obesity. Conclusion: This study revealed that obesity and abdominal obesity, which differed by gender and age, are epidemic in southern China. Moreover, there was a very high, significant, positive correlation between WC, BMI and VAI. However, further studies are needed to explore which indicator of body fat could be used as the best marker to indirectly reflect cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Background: Currently, there are many studies focusing on the influencing factors of the elderly people’s living arrangements or health status, but little is known about the relationship between living arrangements or health status and long-term care models for the old-age, especially the joint effects. Objective: We aimed to assess the effects of health status and living arrangements on long-term care models (LTCM) among the elderly of Xiamen, China, especially their cumulative joint effects. Methods: A total of 14,373 participants aged ≥ 60 years by multistage sampling in Xiamen of China were enrolled. Multinomial logistic regression was used to estimate the Odds ratios (ORs) regressing LTCM on health status and living arrangements using the Anderson model as theoretical framework. Results: Totally, 14,292 valid questionnaires were obtained, of which 86.37% selected home care. With the increase of disability degree, older people are more likely to choose institutional care, compared to living alone (ORs = 1.75, 2.06, 4.00, 4.01 for the “relatively independent’, “mild disability’, “moderate disability’, and “total disability’, respectively, in comparison with “completely independent’). The elderly living with children and other family members preferred to choose home care. (ORs = 0.50, 0.39, 0.40, and 0.43 for the “living with children’, “living with spouse’, “living with children and spouse’, and “living with others’, respectively, in comparison with “alone’). Additionally, residence, number of children, education level, and feelings of loneliness were the determinants of the choice of social pension. Conclusion: A multitude of older people are trended to choose home care in Xiamen of China. There was an interaction and joint effect between the degree of disability and the living arrangements on LTCM. Therefore, policymakers should pay close attention to care for those living alone, childless, and disabled elders to meet their care needs, especially in home care. In addition, the social construction of facilities for elders in rural areas should be strengthened. [ABSTRACT FROM AUTHOR]

Walking, slow running (jogging) and fast running often occur in daily life, Physical Education Class and Physical Fitness Test for children. However, potential impact of jogging and running on plantar pressure of children is not clear. The purpose of this study was to compare the characteristics of plantar pressure distribution patterns in obese and non-obese children during walking, jogging and running, and evaluate biomechanical effects of three movements on obese children. A 2-m footscan plantar pressure plate (RSscan International, Belgium) was used to collect the gait data of 20 obese children (10.69±2.11years; 1.51±0.11m; 65.15±14.22kg) and 20 non-obese children (11.02±1.01years; 1.48±0.07m; 38.57±6.09kg) during three movements. Paired t-test and independent sample t-test were performed for statistical comparisons and ANOVA was used for comparisons of gait characteristics among three movements. Significance was defined as p <0.05. Propulsion phase during jogging for obese children was the longest among three movements (p=0.02). Peak pressures under metatarsal heads IV, V (M4, M5), midfoot (MF), heel medial (HM) and heel lateral (HL) during jogging for obese children were the highest among three movements (p=0.005, p=0.003, p=0.004, p=0.03, p=0.01). Arch index (AI) of left foot during jogging for obese children was the largest (p=0.04).Conclusions: Plantar pressure distribution during three movements changed differently between two groups. The peak pressures under most plantar regions and AI during jogging for obese children were the largest among three movements, indicating that jogging caused more stress to their lower extremities. Obese children perhaps should not consider jogging as regular exercise. [ABSTRACT FROM AUTHOR]

Objectives. To explore the independent associations of sedentary behavior and physical activity with telomere length among Chinese adults. Methods. Data on total time of sedentary behavior, screen-based sedentary behavior (including television watching and computer or phone use), moderate to vigorous physical activity, and dietary intake of 518 adults in Chengdu, Guizhou, and Xiamen in China (54.25% women) aged 20 to 70 years were obtained between 2013 and 2015 through questionnaires. Height, weight, and waist circumference were measured to calculate body mass index and percentage of body fat. Telomere length was measured through Southern blot technique. Results. Television watching was inversely related to adjusted telomere length (-71.75 base pair; SE = 34.40; P = .04). Furthermore, a similar trend between telomere length and television watching was found in the group aged 20 to 40 years after adjusting for all covariates. Adults aged 20 to 40 years in the highest tertile of daily time spent on watching television had 4.0% shorter telomere length than adults in the lowest tertile (P = .03). Conclusions. Although the association is modest, television watching is inversely related to telomere length among Chinese adults, warranting further investigation in large prospective studies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the significance of postoperative inflammatory system response markers in predicting the prognosis of patients with endometrial cancer undergoing surgery.Methods: The present retrospective study included patients who underwent surgical treatment for pathology-confirmed endometrial cancer between January 1, 2007, and June 30, 2013, at the Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China. Potential prognostic factors were investigated by Cox proportional hazards analysis and survival rates were compared using Kaplan-Meier analyses.Results: There were 185 patients with surgically treated endometrial cancer included. Multivariate analyses demonstrated that a preoperative neutrophil-to-lymphocyte ratio (NLR) above 1.81 (P=0.010) and a postoperative NLR above 7.54 (P=0.008) were both independently associated with lower disease free survival. Elevated preoperative and postoperative NLRs were associated with higher tumor stage (P=0.021 and P=0.009, respectively), and only elevated preoperative NLR was associated with lymph node involvement (P=0.023).Conclusion: Preoperative and postoperative NLRs were independently associated with inflammatory system response markers and could be combined to evaluate the prognosis of patients with endometrial cancer following surgery. [ABSTRACT FROM AUTHOR]

Ureaplasma spp. have gained increasing recognition as pathogens in both adult and neonatal patients with multiple clinical presentations. However, the clonality of this organism in the male population and infertile couples in China is largely unknown. In this study, 96 (53 U. parvum and 43 U. urealyticum) of 103 Ureaplasma spp. strains recovered from genital specimens from male patients and 15 pairs of infertile couples were analyzed using multilocus sequence typing (MLST)/expanded multilocus sequence typing (eMLST) schemes. A total of 39 sequence types (STs) and 53 expanded sequence types (eSTs) were identified, with three predominant STs (ST1, ST9 and ST22) and eSTs (eST16, eST41 and eST82). Moreover, phylogenetic analysis revealed two distinct clusters that were highly congruent with the taxonomic differences between the two Ureaplasma species. We found significant differences in the distributions of both clusters and sub-groups between the male and female patients (P < 0.001). Moreover, 66.7% and 40.0% of the male and female partners of the infertile couples tested positive for Ureaplasma spp. The present study also attained excellent agreement of the identification of both Ureaplasma species between paired urine and semen specimens from the male partners (k > 0.80). However, this concordance was observed only for the detection of U. urealyticum within the infertile couples. In conclusion, the distributions of the clusters and sub-groups significantly differed between the male and female patients. U. urealyticum is more likely to transmit between infertile couples and be associated with clinical manifestations by the specific epidemic clonal lineages. [ABSTRACT FROM AUTHOR]

There have been conflicting findings regarding the relationship between body mass index (BMI) and self-rated health (SRH) worldwide. The purpose of this study was to examine the association between BMI and SRH by comparing its relationship in four East Asian countries: South Korea, China, Japan, and Taiwan. Using data from the East Asian Social Survey, the relationship between weight status and SRH status was investigated and compared between four countries, China, Japan, South Korea, and Taiwan. An ordinal logit regression model was estimated for each country, and the results were compared. We found that the relationship between weight status and SRH status differed across the four countries. In China, people who were overweight reported better SRH scores than those of normal weight, whereas in Japan, obese and severely obese people reported poor scores. In contrast, South Koreans who were underweight, obese, or severely obese reported poor ratings of health status than those of normal weight. In Taiwan, however, no differences in respondents’ weight status were found across SRH scores. There were notable differences in the relationship between BMI and SRH status in four East Asian countries. Individual countries should consider these relationships when designing and implementing obesity intervention programs. [ABSTRACT FROM AUTHOR]

Delayed diagnosis of HIV infection is associated with advanced immunosuppression and increased risk of onward transmission. Little data exists regarding factors associated with diagnostic delays among patients presenting with advanced HIV disease in China. Medical records of patients with HIV/AIDS hospitalized at a 2000-bed tertiary hospital in Beijing, China between 1997 and 2012 were retrospectively reviewed. Demographic and clinical data of patients newly diagnosed with HIV at the hospital were abstracted. Patient characteristics, disease parameters, and the time interval between the first medical visit and the visit leading to HIV diagnosis were compared among three periods: 1997–2002, 2003–2008 and 2009–2012. Chi-square, Kruskal-Wallis and logistic regression analyses were used as appropriate. A quarter of patients (72/279) were newly diagnosed with HIV at the hospital, consisting of 11, 29 and 32 patients in 1997–2002, 2003–2008 and 2009–2012 respectively. The median time delay between the first medical visit and the visit leading to HIV diagnosis decreased over time from 91 days among patients diagnosed before 2002, to 75 days between 2003 to 2008, and 39 days after 2009 (p = 0.036). However, the median CD4+T cell count at diagnosis was 26 cells/μL [interquartile range 3–132 cells/μL] in 1997–2002, and remained unchanged across time intervals. Forty-one (57%) patients had AIDS-defining conditions and Pneumocystis jiroveci pneumonia was the most common opportunistic infection (31 cases). These results reveal persistent missed opportunities for timely HIV testing among patients with advanced disease. Strategies for promoting early HIV testing in healthcare settings are needed in China. [ABSTRACT FROM AUTHOR]

Background: Blood collection agencies worldwide are facing ongoing and increasing medical demands for blood products. Many potential donors would search related information online before making decision of whether or not to donate blood. However, there is little knowledge of the online information and services provided by blood centers in China, despite the constantly increase of internet users. Our research investigates the number of blood centers’ official websites and their quality, and highlights the deficiencies that required future advances. Methods: Identified official websites of blood centers were scored using a newly developed evaluation instrument with 42 items concerning technical aspects, information quality, information comprehensiveness and interactive services. Scores of websites were compared between blood centers with different level (provincial vs. regional blood centers) and location (blood centers located in economically developed vs. developing region). Results: For the 253 working official websites all the 350 blood centers in China, and the mean overall score of websites was 24.7 out of 42. 79.1% websites were rated as fair (50–75% of maximum), 5.5% as good (≥75% of maximum) and 15.4% as poor(25–50% of maximum;). Websites got very low sub-scores in information quality (mean = 3.8; range 1–8; maximum = 9) and interactive services (3.3; 0–10; 10). Higher proportions of provincial (vs. regional) blood centers and economically developed (vs. developing) blood centers had official websites (p = 0.044 and p = 0.001; respectively) with better overall quality (p<0.001 and p <0.01) and better sub-scores (in all of the four sections and in technical aspects and information quality). Website overall scores was positively correlated with the number of people served by each blood center (p< 0.001) and the donation rate of each province (p = 0.046). Conclusions: This study suggests there is a need to further develop and improve official websites in China, especially for regional and inland blood centers. The poor information quality and interactive services provided by these websites is of particular concern, given the challenges in blood donor counselling and recruitment. [ABSTRACT FROM AUTHOR]

To examine how L1 influences L2 reading in the brain, two late bilingual groups, Korean-English (KE) and Chinese-English (CE), performed a visual word rhyming judgment task in their L2 (English) and were compared to L1 control groups (i.e., KK and CC). The results indicated that the L2 activation is similar to the L1 activation for both KE and CE language groups. In addition, conjunction analyses revealed that the right inferior frontal gyrus and medial frontal gyrus were more activated in KK and KE than CC and CE, suggesting that these regions are more involved in Korean speakers than Chinese speakers for both L1 and L2. Finally, an ROI analysis at the left middle frontal gyrus revealed greater activation for CE than for KE and a positive correlation with accuracy in CE, but a negative correlation in KE. Taken together, we found evidence that important brain regions for L1 are carried over to L2 reading, maybe more so in highly proficient bilinguals. [ABSTRACT FROM AUTHOR]

Aim: To assess pregnancy outcomes in pregnancies with idiopathic polyhydramnios at term.Methods: We conducted a retrospective cohort study of 106 225 term pregnancies from 37 hospitals in China. Maternal and fetal outcomes in pregnancies with idiopathic polyhydramnios were compared with pregnancies with normal amniotic fluid. The primary outcome was intra-uterine fetal death (IUFD).Results: In all, 307 out of 106 225 (0.3%) had idiopathic polyhydramnios at term, 276 of which were mild and 31 of which were moderate-severe. Compared to term pregnancies with normal amniotic fluid, pregnancies idiopathic polyhydramnios was associated with over 24-fold higher risk for IUFD (adjusted odds ratio [aOR] 24.4, 95% confidence interval (CI) 7.3-82.0), macrosomia (aOR 2.8, 95%CI 2.0-3.8), malpresentation (aOR 2.5, 95%CI 1.7-3.7), cesarean delivery (aOR 2.5, 95%CI 1.7-3.7) and low APGAR scores at 5 min (aOR 4.3, 95%CI 2.4-7.8), which increased with severity of idiopathic polyhydramnios.Conclusion: Term pregnancies with idiopathic polyhydramnios, especially moderate-severe ones are at a significantly increased rate for adverse pregnancy outcome. Increased antepartum surveillance of fetal well-being and timed delivery are warranted. [ABSTRACT FROM AUTHOR]

Background: Glomerular filtration rate (GFR) is essential for renal function evaluation and classification of chronic kidney disease (CKD), while the reference method in children are cumbersome. In the Chinese children, there was no data about GFR measured through plasma or renal clearance of the exogenous markers, and therefore no validated GFR-estimating tools in this population. Methods: We measured GFR with double-sample plasma clearance of 99mTc-DTPA (mGFR) in 87 hospitalized children with renal injury. Using mGFR as the golden standard, we evaluate the efficiency of four different GFR estimation equations (the original and update Schwartz equation, the Filler equation, the CKiD equation) by statistical parameters of correlation, precision and accuracy. Results: In our population, mGFR was 97.0± 31.9 mL/min/1.73m2. The updated Schwartz equation, the Filler equation and the CKiD equation, produced eGFR with strong correlation with mGFR, strong explanation capacity of variance in mGFR, small bias, satisfactory performance in Bland-Altman analysis, high intra-class correlation coefficients, high ratio of eGFR within mGFR±10% and eGFR within mGFR±30%, good agreement in CKD staging between eGFR and mGFR. The original Schwartz equation produced eGFR with large bias, poor precision and accuracy. Conclusion: The validated equations to estimate GFR in our patients are the updated Schwartz equation, which is simple for bedside use, the Filler equation and the CKiD equation, which provide more accurate eGFR. The original Schwartz equation should not be applied to estimate GFR in Chinese children with kidney injuries. [ABSTRACT FROM AUTHOR]

Background/Aims: The aim of the present study was to identify and quantify the polyamine levels in human milk obtained from different countries and through different modes of delivery, and to investigate their association with breast milk microbes. Methods: Mature breast milk samples were obtained from 78 healthy mothers after 1 month of lactation from 4 different geographical locations: Finland, Spain (Europe); South Africa (Africa); and China (Asia). Polyamines were determined using HPLC after dansyl derivatization and milk microbiota was obtained by 16S rRNA gene sequencing. Results: The mean values of polyamines in breast milk were 70.0, 424.2, and 610.0 nmol/dL for putrescine, spermidine and spermine, respectively, and 1,170.9 nmol/dL of total polyamines. The levels of putrescine were significantly higher in Spain ( p < 0.05) and spermidine levels were significantly higher in Finland ( p < 0.05) compared with other countries. Cesarean delivery had an impact on polyamine levels and it was related to an increase in the putrescine concentration being significant in Spanish samples ( p < 0.01). Furthermore, putrescine levels were correlated positively with Gammaproteobacteria ( r = 0.46, p < 0.001), especially with Pseudomonas fragi ( r = 0.40, p < 0.001). Conclusions: The results demonstrate significant effect of geographical variations in human milk polyamine concentrations, being correlated with human milk microbiota composition. These differences may have an impact on infant development during lactation. [ABSTRACT FROM AUTHOR]

Swimming performance is extremely important to critical activities of fishes, such as foraging, anti-predator, and migration. As one of primary stock enhancement fish species in China, it is imperative to study on swimming performance of the large yellow croaker (Larimichthys crocea). In the present study, the swimming performance of juvenile large yellow croaker was investigated, including the behavior, muscle morphology, stress physiology, and genetic mechanisms underlying the individual difference. Juveniles of the croaker were individually subjected to the critical swimming speed (U crit) test, and thereby divided into fast (36.47 cm/s) and slow (18.65 cm/s) groups. The juveniles in the fast group had significantly higher tail beat frequency, smaller muscle fiber diameter and more muscle fiber number, as well as lower plasma cortisol and corticotropin releasing hormone (CRH) levels than those in the slow group. Meanwhile, expression levels of hsp70 and pcna in the brain were significantly higher in the fast group than in the slow group, however no significant difference was observed in syt1a expression. Furthermore, the key genes and pathways involved in the swimming performance were assessed by mapping the white skeletal muscle transcriptome. We found that a total of 157 transcripts was differentially expressed between the fast and slow groups, enriched in oxidative phosphorylation, glycosaminoglycan biosynthesis, nicotinate and nicotinamide metabolism, cellular senescence, and cardiac muscle contraction pathways. A multitude of mitochondrial NADH dehydrogenase subunits and solute carrier family genes were especially related. In conclusion, we for the first time found that fish swimming performance directly links to muscle fiber plasticity, stress physiology, and molecular base divergence in the large yellow croaker. The present results lay a foundation for ethological-character-based selective breeding for the large yellow croaker in the regards of swimming performance. • Large yellow croakers have inter-individual difference of swimming performance. • Muscle fiber plasticity and stress physiology affect the swimming performance. • Molecular divergence in energy metabolism determines the swimming performance. [ABSTRACT FROM AUTHOR]