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Limited evidence was available on ambient air pollution and pediatric atopic dermatitis (AD). The study aimed to evaluate the associations between short-term exposure to air pollutants and outpatient visits for pediatric AD. From 2016-2018, we collected data on six criteria air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO and O 3 ) and daily outpatient visits for pediatric AD in 66 hospitals, covering all districts in Shanghai, China. The over-dispersed Poisson generalized additive model (GAM) was applied to fit the associations of criteria air pollutants with hospital visits. Two-pollutant models were fitted and stratified analyses by sex, age and season were conducted. We identified 477,833 outpatient visits for pediatric AD. Each interquartile range (IQR) increase in PM 2.5 (IQR: 30.9 μg/m 3 ), PM 10 (8.9 μg/m 3 ), NO 2 (25.5 μg/m 3 ), SO 2 (5.8 μg/m 3 ) and CO (0.283 mg/m 3 ) on the concurrent day was significantly associated with increments of 2.08 % (95 % CI: 0.53 %, 3.65 %), 2.53 % (95 % CI: 0.87 %, 4.22 %), 8.14 % (95 % CI: 6.24 %, 10.08 %), 5.67 % (95 % CI: 3.58 %, 7.80 %), and 2.27 % (95 % CI: 0.70 %, 3.87 %) in pediatric AD outpatient visits, respectively. The effects of NO 2 remained robust after adjustment for other air pollutants. The exposure-response curves for PM 2.5 and PM 10 were steeper for moderate-lower concentrations, with a flatten curves at high concentration; nearly linear relationships were found for NO 2 . Higher associations of NO 2 exposure on AD were detected in children under 6 years old (p=0.01); and we observed larger effect of air pollutants in cool seasons (p<0.001 for PM 2.5 , PM 10 , NO 2 and CO; p=0.043 for SO 2 ). This study indicated that short-term exposure to air pollution could increase risk of outpatient visits for pediatric AD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Although it is well established that obesity is a risk factor for hypertension, the effect of distinct long-term patterns of body mass index (BMI) on blood pressure (BP) in later life is poorly understood., Methods: Based on the China Health and Nutrition Survey, we analyzed 2920 participants aged 3-17 years with initial normal BP at baseline (1991-2011), who were followed up for the development of hypertension (1993-2015). The group-based trajectory model was applied to identify BMI trajectories, and Cox regression was used to assess their associations with hypertension risk. Stratified analyses were conducted to explore differences across subgroups., Results: During an average follow-up time of 11.20 (7.69) years for males and 7.20 (5.21) years for females, 339 males and 212 females were identified with hypertension, respectively. Three BMI trajectories were identified: low-increasing (60.58% of males and 73.03% of females), moderate-increasing (33.08% of males and 24.22% of females), and high-increasing (6.34% of males and 2.76% of females). Our study found a significant positive association between a higher BMI trajectory and hypertension risk in males (all P for trend < 0.05). Specifically, males in the high-increasing BMI group had a higher risk of hypertension compared with those in the low-increasing group (HR = 1.76, 95% CI: 1.04-2.97). Stratified analyses revealed stronger associations among smokers, drinkers, and inactive individuals., Conclusion: Our findings suggest that maintaining a normal BMI and healthy lifestyle from childhood may lower subsequent risk of hypertension., (© 2024. The Author(s).)

To assess if the impacts of prenatal maternal stress (PNMS) on neonatal physical development including birth weight and body length vary by trimesters, and to explore the mediating effect of sleep quality in the relationships. A total of 2778 pregnant women were included from the Shanghai Maternal-Child Pairs Cohort. PNMS and sleep quality were measured in the first trimester (12-16 gestational weeks) and third trimester (32-36 gestational weeks) using the Life Event Scale for Pregnant Women (LESPW) and Pittsburgh Sleep Quality Index, respectively. And total LESPW scores were classified into three groups: high stress (≥75th percentile), medium stress (≥25th and <75th percentile), and low stress (<25th percentile). Multiple linear and logistic regressions were employed to examine the associations between PNMS and birth weight, and bootstrap were utilized to explore the mediating effects of maternal sleep. Higher (adjusted odds ratio, aOR = 1.521; 95% confidence interval (CI), 1.104-2.096) and medium (aOR = 1.421; 95% CI, 1.071-1.885) PNMS and stress from subjective events (aOR = 1.334; 95% CI, 1.076-1.654) in the first trimester were significantly associated with elevated risk for large for gestational age. Maternal severe negative objective events stress (OE3) in the third trimester were negatively associated with birth weight (β = -0.667; 95% CI, -1.047∼-0.287), and maternal sleep latency during this period acted as a mediator in the association (indirect effect: β = -0.0144; 95% CI, -0.0427∼-0.0003). Besides, a significant negative correlation between total LESPW score (β = -0.022; 95% CI, -0.038∼-0.006; per 100 score) and body length in the third trimester was also observed. The impact of PNMS on neonatal birth weight varies by stress types and exposure timing. Prolonged maternal sleep latency in the third trimester correlated with lower birth weight, and mediating the link of OE3 and birth weight, which might indicate a critical period of vulnerability to the effects of PNMS on neonatal physical development., (© 2024 John Wiley & Sons Ltd.)

Background: Concerns remain about the neurotoxic properties of the ubiquitous organophosphate esters (OPEs), the replacement of the toxicant polybrominated diphenyl ethers., Objectives: We examined the associations of prenatal exposure to OPEs and their mixtures with early-life neurodevelopment trajectories., Methods: Totally 1276 mother-child pairs were recruited from the Shanghai Maternal-Child Pairs Cohort. A high-performance liquid chromatography-triple quadrupole mass spectrometer was used to measure the levels of 7 OPEs in cord serum. Ages and Stages Questionnaires was used to examine children's neuropsychological development at 2, 6, 12, and 24 months of age. Group-based trajectory models were applied to derive the neurodevelopmental trajectories. Multiple linear regression and logistic regression model were performed to assess the relationships between OPEs exposure and neurodevelopment and trajectories. Mixtures for widely detected OPEs (n = 4) were investigated using quantile-based g-computation., Results: Tributyl phosphate (TBP), tris (2-butoxy ethyl) phosphate (TBEP), tris(1,3-dichloro-2-propyl) phosphate (TDCPP), and 2-ethylhexyl diphenyl phosphate (EHDPP), had detection rates >50 %. TDCPP had the highest median concentration (1.02 μg/L) in cord serum. EHDPP concentrations were negatively associated with scores in most domains at 12 months of age, with effect values (β) ranging from -1.89 to -0.57. EHDPP could negatively affect the total ASQ (OR = 1.07, 95 % CI: 1, 1.15) and gross-motor (OR = 1.09, 95 % CI: 1.02, 1.17) trajectory in infancy. Joint exposure to OPEs was associated with decreased scores in the total ASQ, gross-motor, fine-motor and problem-solving domain of 12-month-old infants, with β ranging from -5.93 to -1.25. In addition, the qgcomp models indicated significant positive associations between the concentrations of OPEs mixtures and risks of the persistently low group of the total ASQ, gross-motor and fine-motor development in early childhood. The impact of OPEs was more pronounced in boys., Discussion: Our findings suggested OPEs, especially EHDPP, had a persistently negative effect on neurodevelopment during the first 2 years., Competing Interests: Declaration of competing interest The authors declare they have nothing to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The majority of pigeon paramyxovirus type 1 (PPMV-1) strains are generally non-pathogenic to chickens; however, they can induce severe illness and high mortality rates in pigeons, leading to substantial economic repercussions. The genomes of 11 PPMV-1 isolates from deceased pigeons on meat pigeon farms during passive monitoring from 2009 to 2012 were sequenced and analyzed using polymerase chain reaction and phylogenetic analysis. The complete genome lengths of 11 isolates were approximately 15,192 nucleotides, displaying a consistent gene order of 3'-NP-P-M-F-HN-L-5'. ALL isolates exhibited the characteristic motif of 112RRQKRF117 at the fusion protein cleavage site, which is characteristic of velogenic Newcastle disease virus. Moreover, multiple mutations have been identified within the functional domains of the F and HN proteins, encompassing the fusion peptide, heptad repeat region, transmembrane domains, and neutralizing epitopes. Phylogenetic analysis based on sequences of the F gene unveiled that all isolates clustered within genotype VI in class II. Further classification identified at least two distinct sub-genotypes, with seven isolates classified as sub-genotype VI.2.1.1.2.2, whereas the others were classified as sub-genotype VI.2.1.1.2.1. This study suggests that both sub-genotypes were implicated in severe disease manifestation among meat pigeons, with sub-genotype VI.2.1.1.2.2 displaying an increasing prevalence among Shanghai's meat pigeon population since 2011. These results emphasize the value of developing pigeon-specific vaccines and molecular diagnostic tools for monitoring and proactively managing potential PPMV-1 outbreaks., (© 2024. The Author(s).)

This study evaluated the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and food effects (FE) of SC0062, a highly active endothelin-A (ET A ) receptor antagonist, in healthy subjects. The primary objectives of this first-in-human phase I study, comprised of single-ascending-dose, multiple-ascending-dose, and FE parts, were to characterize the safety and tolerability of SC0062, and FE. The secondary objectives were to determine the PK behavior of SC0062 and its major active metabolite M18, whereas exploratory objectives focused on PD effects, principally effects on endothelin-1 (ET-1) and total bile acids (TBA). Single doses of 10 to 100 mg and multiple daily doses of 20 and 50 mg for 6 days were well tolerated. SC0062 was rapidly absorbed and plasma exposure of SC0062 and M18 increased disproportionately with dose, achieving steady state by day 3, with accumulation ratios of 1.22 and 1.89 on day 6 for SC0062 and M18, respectively. The geometric mean (geometric standard deviation) terminal elimination half-life (t 1/2 ) values of SC0062 and M18 were 7.25 (1.70) h and 13.73 (1.32) h, respectively. Plasma ET-1 concentrations were dose-proportional, whereas plasma TBA concentrations behaved erratically. Following a single 50 mg dose of SC0062 after a high-fat meal, C max values for SC0062 and M18 increased by 41% and 32%, respectively, and median T max values for SC0062 were 3 h longer than fasting values; exposure was unaffected. These favorable safety, PK, and PD results provide a foundation for further studies of SC0062 in pulmonary arterial hypertension, chronic kidney disease, and other relevant indications., (© 2024 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

Importance: Sleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified., Objective: To examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs)., Design, Setting, and Participants: This cohort study used data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023., Exposures: Sleep disturbances were assessed using the Children's Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire., Main Outcomes and Measures: Occurrence of incident and resolved EBDs at the 2-year follow-up., Results: The cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P < .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P < .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P < .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P < .001) were higher than among the group with no sleep disturbances., Conclusions and Relevance: In this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.

The aim of this study was to evaluate the net effects of dietary consumption on the potential neurodevelopmental effects of largemouth bass (Micropterus Salmoides, simplify as bass) cultured in China, especially when the bait of largemouth bass is changed from iced trash fish to formulated feed. A total of three bait group bass samples were collected from main producing areas during harvest period, including formulated feed group, iced trash fish group, and both group (converting from iced trash fish to formulated feed). Net neurodevelopment value (expressed as intelligence quotient or IQ) was calculated using FAO/WHO deterministic methods and probabilistic assessment model. The results showed net IQ of largemouth bass fed by the three baits groups all showed positive or beneficial neurodevelopmental effects, with the values of 1.55 ± 0.97 (formulated feed group), 3.17 ± 1.76 (iced trash fish group), and 2.65 ± 1.29 (both group) respectively. Bass samples fed with ice trash fish showed the highest neurodevelopmental effect. The present study suggested that more valuable formulated feed should be developed to improve the quality of cultured largemouth bass., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Few studies have simultaneously explored which size of particles has the greatest impact on the risk for pediatric asthma, bronchitis and upper respiratory tract infections (URTIs)., Objectives: To investigate the short-term association between size-segregated particle number concentrations (PNCs) and outpatient-department visits (ODVs) for major pediatric respiratory diseases., Methods: Daily counts of pediatric ODVs for asthma, bronchitis and URTIs were obtained from 66 hospitals in Shanghai, China, from 2016 to 2018. Pollutant effects were estimated using Poisson generalized additive models combined with polynomial distributed lag models. We also fitted co-pollutant cumulative effects models included six criteria air pollutants and conducted stratifying analyses by gender, age, season and geographic distances., Results: We identified a total of 430,103 patients with asthma, 1,547,013 patients with bronchitis, and 2,155,738 patients with URTIs from the hospitals. Effect estimates increased with decreasing particle size. Ultrafine particle (UFP) and PNCs of 0.10-0.40 µm particles (PNC 0.10-0.40 ) were associated with increased ODVs for asthma, bronchitis and URTIs at cumulative lags up to 3d. Associations tended to appear stable after adjusting for criteria air pollutants. At the cumulative lag 0-2d, each interquartile range increase in UFP was associated with increased ODVs due to asthma (relative risk 1.21, 95% CI: 1.07, 1.38), bronchitis (1.20, 95% CI: 1.07, 1.34) and URTI (1.17, 95% CI: 1.06, 1.30), whereas the associations for PNC 0.10-0.40 remained significant but attenuated in magnitude., Conclusions: UFP may be a leading contributor to the adverse respiratory effects of particulate air pollution and the effects increased with decreasing particle size., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The Junggar Basin plague focus was the most recently identified natural plague focus in China. Through extensive field investigations, great gerbils (Rhombomys opimus) have been confirmed as the main host in this focus, and the community structure of their parasitic fleas is associated with the intensity of plague epizootics. The aim of this study is to provide an indicator that can be surveyed to evaluate the risk of plague epizootics., Methods: Between 2005 and 2016, rodents and fleas were collected in the Junggar Basin plague focus. The parasitic fleas on great gerbils were harvested, and anti-F1 antibody in the serum or heart infusion of great gerbils was detected through indirect hemagglutination assay. Yersinia pestis (Y. pestis) was isolated from the liver and spleen of great gerbils and their parasitic fleas using Luria-Bertani plates. Receiver-operating characteristic (ROC) curve was used to evaluate the predictive value of flea index., Results: Between 2005 and 2016, 98 investigations were performed, and 6778 great gerbils and 68,498 fleas were collected. Twenty-seven rodents were positive for Y. pestis isolation with a positivity rate of 0.4%; 674 rodents were positive for anti-F1 antibody with a positivity rate of 9.9%. Among these 98 investigations, plague epizootics were confirmed in 13 instances by Y. pestis-positive rodents and in 59 instances by anti-F1 antibody-positive rodents. We observed a higher flea index among rodents with confirmed plague epizootic compared to the negative ones (P = 0.001, 0.002), with an AUC value of 0.659 (95% CI: 0.524-0.835, P = 0.038) for Y. pestis-positive rodents and an AUC value of 0.718 (95% CI: 0.687-0.784, P < 0.001) for anti-F1 antibody-positive rodents., Conclusions: Significantly higher flea index was associated with confirmed plague epizootic cases among great gerbils and could be used to predict plague epizootics in this focus., (© 2022. The Author(s).)

Background: Currently, the treatment of radiation pneumonitis (RP) remains a clinical challenge. Although glucocorticoids are used for RP treatment, they have associated side effects. Xuebijing injection (XBJ) has been widely used for RP treatment in China, but so far no meta-analysis has evaluated its efficacy and safety., Methods: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, WANFANG database, SinoMED, and China Science and Technology J Database were searched for randomized controlled trials related to XBJ in RP treatment. Two researchers independently conducted literature screening, data extraction, and risk of bias assessment. The outcomes were synthesized and analyzed using the Cochrane Review Manager (RevMan 5.3) software, and a forest plot generated., Result: Eight articles met the eligibility criteria for further data extraction and meta-analysis. A total of 578 patients with RP participated in these studies, including 296 in the experimental group (XBJ+BT), and 282 in the control group (BT). The results of the meta-analysis revealed that compared to the BT group, XBJ+BT significantly increased the total effective rate (n = 578; RR = 1.45, 95% CI: 1.30 to 1.61, p<0.0001), and IL-10 expression (n = 296; MD = 17.62, 95% CI:13.95 to 21.29, p<0.00001), decreased interleukin-6 (IL-6) expression (n = 296; MD = -21.56, 95% CI:-27.37 to -15.76, p<0.00001), that of tumor necrosis factor alpha (n = 246; MD = -25.63, 95% CI:-30.77 to -20.50, p<0.00001), and that of C-reactive protein (n = 296; MD = -48.61, 95% CI:-56.49-40.73, p< 0.00001)., Conclusion: Based on our results, we do not recommend XBJ as an adjuvant treatment for RP. Further randomized controlled trials with rigorous design, strict implementation, and standard reporting are needed to further evaluate the efficacy and safety of XBJ for RP treatment., Systematic Review Registration: INPLASY registration number: INPLASY2020120037., Competing Interests: The authors have declared that no competing interests exist.

Aquatic products contain both beneficial substances such as polyunsaturated fatty acids and harmful compounds such as methylmercury, and their combined health effects should be assessed at a common end point for a rational analysis. We used a risk-benefit model to assess net IQ point gain from consumption of Chinese mitten crabs (Eriocheir sinensis) from Jiangsu Province. Levels of methylmercury in the edible parts of the crabs ranged from 0.79 to 69.47 μg/kg (mean: 26.88 ± 15.09 μg/kg). Levels of methylmercury did not differ by sampling location. In aquaculture experiments, we simulated artificial pond farming using either iced trash fish or formulated feed. Crabs fed iced trash fish contained 28.72 ± 2.30 mg/g of eicosapentaenoic acid and docosahexaenoic acid and crabs fed formulated feed contained 19.64 ± 3.62 mg/g of eicosapentaenoic acid and docosahexaenoic acid. Model calculations estimated a gain of 7.52 IQ points from consumption of crabs fed formulated feed and 11.00 IQ points from consumption of crabs fed iced trash fish. They are all above the maximum theoretical IQ point gain value. Chinese mitten crab is a kind of high-quality food which is beneficial to the neural development of infants. Our findings may assist in improving crab farming methods and consumption patterns, accelerating the sustainable development of the Chinese mitten crab industry., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

We used a risk-benefit model to evaluate the effects of different farming methods and consumption habits on dietary risk of Chinese mitten crab. In this study, we found that cadmium levels in the total edible parts and brown meat were 0.029-0.462 mg/kg and 0.017-1.694 mg/kg, respectively. Cadmium exposure experiment showed that brown meat was the main enrichment site of cadmium. Fatty acid test found that the EPA + DHA content in total edible parts fed with formulated feed and iced trash fish was 19.64 ± 3.62 mg/g and 28.72 ± 2.30 mg/g (p > 0.05), respectively, and that in brown meat was 27.66 ± 5.16 mg/g and 40.15 ± 3.50 mg/g (p > 0.05), respectively. According to the risk-benefit model analysis, the dietary risk of brown meat under the two breeding methods is relatively high, but the risk quotient is less than 1., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Preterm birth (PTB), defined as live birth before the 37th week of gestation, is believed to have profound impacts on the infant's health in later life. Air pollution has been suggested to be a potential risk factor of PTB, but the evidence was inconsistent. In this multicenter birth cohort study, we aimed to examine the association between fine particulate matter (PM 2.5 ) exposure during pregnancy and PTB in China. A total of 5976 live births were identified between Jan. 2009 and Feb. 2011 from 8 provinces in China. Residential exposures to PM 2.5 were assigned based on satellite remote sensing estimates. Cox proportional hazards regressions were employed to explore the correlation for each trimester as well as the entire pregnancy. A total of 443 (7.4%) preterm births were observed. The average PM 2.5 during pregnancy was 57.2 ± 8.8 μg/m 3 . We found exposure to PM 2.5 during the whole pregnancy (hazard ratio, HR = 1.262; 95% CI: 1.087-1.465) and in the first trimester (HR = 1.114; 95% CI: 1.007-1.232) was associated with higher risk of PTB. The associations of PM 2.5 were stronger for subjects with older maternal or paternal age, lower maternal pre-pregnancy BMI, and lower family income. This study adds supports to the cumulating evidence linking PM 2.5 exposure and elevated PTB risk. Measures of air pollution reduction are needed during pregnancy, especially at early stage of pregnancy to prevent adverse birth outcomes., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The COVID-19 pandemic has become a global health catastrophe. By far, there has been no specific antiviral treatment for COVID-19. Developing a vaccine against COVID-19 appeared to be the most cost-effective strategy to stop the repeated outbreak. This study aimed to investigate the attitudes of psychiatric patients with regards to COVID-19 vaccination and potential factors that might influence their decision-making process., Methods: Psychiatric patients participated in this cross-sectional survey in China. Family caregivers, usually a guardian or next of kin completed the questionnaire when the patient is unable to consent. Data was collected via an online self-administered questionnaire. This questionnaire focused on four main attributes: (1) sociology-demographic characteristics, such as age and sex; (2) questions relating to the COVID-19 pandemic, such as perceived risk of COVID-19; (3) Flu vaccination history; and (4) attitude towards COVID-19 vaccination and affected factors, such as preferred vaccine type and vaccination site. The associated factors that influenced vaccination acceptance were analyzed by Chi-square analysis and binary logistic regression., Results: In total, 416 individuals were recruited, from which 408: 229 patients and 179 family caregivers completed the online survey (response rate: 98.1%). 78.7% of the participants (178 patients and 143 family caregivers) said they intended to receive vaccination once the COVID-19 vaccine became available on the market. Our results showed that participants would have a greater likelihood of joining the COVID-9 immunization programme if the people they knew (community residents or their friends and relatives) presented with high vaccine coverage (OR = 0.24; 95% CI:0.09-0.59). If the pandemic returns, participants were also more likely to accept vaccination (OR = 0.21; 95% CI:0.07-0.62). Moreover, those who believed that the vaccination was an important way to control the COVID-19 pandemic also showed a tendency to receive vaccination (OR = 0.21; 95% CI:0.11-0.40). For those who did not intend to get vaccinated either for themselves or their psychiatric family member, the safety of vaccine was their main concern (71.3%)., Conclusions: This study showed a high acceptance rate for COVID-19 vaccination amongst psychiatric patients, while worries about the safety of vaccine led to refusal towards vaccination. To increase vaccination uptake amongst this vulnerable group, the public health messaging should include updated vaccination coverage in local communities, and the number of newly COVID-19 infected cases. Specific information about vaccine safety concerning psychiatric patients; as well as the importance of vaccination in controlling the pandemic should be explained in detail., (© 2021. The Author(s).)

Background: The prevalence of allergic diseases (ADs), such as asthma and allergic rhinitis (AR), is increasing worldwide in both adults and children. Although ADs are common and frequently coexist in outpatient care, city-level data regarding the characteristics of childhood AD remain limited in China. This study aimed to assess the profile and characteristics of ADs in the city of Shanghai., Methods: A multicenter retrospective study was designed to collect routine administrative data from outpatient and emergency departments from 66 hospitals in Shanghai, China, from 2016 to 2018. Children with asthma, AR, allergic conjunctivitis (AC), and allergic skin diseases were investigated. Demographic characteristics, patients visit pattern, spectrum of diagnosis, and comorbidities were analyzed., Results: A total of 2,376,150 outpatient and emergency visits for ADs were included in the period from 2016 to 2018. Allergic skin diseases accounted for 38.9%, followed by asthma (34.8%), AR (22.9%), and AC (3.3%), with a male predominance in all four diseases. Asthma and allergic skin diseases were most frequent in the 1 to < 4 years of age group, while AR and AC were more common in the 4 to < 7 years of age group. Asthma accounted for the greatest number of annual and emergency visits. The most frequent comorbidity of asthma was lower respiratory tract infection (LRTI) (49.3%), followed by AR (20.5%) and upper respiratory tract infection (14.1%). The most common comorbidities of AR were otitis media (23.4%), adenoid hypertrophy/obstructive sleep apnea (22.1%), followed by LRTI (12.1%), asthma (9.4%) and chronic pharyngitis (8.9%)., Conclusions: Asthma and allergic skin diseases were the most common ADs in outpatient and emergency departments in the study period. Respiratory tract infection was the most common comorbidity of asthma in children. More attention should be devoted to the treatment of comorbidities to improve childhood AD outcomes with a better understanding of the characteristics of ADs in outpatient care., (© 2021. The Author(s).)

Purpose: Nausea and vomiting are the most painful and feared side effects for patients during chemotherapy. Currently, most studies focus on the occurrence of CINV during the risk phase. We initiated this real-world study to understand the actual occurrence of CINV throughout all phases, to provide a basis to prevent CINV in patients during chemotherapy and improve their quality of life., Methods: This prospective real-world study was conducted at 17 major cancer centers in Sichuan, China. Cancer patients who were about to receive moderately/highly emetogenic chemotherapy were included in the study. Occurrences of nausea and vomiting were recorded using patient diaries, and physicians are responsible for recording patient clinical data., Results: A total of 1,139 patients were included in this study between August 2018 and April 2019. In this study, the incidence of acute CINV was 55.3%, delayed CINV was 62.3%, and CINV beyond the risk period was 36%. All phases overall, the overall complete control (CC) rate of CINV was 30.1 and 32.1% for highly and moderately emetogenic chemotherapy regimens, respectively. The median CC time for CINV was 7 days, but only 21.5% of these patients used antiemetic regimens according to the NCCN guideline., Conclusion: In the real world, the incidence of CINV is high in patients receiving chemotherapy, and nausea and vomiting may occur beyond the risk period; the low level of standardized antiemetic treatment in compliance with the guideline might have been the main reason for unsatisfactory prevention and control of CINV in this study., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

Background: Although ambient fine particulate matter (PM 2.5 ) has been associated with adverse respiratory outcomes in children, few studies have examined PM 2.5 constituents with respiratory diseases in children in China., Objectives: To investigate the associations of short-term exposure to PM 2.5 and its constituents with pediatric emergency room visits (ERVs) for respiratory diseases in Shanghai, China., Methods: We collected daily concentrations of PM 2.5 and its constituents in urban Shanghai from January 1, 2016, to December 31, 2018. Daily pediatric ERVs for four major respiratory diseases, including upper respiratory tract infection, bronchitis, pneumonia, and asthma, were obtained from 66 hospitals in Shanghai during the same period. Associations of exposure to daily PM 2.5 and constituents with respiratory ERVs were estimated using the over-dispersed generalized additive models., Result: Short-term exposure to PM 2.5 and its constituents were associated with increased pediatric ERVs for respiratory diseases. Specifically, an interquartile range increase in the 3-day average PM 2.5 level (31 μg/m 3 ) was associated with 1.86% (95%CI: 0.52, 3.22), 1.53% (95%CI: 0.01, 3.08), 1.90% (95%CI: 0.30, 3.52), and 2.67% (95%CI: 0.70, 4.68) increase of upper respiratory tract infection, bronchitis, pneumonia, and asthma ERVs, respectively. As for PM 2.5 constituents, we found organic carbon, ammonium, nitrate, selenium, and zinc were associated with higher risk of respiratory ERVs in the single constituent and the constituent-PM 2.5 models., Conclusion: Short-term exposure to PM 2.5 was associated with increased pediatric ERVs for respiratory diseases. Constituents related to anthropogenic combustion and traffic might be the dominant contributors of the observed associations., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

Background: Few studies have explored the short-term effects of ultrafine particles (UFPs, particles < 0.1 μm) air pollution on the exacerbations of pediatric respiratory diseases., Objectives: We aimed to evaluate short-term association between UFP and emergency-department visits (EDVs) for main pediatric respiratory diseases., Methods: We collected daily data on UFP and pediatric EDVs for main respiratory diseases [asthma, pneumonia, bronchitis and upper respiratory tract infections (URTI)] from 66 hospitals in Shanghai, China from 2016 to 2018. Generalized additive models combined with polynomial distributed lag models were applied to explore the associations between UFP level and pediatric EDVs for respiratory diseases. We fitted two-pollutant models with criteria air pollutants and performed stratified analyses by gender and age., Results: UFP was associated with increased EDVs for all respiratory diseases in cumulative lags up to 2 d and 3 d. The greatest risk was found at cumulative lags (0-2 d) for all respiratory diseases. At cumulative lags (0-2 d), an interquartile range increase in concentrations of UFP (1800 particles/cm 3 ) was associated with relative risks of EDVs due to asthma [1.35, 95% confidence interval (CI): 1.14-1.59], pneumonia (1.20, 95% CI: 1.04-1.38), bronchitis (1.17, 95% CI: 1.03-1.33) and URTI (1.14, 95% CI: 1.02-1.28). These associations were almost unchanged when controlling for criteria air pollutants, and there was no threshold below which the associations were not present. There were stronger associations in children aged 0-13 years., Conclusions: Short-term exposure to UFP may independently increase the risks of EDVs for asthma, pneumonia, bronchitis and URTI exacerbations among children., Competing Interests: Declaration of competing interest The authors declare no competing financial interest., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Few evidences are available about the impact of temperature variation on childhood asthma in different seasons. This study aimed to assess the influence of temperature changes between neighboring days (TCN) on the exacerbation of asthma among children. Daily outpatient visits for childhood asthma (DOVCA) were collected from 17 main hospitals in Shanghai, China, from 2016 to 2018. A quasi-Poisson regression combined with distributed lagged nonlinear models was employed to estimate the association between TCN and asthma visits in cool or warm seasons, after controlling for short- and long-term trends, day of week, holidays, daily mean temperature, daily mean relative humidity, and air pollutants. The TCN varied from - 9.6 to 6.7 °C. The relationship between TCN and DOVCA greatly varied by season. In warm seasons, positive TCN (temperature rise) was associated with higher risks of asthma outpatient visits and negative TCN (temperature drop) was associated with lower risks; the associations were present on lag 1 day and lasted for 2 weeks; the cumulative relative risk of childhood asthma over 0 to 14 days was 1.98 (95% confidence interval: 1.42, 2.76) and 0.31 (95% confidence intervals: 0.21, 0.44) comparing a TCN of 2.5 °C (5th percentile) and - 3.2 °C (95th percentile) with 0 °C, respectively. In cool seasons, neither negative nor positive TCN showed significant risks. In conclusion, temperature rise might increase the risk of childhood asthma exacerbation and temperature drop might decrease the risks in warm seasons. There were no statistically significant influences in cool seasons.

Genetic factors are one of the most important causes of non-obstructive azoospermia (NOA). ESX1 is an X-linked testis-biased expressed gene, and a potential biomarker for testicular sperm retrieval in NOA patients, yet few systematic studies have investigated its association with NOA. Here, we performed selected exonic sequencing in a large cohort of Chinese males, and four novel missense mutations (including one compound mutation), one novel synonymous mutation of ESX1 unique to NOA patients were identified. We analyzed the effects of ESX1 mutations on cyclin A degradation and cell cycle progression by immunoprecipitation assay and flow cytometry, and found that the compound mutant p.[P365R; L366V] ESX1 compromised the stabilizing effect of ESX1 on polyubiquitinated cyclin A, thereby causing the failure of M phase arrest in cells. Further studies showed that the deleterious effect of the compound mutations on ESX1 protein function was attributed to p.P365R but not p.L366V alteration. The novel ESX1 mutation p.P365R might confer high risk for NOA in Han Chinese population, probably via affecting cell cycle control.

There is limited evidence regarding the relationship between air pollution and pediatric asthma in developing countries. This study aimed to investigate the association between short-term exposure to ambient air pollutants and pediatric asthma emergency department (ED) visits in Shanghai, China. We collected data on six criteria air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO, and O 3 ) and daily ED visits for pediatric asthma patients from 66 hospitals in Shanghai from 2016 to 2018. The generalized additive model combined with polynomial distributed lag model was applied to explore the associations. We fitted two-pollutant models and stratified the analyses by sex, age, and season. In total, we identified 108,817 emergency department visits for pediatric asthma. A 10 μg/m 3 increase in the concentrations of PM 2.5 , NO 2 , SO 2 , and O 3 was significantly associated with increased risks of pediatric asthma ED visits, with relative risk of pediatric asthma of 1.011 [95% confidence interval (CI): 1.002, 1.021], 1.030 (95%CI: 1.017, 1.043), 1.106 (95%CI: 1.041, 1.174), and 1.009 (95%CI: 1.001, 1.017), respectively. The associations of NO 2 remained robust in the two-pollutant models. There were stronger associations for older children (6-18 years) and in warm seasons. The concentration-response curves for pediatric asthma and PM 2.5 , NO 2 , SO 2 , and O 3 were steeper at lower and moderate concentrations but became flatter at higher concentrations. This analysis provided evidence that short-term exposure to air pollutants (PM 2.5 , NO 2 , SO 2 , and O 3 ) could increase the risk of asthma exacerbations among children, and health benefits would be gained from improved air quality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background : Recently, considerable evidence pointed out monocyte to high-density lipoprotein ratio (MHR) is highly related to inflammatory related diseases. We aim to explore the level of MHR in acute aortic dissection (AAD) patients and determine whether MHR can be a novel diagnostic marker of AAD. Research design and methods : A total of 228 subjects including 128 AAD patients and 110 healthy control were enrolled. MHR levels and other serum samples were obtained at admission. Results : The baseline MHR levels were significantly higher in patients with AAD ( p  < 0.0001). A cutoff value of MHR >0.37 was associated with a sensitivity of 86.70% and a specificity of 93.60% for AAD. MHR levels were positively correlated with the time from symptom onset (R 2  = 0.0318, p  = 0.0003). Additionally, the area under the curve (AUC) was increased to 0.979 in patients whose time from onset of symptoms >24 h, with a sensitivity of 98.04% and a specificity of 93.64%. Multivariate logistic regression demonstrated that MHR levels, history of hypertension, and coronary artery disease (CHD) emerged as independent predictors of AAD. Expert Opinion: MHR has a high diagnostic value in AAD patients, especially in those whose time from onset of symptoms >24 h.

Biological trait analysis (BTA) has been proved to be a powerful tool to evaluate marine water quality. The species trait distributions of biofilm-dwelling protozoa were studied in a coastal region of the Yellow Sea, northern China, during a four-season cycle. The BTA demonstrated that: (1) the protozoa showed a significant seasonal variability in biological trait pattern during the colonization process across four seasons; (2) the colonization dynamics in species trait distribution followed different temporal models; (3) the functional dynamics in spring and summer were significantly different from those in autumn and winter (P < 0.05); and (4) functional diversity showed lower values in spring and summer than in autumn and winter. These findings suggest that BTA is subject to a high seasonal variability during colonization surveys when protozoa are used as bioindicators of marine water quality., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

An outbreak of pneumonia caused by a novel coronavirus (COVID-19) began in Wuhan, China in December 2019 and quickly spread throughout the country and world. An efficient and convenient method based on clinical characteristics was needed to evaluate the potential deterioration in patients. We aimed to develop a simple and practical risk scoring system to predict the severity of COVID-19 patients on admission. We retrospectively investigated the clinical information of confirmed COVID-19 patients from 10 February 2020 to 29 February 2020 in Wuhan Union Hospital. Predictors of severity were identified by univariate and multivariate logistic regression analysis. A total of 147 patients with confirmed SARS-CoV-2 infection were grouped into non-severe (94 patients) and severe (53 patients) groups. We found that an increased level of white blood cells (WBC), neutrophils, D-dimer, fibrinogen (FIB), IL-6, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), α-hydroxybutyrate dehydrogenase (HBDH), serum amyloid A (SAA) and a decreased level of lymphocytes were important risk factors associated with severity. Furthermore, three variables were used to formulate a clinical risk scoring system named COVID-19 index = 3 × D-dimer (µg/L) + 2 × lgESR (mm/hr) - 4 × lymphocyte (×10 9 /L) + 8. The area under the receiver operating characteristic (ROC) curve was 0.843 (95% CI, 0.771-0.914). We propose an effective scoring system to predict the severity of COVID-19 patients. This simple prediction model may provide healthcare workers with a practical method and could positively impact decision-making with regard to deteriorating patients., (© 2020 Blackwell Verlag GmbH.)

To reveal the seasonal variability in biological trait distribution for monitoring surveys based on periphytic protozoa, a baseline survey was carried out in a coastal region of Yellow Sea, northern China. A total of 40 slide samples were collected in a four season cycle after an exposure time period of 14 days. The results demonstrated that: (1) the community-weighted means (CWM) of algivores with large and medium sizes were high in spring and summer, while bacterivores with small size were high in autumn and winter; (2) there was a significant seasonal variation in the protozoan community functions, especially from spring/summer to autumn and winter; and (3) functional diversity indices generally peaked in spring or summer. Thus, there was a significant seasonal variation in protozoan community functions and this approach may be used to determine an optimal sampling strategy for monitoring programs in marine ecosystems., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: To derive normative carotid artery stiffness data in rural adult Chinese population-based study of ultrasound measurements of carotid elasticity by using quality arterial stiffness (QAS), and to assess the changes of relevant parameters in Chinese adults 40 years of age and older., Design: A China stroke cohort study (total number: 1586) in the northern countryside were carried out between June 2013 and April 2016, designed to investigate the risk factors of cardiovascular and age-related diseases., Setting: The present study was a cross-sectional analysis of an ongoing community-based Shunyi cohort study in China., Participants: A total of 583 participants (227 men and 356 women; aged 40-80 years) with ultrasound carotid QAS examination were retrieved from the study to analyse., Primary and Secondary Outcome Measures: Arterial stiffness parameters included diastolic diameter (Dd), pulse wave velocity (PWV), stiffness indices α and β were calculated by QAS. Other clinical indicators included physical measurements, medical histories and blood biochemical test., Results: In the entire study sample, mean Dd was 7.93±0.88 mm, mean PWV was 9.4±2.4 m/s, mean α was 7.65±5.13 and mean β was 15.53±10.29. PWV was significant higher in participants with hypertension (9.9 m/s vs 9.2 m/s in those without, p=0.002), and with diabetes (10.3 m/s vs 9.2 m/s in those without, p=0.003). PWV were significantly higher in participants with HbA1c at 5.8%-6.4% versus <5.8%, but no difference was found between subjects with glycohaemoglobin (HbA1c) at 5.8%-6.4% versus >6.4% (p=0.005, p=0.955, respectively). Age increase by every 10 years was associated with Dd increased by 0.27 mm, PWV increased by 1.2 m/s, α increased by 1.34 and β increased by 2.71. Systolic blood pressure (SBP) increase by every 10 mm Hg was associated with Dd increased by 0.15 mm, PWV increased by 0.35 m/s, α increased by 0.13 and β increased by 0.15., Conclusion: Among the participants older than 40 years, stiffness of the carotid artery had differences between hypertension and non-hypertension adults, as well as between diabetes and non-diabetes adults. Stiffness of the carotid artery also have differences between adults with HbA1c at 5.8%-6.4% versus <5.8%. Stiffness of the carotid artery increases with increasing age and increasing SBP at a range from 40 and up., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) induced Coronavirus Disease 2019 (COVID-19) has posed a global threat to public health. The immune system is crucial in defending and eliminating the virus and infected cells. However, immune dysregulation may result in the rapid progression of COVID-19. Here, we evaluated the subsets, phenotypic and functional characteristics of natural killer (NK) and T cells in patients with COVID-19 and their associations with disease severity., Methods: Demographic and clinical data of COVID-19 patients enrolled in Wuhan Union Hospital from February 25 to February 27, 2020, were collected and analyzed. The phenotypic and functional characteristics of NK cells and T cells subsets in circulating blood and serum levels of cytokines were analyzed via flow cytometry. Then the LASSO logistic regression model was employed to predict risk factors for the severity of COVID-19., Results: The counts and percentages of NK cells, CD4 + T cells, CD8 + T cells and NKT cells were significantly reduced in patients with severe symptoms. The cytotoxic CD3 - CD56 dim CD16 + cell population significantly decreased, while the CD3 - CD56 dim CD16 - part significantly increased in severe COVID-19 patients. More importantly, elevated expression of regulatory molecules, such as CD244 and programmed death-1 (PD-1), on NK cells and T cells, as well as decreased serum cytotoxic effector molecules including perforin and granzyme A, were detected in patients with COVID-19. The serum IL-6, IL-10, and TNF-α were significantly increased in severe patients. Moreover, the CD3 - CD56 dim CD16 - cells were screened out as an influential factor in severe cases by LASSO logistic regression., Conclusions: The functional exhaustion and other subset alteration of NK and T cells may contribute to the progression and improve the prognosis of COVID-19. Surveillance of lymphocyte subsets may in the future enable early screening for signs of critical illness and understanding the pathogenesis of this disease., (Copyright © 2020 Li, Guo, Dong, Wang, Dai, Liu, Wu, Li, Zhang, Zhou, Zhang, Lin, Kang, Yu, Tian, Qin, Gui, Jiang, Fan, Heissmeyer, Sarapultsev, Wang, Luo and Hu.)

Colonization dynamics of protozoan communities were investigated at a depth of 1 m in the coastal waters of the Yellow Sea, northern China from May to June 2019, using modified glass slide (mGS) and modified polyurethane foam unit (mPFU) systems. The colonization process and growth curves of protozoa were well fitted to the MacArthur-Wilson and logistic models in both systems, respectively. However, they showed significant differences in both colonization dynamics and biodiversity/functional parameters between the mGS and mPFU systems. The H' (species diversity), the G (colonization rate), and A max (maximum abundance) were higher, while the value of T 90% (the time for reaching 90% equilibrium species number) was lower in the mGS system than those in the mPFU system. Multivariate analyses demonstrated that protozoa showed different models of colonization dynamics in both systems. The results suggest that the mGS system might be more effective than the mPFU system in marine bioassessment surveys., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aim: Our study investigated the association between soluble endoglin and carotid subclinical atherosclerosis., Methods: We used endoglin as an adjunct to atherosclerotic cardiovascular disease (ASCVD) risk, in recognition of carotid clinical atherosclerosis, in order to explore a new model to refine risk assessment. Out of 3,452 participants, 978 subjects with detected soluble endoglin were enrolled in a cross-sectional investigation in Fujian Province were enrolled. Soluble endoglin concentration in serum samples was evaluated using an enzyme-linked immunosorbent assay method. Carotid ultrasonography was used to detect intima-media thickness and carotid plaque., Results: The mean 10-year ASCVD risk by the new Pooled Cohort Equations accounted for 10.04% (±12.35). The mean soluble endoglin level was 15.35 ng/ml (±6.64). Multivariable regression demonstrated that age, systolic blood pressure, diastolic blood pressure, total cholesterol, high density lipoprotein cholesterol, and serum uric acid were independent determinants of soluble endoglin. Adding tests of ASCVD and endoglin together, in parallel, will increase the sensitivity and decrease specificity in recognizing carotid subclinical atherosclerosis. Evaluating the added value of endoglin to the ASCVD risk model showed significantly improved discrimination with analysis of C-statistics, continuous net reclassification index and integrated discrimination index. Both ASCVD risk and soluble endoglin showed positively linear correlation with carotid intima-media thickness (cIMT) (β=0.006, P＜0.001; β=0.485, P＜0.001). Even with adjustment for other factors, the relationship between log-transformed soluble endoglin with cIMT was still significant (β=0.369, P＜0.001)., Conclusions: The combination of ASCVD risk and endoglin levels increases carotid atherosclerosis recognition.

Background: Off-label drug use is widespread in pediatric drug treatment, and the implementation of guidelines on this topic remains challenging. The objective of this study was to evaluate current practice and awareness of healthcare professionals towards pediatric off-label drug use, as well as the barriers to guideline implementation among pediatric healthcare professionals in Shanghai, China., Methods: A validated questionnaire was issued to representatives of pediatricians, pharmacists, nurses and administrators from hospitals with pediatric qualification in Shanghai., Results: A total of 679 completed questionnaires from 69 hospitals were included in the analysis. Nearly half (47.9%) of the pediatricians acknowledged that they had prescribed off-label drugs. Most (88.4%) of the pharmacists acknowledged that they had dispensed off-label medicines. The main reason for off-label prescribing was the lack of pediatric dosage information. The most common category of off-label prescribing in children was dosage. Nearly half (42.0%) of the participating hospitals had developed internal protocols for off-label drug use. However, approximately half of the respondents reported that they did not adhere to the guidance and that it had barriers to implementation. Most respondents (84.5%) declared that they were familiar with the term "off-label drug use". However, the awareness rate of the Chinese Expert Consensus of Pediatric Off-Label Drug Use was low (45.7%). More than half (55.4%) of the respondents declared that they did not adhere to the process proposed in the consensus and that barriers existed for its utilization., Conclusions: Pediatric off-label drug use is widespread in Shanghai, China, and barriers exist to the implementation of the guideline. A legally recognized national guideline with a broad scope of application for off-label drug use is urgently needed; at the same time, more education and training on off-label drug use should be provided to targeted healthcare professionals.

Congenital heart disease (CHD) is one of the most common birth defects in humans, but its genetic etiology remains largely unknown despite decades of research. The Notch signaling pathway plays critical roles in embryonic cardiogenesis. Mind bomb 1 (Mib1) is a vital protein that activates the Notch signaling pathway through promoting ubiquitination, endocytosis and subsequent activation of Notch ligands. Previous studies show that Mib1 knockout in mice completely abolishes Notch signaling, leading to cardiac deformity. However, the function of MIB1 and its potential disease-causing mutations are poorly studied in human CHD. In this research, we identified four novel non-synonymous heterozygous rare mutations of MIB1 from 417 Han Chinese CHD patients. The following biochemical analyses revealed that mutations p.T312K fs*55 and p.W271G significantly deplete MIB1's function, resulting in a lower level of JAGGED1 (JAG1) ubiquitination and Notch signaling induction. Our results suggest that pathologic variants in MIB1 may contribute to CHD occurrence, shedding new light on the genetic mechanism of CHD in the context of the Notch signaling pathway., (© 2018 The Author(s).)

Introduction: The objective of our study was to evaluate the performance of detailed fetal echocardiography by skilled obstetric physician sonologists in the diagnosis of congenital heart disease (CHD) in a Chinese population., Material and Methods: This investigation included a multicenter prospective cohort of 10 259 pregnant women attending 10 regional tertiary hospitals in China. The inclusion criteria were singleton pregnancy and gestational age from 18 to ≤28 weeks. Women with multiple pregnancies were excluded. A detailed fetal echocardiography was performed by trained physicians with at least 3 years of experience. The primary outcome measures included sensitivity, specificity, and positive and negative likelihood ratios of detailed fetal echocardiography in prenatal detection of CHD., Results: The sensitivity and specificity of fetal echocardiography in detecting any CHD were 33.9 and 99.8%, respectively, in the low-risk population, and 68.8 and 99.4%, respectively, in the high-risk population. For detecting major CHDs, fetal echocardiography had a high sensitivity and specificity, and satisfactory positive and negative likelihood ratios in both the low-risk population (88.2, 100%, 6947.7, and 0.118, respectively) and high-risk population (100, 99.9%, 833.3, and <0.0001, respectively). The sensitivity and likelihood ratios were substantially lower for detecting minor CHDs in both populations., Conclusions: Detailed fetal echocardiography performed by skilled physicians had high detection rate for major CHD in both low-risk and high-risk populations. However, its value for detecting minor CHD was limited. The incorporation of fetal echocardiography with multiple cardiac views into routine ultrasound screening may improve the detection rate of fetal major CHD and facilitate appropriate parental counseling., (© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.)

Agaricus is a genus of saprobic basidiomycetes with more than 400 species recognized worldwide, with about 50 species known in China. Our objective was to investigate three new species of section Arvenses in highland subtropical Southwest China. Agaricus guizhouensis is a new species characterized by a white pileus with yellowish squamules, small ellipsoid spores and cheilocystidia with yellowish-brown pigments; another new species, Agaricus longistipes is recognized by its slender stipe, and its elongate-ellipsoid basidiospores; the third new one, Agaricus megalocarpus is remarkable by its large size and its pileus surface covered with fine brown squamules. It is firstly reported for Guizhou Province that Agaricus abruptibulbus, Agaricus flocculosipes, and Agaricus subrufescens are illustrated. Two probable new species require further studying. A phylogenetic analyses of rDNA-ITS sequence data belonging to section Arvenses showed that the section Arvenses is monophyletic and can be subdivided in five branches, the branch of A. subrufescens and four clades (A-D). The eight species from highland subtropical Southwest China were distributed in all five branches, indicating that this highland is at the climatic crossroads. The white pileus trait and the potential interest are discussed. These data suggest a potential species richness that remains to be discovered., (Copyright © 2014 The British Mycological Society. Published by Elsevier Ltd. All rights reserved.)

The interleukin-12B (IL12B) gene encodes the p40 chain of IL-12, a pro-inflammatory cytokine that antagonizes Th2 phenotype and, hence, may have a critical role in the pathogenesis of allergic asthma. In this report, we describe the identification of a novel IL12B promoter polymorphism (T-to-A exchange) at position -536. The IL12B -536AA genotype was significantly associated with asthma in the Chinese populations (P=0.011, odds ratio=2.227). The risk-associated A allele was linked to reduced expression of IL12B mRNA levels and IL12B production in asthmatic patients. Luciferase reporter assay provided evidence that risk-associated A allele reduced the promoter activity of IL12B gene compared with those of the promoter containing the protective T allele. We further observed that decreasing binding effects between the risk alleles A of IL12B and CCAAT/enhancer binding protein alpha (C/EBPα) through A allele sequence mediated streptavidin-conjugated agarose pulldown and biotin-labelled A allele mediated electrophoretic mobility shift assay. We also observed additive effects of the risk alleles of IL12B and decreased mRNA levels of C/EBPα in asthmatic patients. Therefore, we postulated that the presence of -536A allele in IL12B promoter could predispose to the development of allergic asthma.

Background and Purpose: Paired-like homeodomain transcription factor 3 (PITX3) is an important transcription factor for differentiation and survival of dopaminergic neurons. Recent reports have shown a strong association of polymorphisms in the PITX3 gene with Parkinson's disease (PD). Our study was designed to verify whether three previous PITX3 SNPs (rs2281983, rs4919621 and rs3758549) were associated with PD in the Chinese population. We also investigate the association of novel polymorphisms in PITX3 gene with PD., Methods: All the polymorphisms of PITX3 we found in this study were sequenced by PCR products from both directions with dye terminator methods using an ABI-3100 sequencer. We included 356 sporadic PD patients and 300 healthy elderly people as controls., Results: We provide evidence for strong association of a novel polymorphism c.219G>A (p = 0.000307) with PD. Our data showed that the substitution of c.219G>A in PITX3 Exon 3 was significantly higher in PD compared with control. Previous finding suggesting three SNPs (rs2281983, rs4919621 and rs3758549) in the PITX3 gene to be associated with PD could not be replicated., Conclusions: Our findings indicate that a novel synonymous SNP in PITX3 gene may contribute to PD risk in the Chinese population.

Introduction: The use of ketamine as a recreational drug is on the increase among young adults attending clubs and parties. Recreational ketamine users have anecdotally reported increased lower urinary tract symptoms while using the substance., Methods: We describe the severe lower urinary tract symptoms experienced in 6 patients with chronic recreational ketamine use. We obtained a detailed history and physical examination along with further investigation to identify a relationship between recreational ketamine use and these symptoms., Results: The urine cultures were sterile in all cases. Intravenous urography was performed in 3 patients and demonstrated bilateral upper ureteric narrow, mild bilateral hydronephrosis and contracted bladder urodynamic studies showed detrusor instability with urinary leakage when the bladder was filled to a capacity of 30- 50 ml. Cystoscopy revealed a small capacity bladder with erythematous lesions throughout the bladder. Bladder biopsies were performed in 3 patients and showed up as chronic cystitis. Ketamine cessation along with intravesical sodium hyaluronate solution appeared to provide some symptomatic relief., Conclusion: Ketamine-associated urinary tract dysfunction appears to be a relatively new clinical phenomenon. The pathological mechanism of ketamine-associated urinary tract dysfunction is unknown and current management strategies are ketamine cessation along with intravesical sodium hyaluronate solution., (Copyright © 2012 S. Karger AG, Basel.)

Objective: To assess the relationship between diurnal temperature range (DTR) and sudden infant death (SID) between 2001 and 2004 in Shanghai, China., Methods: We conducted a time-stratified case-crossover analysis to estimate the percent increase of SID associated with changes in DTR after adjustment for daily weather conditions (temperature and relative humidity) and outdoor air pollution., Results: DTR was significantly associated with daily SID. An increase of 1 °C in the current-day (L0) and in the 2-day moving average (L01) DTR corresponds to a 1.56% (95% CI: 0.97%, 2.15%) and a 1.89% (95% CI: 1.17%, 2.60%) increase in SID, respectively., Conclusion: An increased DTR was associated with an increased risk of SID in Shanghai. More studies are needed to understand the effect of DTR on infant deaths., (Copyright © 2011 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.)

No prior studies exist in Mainland China examining the association of outdoor air pollution with hospital admissions. In this study, we conducted a time-series analysis to examine the association of outdoor air pollutants (PM(10), SO(2), and NO(2)) with both total and cause-specific hospital admission in Shanghai, using three years of daily data (2005-2007). Hospital admission and air pollution data were collected from the Shanghai Health Insurance Bureau and Shanghai Environmental Monitoring Center. Natural spline model was used to analyze the data. We found outdoor air pollution was associated with increased risk of total and cardiovascular hospital admission in Shanghai. The effect estimates of air pollutants varied by lag (L) structures of pollutants' concentrations. For lag 5, a 10 microg/m(3) increase in concentration of PM(10), SO(2) and NO(2) corresponded to 0.18% (95% CI: -0.15%, 0.52%), 0.63% (95% CI: 0.03%, 1.23%), and 0.99% (95% CI: 0.10%, 1.88%) increase of total hospital admission; and 0.23% (95% CI: -0.03%, 0.48%), 0.65% (95% CI: 0.19%, 1.12%), and 0.80% (95% CI: 0.10%, 1.49%) increase of cardiovascular hospital admission. The associations appeared to be more evident in the cool season (from November to April) than in the warm season (from May to October). We found significant effects of gaseous pollutants (SO(2) and NO(2)) after adjustment for PM(10). Our analyses provide the first evidence in China that the current air pollution level has an effect on hospital admission and strengthen the rationale for further limiting air pollution levels in Shanghai., (Copyright 2010 Elsevier B.V. All rights reserved.)

The ideal treatment of localized cancer should directly cause an irreversible and complete death of tumor cells without damage to surrounding normal tissue. High intensity focused ultrasound (HIFU) is such a potential treatment, which induces a complete coagulative necrosis of a tumor at depth through the intact skin. The idea that using an extracorporeal source of therapeutic ultrasound was introduced more than 50 years ago [J. Gen. Physiol. 26 (1942) 179]. However, up to now, most of the studies on HIFU have been dealing with animal experiments because this extracorporeal technique is very complicated in clinical applications. The purpose of this study is to introduce Chinese clinical experience of using extracorporeal HIFU for the treatment of patients with various kinds of solid tumor. From December 1997 to October 2001, a total of 1038 patients with solid tumors underwent HIFU ablation in China. Among them, 313 patients were treated at the Chongqing University of Medical Sciences, China. Pathological examination showed that the target region presented clear evidence of cellular destruction. Small blood vessels less than 2 mm in diameter were severely damaged. Follow-up diagnostic imaging revealed that there was no, or reduced, blood supply, and no uptake of radioisotope in the treated tumor after HIFU, both indicating a positive therapeutic response and an absence of viable tumor. Imaging at 6-12 months showed obvious regression of the lesion. Four-year follow-up data were significantly observed in patients with hepatocellular carcinoma, osteosarcoma, and breast cancer. An extremely low major complication rate was noted. It is concluded that HIFU ablation is a safe, effective, and feasible modality for the ablation of carcinomas.