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To explore meteorological and environmental impacts on human health, a distributed lag non-linear model and a generalized additive model were employed to study the exposure-response relationship between meteorological factors and respiratory system diseases from 2013 to 2016 in Funan, China. The results showed that the decline in patient numbers occurs in the high temperature seasons. At a short time lag, high temperature is a risk factor, but high temperature reduces the number of patients with respiratory system disease at long time lags. Low relative humidity (RH) increases the risk of respiratory system diseases, and largescale 48-hour temperature changes (ΔT48) increase the risk of disease for a whole range of lags. There is a remarkable correlation between morbidity and meteorological factors, with temperature minima corresponding to peaks in the number of patients. For low RH, the lag effect is obvious for the first 4 days; for higher RH, the effect is weak. A back-propagation artificial neural network model constructed in this study was capable of effectively predicting respiratory system disease, using average temperature, ΔT48, RH, and maximum wind speed as inputs. [ABSTRACT FROM AUTHOR]

Birth defect and perinatal death are major public issues threatening the health of women and children in China. However, perinatal death attributed to birth defects has not yet received sufficient attention. To minimize the occurrence of perinatal death caused by birth defects, this review article deeply analyzed the current status of epidemiology, clinical, and basic research on perinatal death attributed to birth defects both domestically and internationally, and proposed to encourage the conduct of national research on perinatal causes. We should also pay attention to the application of the perinatal cause of death classification system, and focus on accurate diagnosis and the three-level prevention and control of perinatal death attributed to birth defect.

Objective: To analyze the association between maternal blood pressure and congenital heart disease (CHD) in offspring. Methods: From February 2018 to December 2020, pregnant women who participated in the China birth cohort study in Beijing Obstetrics and Gynecology Hospital, Shenzhen Maternal and Child Healthcare Hospital and Chengdu Women's and Children's Central Hospital were enrolled in this study. The baseline and follow-up information were collected using an electronic data collection system. Stepwise logistic regression model was used to analyze the association between maternal blood pressure including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure difference (PP) in the first trimester of pregnancy and the risk of CHD in the offspring. A restrictive cubic spline curve was used to draw the dose-response curve between maternal blood pressure and CHD. Results: A total of 55 552 participants were included in this study. Of them, 31 038, 15 375 and 9 139 pregnant women were enrolled in Beijing Obstetrics and Gynecology Hospital, Shenzhen Maternal & Child Healthcare Hospital and Chendu Women's and Children's Central Hospital, respecitively. The age of pregnant women was (31.3±4.0) and the incidence of CHD in the offspring was 0.78% (435/55 552) . Multivariable logistic regression model analysis showed that the increase of SBP ( OR =1.01, 95% CI : 1.00-1.02), DBP ( OR =1.01, 95% CI : 1.00-1.03) and MAP ( OR =1.02, 95% CI : 1.00-1.03) in the first trimester were significantly associated with the risk of CHD in the offspring. The restrictive cubic spline analysis showed a positive linear association of SBP ( P total <0.001; P non-liear =0.315), DBP ( P total <0.001; P non-liear =0.928) and MAP ( P total <0.001; P non-liear =0.929) with the risk of CHD in the offspring. Conclusion: Maternal SBP, DBP and MAP in the first trimester of pregnancy were positively associated with the risk of CHD in the offspring.

Objective: To investigate the relationship between maternal exposures to peri-conceptional risk factors and the risk of hypospadias and cryptorchidism in offspring. Methods: Pregnant women who delivered male newborns and participated in the China birth cohort study between February 2018 and December 2020 at the research center of Beijing Obstetrics and Gynecology Hospital, Capital Medical University were selected for the study. All were enrolled at 6-13 +6 weeks of their gestation. Baseline risk factor information was collected by questionnaire survey. Information on the outcome of hypospadias and cryptorchidism was obtained by clinical examination at birth and ultrasonography. Logistic regression was used to analyze the Odds Ratio ( OR ) and 95% Confidence Interval (95% CI ) of each factor with respect to the onset of the outcome. Results: A total of 15, 833 pregnant women with an average age of (31.81±3.84) years were included. Among their offsprings, 113 were diagnosed as hypospadias or cryptorchidism (42 hypospadias, 69 cryptorchidism, and 2 both hypospadias and crypterchidism), with an incidence of 7.14‰. The results of multivariate logistic regression analysis showed that mothers with pregnancy history of birth defects ( OR= 3.01, 95% CI : 1.09-8.35), with preconception Hepatitis B infection ( OR =4.74, 95% CI: 1.10-20.42), fetal growth restriction ( OR =4.02, 95% CI : 2.10-7.68), multivitamin use since preconception ( OR= 1.98, 95% CI : 1.12-3.52), and never cook and eat at home ( OR =2.17, 95% CI : 1.23-3.82) were risk factors for hypospadias and cryptorchidism (all P <0.05). Conclusions: Obesity in early pregnancy, preconception Hepatitis B infection, pregnancy history of birth defects, fetal growth restriction, multivitamin use before pregnancy, and rarely cook and eat at home were associated with an increased risk of hypospadias or cryptorchidism in their offsprings.

Globally, postpartum hemorrhage (PPH) is the leading cause of maternal death. Women with immune thrombocytopenia (ITP) are at increased risk of developing PPH. Early identification of PPH helps to prevent adverse outcomes, but is underused because clinicians do not have a tool to predict PPH for women with ITP. We therefore conducted a nationwide multicenter retrospective study to develop and validate a prediction model of PPH in patients with ITP. We included 432 pregnant women (677 pregnancies) with primary ITP from 18 academic tertiary centers in China from January 2008 to August 2018. A total of 157 (23.2%) pregnancies experienced PPH. The derivation cohort included 450 pregnancies. For the validation cohort, we included 117 pregnancies in the temporal validation cohort and 110 pregnancies in the geographical validation cohort. We assessed 25 clinical parameters as candidate predictors and used multivariable logistic regression to develop our prediction model. The final model included seven variables and was named MONITOR (maternal complication, WHO bleeding score, antepartum platelet transfusion, placental abnormalities, platelet count, previous uterine surgery, and primiparity). We established an easy-to-use risk heatmap and risk score of PPH based on the seven risk factors. We externally validated this model using both a temporal validation cohort and a geographical validation cohort. The MONITOR model had an AUC of 0.868 (95% CI 0.828-0.909) in internal validation, 0.869 (95% CI 0.802-0.937) in the temporal validation, and 0.811 (95% CI 0.713-0.908) in the geographical validation. Calibration plots demonstrated good agreement between MONITOR-predicted probability and actual observation in both internal validation and external validation. Therefore, we developed and validated a very accurate prediction model for PPH. We hope that the model will contribute to more precise clinical care, decreased adverse outcomes, and better health care resource allocation., (© 2021 Wiley Periodicals LLC.)

Mytilopsis sallei, an invasive alien species, has strong reproductive ability and high adaptability. It can severely endanger biodiversity of intertidal ecosystem after invasion. The intertidal zones and oyster breeding areas in some coastal areas of Guangdong Province have been severely invaded by M. sallei. To examine the potential habitat of M. sallei in China, we established a potential habitat prediction model of M. sallei using Maxent and ArcGIS method for China and global scales. The model was verified by the method of receiver operating characteristic curve (ROC) analysis and field investigation. The results showed that M. sallei could distribute with high probabili-ty in the area between North and South America, South India in Asia, Sri Lanka, the south coast of the Yangtze River in China, and in Van Dimen Bay of the southern hemisphere. In China, M. sallei mainly distributed in coastal provinces south of Shanghai. The main environmental factors affecting the suitable distribution areas for M. sallei were water vapor pressure, temperature, and solar radiation. After ROC detection, the AUC values of both the training and testing sets were 0.996, indicating that the prediction reached an excellent level. Our results provide theoretical basis for the risk assessment and management of M. sallei, and complement the potential habitat prediction of invasive species in China.

Trace elements play a critical role in the pathogenesis of autism spectrum disorders (ASD). The aim of this study was to investigate the serum levels of zinc (Zn) and copper (Cu) in Chinese children with ASD. Sixty patients (48 males, 12 females) diagnosed with ASD and 60 healthy sex-matched and age-matched control participants were assessed for serum Zn and Cu content at admission. The severity of ASD was also evaluated using the Childhood Autism Rating Scale (CARS) score. The results indicated that the mean serum Zn levels and Zn/Cu ratio were significantly lower in children with ASD compared with normal cases (P<0.001, respectively), whereas serum Cu levels were significantly higher (P<0.001). There was a significant negative association between Zn/Cu and CARS scores (r=-0.345, P=0.007). On the basis of the receiver operating characteristic curve, the optimal cut-off value of serum levels of Zn/Cu as an indicator for an auxiliary diagnosis of autism was projected to be 0.665, which yielded a sensitivity of 90.0% and a specificity of 91.7%; the area under the curve was 0.968 (95% confidence interval, 0.943-0.993). In conclusion, these results suggested an association between serum levels of Zn and Cu and ASD among Chinese patients, and the Zn/Cu ratio could be considered a biomarker of ASD.

SigmaC (σC) protein, which mediates virus attachment to target cells, is the most variable proteins of avian reovirus (ARV). It is responsible for inducing protective antibody immune responses in animals. To understand the antigenic determinants of σC protein, a set of partially overlapping and consecutive peptides spanning σC were expressed and then screened with the monoclonal antibody (mAb) 2B5 directed against σC. The mAb 2B5 recognized peptides with the σC motif (45)ELLHRSISDISTTV(58). Further identification of the displayed B-cell epitope was conducted with a set of truncated peptides expressed as GST fusion proteins. The Western blot and ELISA results indicated that (45)ELLHRSISDI(54) was the minimal determinant of the linear B-cell epitope. Using sequences analysis, we found that this epitope was not a common motif shared among the other members of the ARV and DRV groups. Furthermore, cross reactivity analysis showed that the associated coding motif of other ARV and DRV groups was not recognized by 2B5. These data suggested that (45)ELLHRSISDI(54) was a type-specific linear B-cell epitope of avian reovirus. The results in this study may have potential applications in the development of diagnostic techniques and epitope-based marker vaccines against ARV, which is prevalent in China., (Copyright © 2013. Published by Elsevier B.V.)

Objective: The identification of patients at highest risk for adverse outcome who are presenting with acute ischemic stroke to the emergency department remains a challenge. This study firstly investigates the long-term prognostic value of the stress marker copeptin in Chinese patients with acute ischemic stroke., Methods: In a prospective study, copeptin levels were measured using a new sandwich immunoassay on admission in plasma of 245 consecutive patients with an acute ischemic stroke. The prognostic value of copeptin to predict the functional outcome and mortality within one year was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors., Results: Patients with an unfavorable outcomes and non-survivors had significantly increased copeptin levels on admission (P < 0.0001 and P < 0.0001). Multivariate Cox regression analysis adjusted for common risk factors showed that copeptin was an independent predictor of functional outcome (hazard ratio = 3.88; 95% CI: 1.94-7.77) and non-survivors (hazard ratio = 5.99; 95% CI: 2.55-14.07). The area under the receiver operating characteristic curve of copeptin was 0.75 (95% CI, 0.70-0.82) for functional outcome and 0.867 (95% CI, 0.802-0.933) for mortality., Conclusions: Copeptin levels are a novel and complementary biomarker to predict functional outcome and mortality 1 year after acute ischemic stroke., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To provide scientific basis for angiostrongyliasis cantonensis control and prevention in Beijing., Methods: Descriptive epidemiological method was used to analyze angiostrongyliasis cantonensis reported from June to September in 2006., Results: 141 cases were treated at the Beijing Friendship Hospital with the peak in July (61 cases) and August (68 cases). All patients had dined at the same restaurant in Beijing city and they ate undercooked Pomacea canaliculata or related eatables. The source of Pomacea canaliculata was from Guilin in Guangxi. Major manifestations would include fever (56.79%), headache (93.83%), neck stiffness (100%), and skin paresthesia (77.78%). Some cases had significant eosinophil increase in peripheral blood picture and cerebrospinal fluid respectively., Conclusion: The source of infection related to angiostrongyliasis cantonensis was clear, suggesting that the improvement of restaurant sanitation and on awareness of personal hygiene were important preventive and control measures on angiostrongyliasis cantonensis.

Objective: To summarize the clinical features of severe angiostrongyliasis cantonensis (AC) patients., Methods: Clinical data on symptoms, physical signs, auxiliary examination and prognosis of 25 severe AC patients hospitalized in June-Sept 2006 were analyzed., Results: Epidemiologically, all cases had eaten uncooked fresh water snails. One of the early symptoms was fever (16 cases, 64.0%), including 8 cases with low-grade fever, 7 cases with mid-range fever, and 1 case high fever. Nervous system manifestation: (1) All cases had headache, entire headache (56.0%) or partial (44.0%), especially in occipitalis. (2) Patients had distinct degree neck rigidity, with negative pathologic reflex; 12 cases had nausea and vomiting (48.0%). (3) 20 cases (80.0%) had skin paresthesia, 5 had severe pain and hyperalgia on skin; 3 cases with skin numbness, and 2 with thermohypesthesia. (4) 11 cases (44.0%) appear distinct degree depraved vision; 3 cases had photophobia, 5 with blur vision, 1 each with diplopia, defect of field vision or bug sign, respectively. (5) Nasolabial groove became shallow and distortion of commissure in 4 cases (16.0%), and 2 cases (8.0%) couldn't close up eyelid. (6) 4 cases had sustained or curative tinnitus. Laboratory examination showed that eosinophilic granulocytes increased in both peripheral blood and cerebrospinal fluid. Skull MRI for 14 cases revealed linear enhancement in local meninx or abnormal enhancement in cerebral parenchyma. Chest CT examination in 7 cases showed nodule shadow and spot flaky ground-glass shadow in lungs. One and 3 months after being discharged from hospital, 12 patients (48.0%) still had sequelaes--7 cases had tingling sensation on skin, 1 case had temperature sensation dysfunction on the skin of chest and abdomen, 3 cases had headache occasionally, and 1 case still had defect of field vision., Conclusion: Central nervous system has been impaired in the angiostrongyliasis cantonensis patients who may need a longer convalescent period.

Objective: To investigate incidence, causes and mortality of acute respiratory distress syndrome (ARDS) in intensive care units (ICU) in Beijing., Methods: Patients in ICU of eight general hospitals in Beijing from May 1998 to April 2003 were retrospectively studied. ARDS was diagnosed according to the 1994 American-European consensus conference criteria. Results Of 8 482 patients admitted to ICUs in the same period, there were 383 patients (4.5%) diagnosed as having ARDS. Major primary diseases for ARDS were sepsis (21.7%), pneumonia (16.2%), surgical operation (13.1%), acute pancreatitis (12.8%) and multiple severe trauma (10.7%). The mean interval between onset of the primary disease and onset of ARDS was (61.8 +/- 43.7) hours. The overall mortality of ARDS was 52.0%, the mortality adjusted for age (< or =39, 40-64, > or =65 years old) and gender (male) showed significant changes in each year (all P<0.05), but acute physiology and chronic health evaluation II (APACHE II, < or =12, 13-19, > or =20 scores) score showed no significant changes during the 5 years. Septic shock (36.2%) and heart failure (20.6%) were major lethal causes, while only 14.6% died of respiratory failure., Conclusion: ARDS was frequent in ICU in Beijing, the mortality remains high, and there is no tendency to decline in recent years.

Objective: To establish the diagnostic criteria for multiple organ dysfunction syndrome (MODS) with illness severity score according to the evaluation of clinical MODS data from hosptal in Beijing., Methods: The clinical data from 413 MODS cases in eight hospitals with III-leve in Beijing was analyzed by multi-center retrospective cohort study. The significant difference of the each descriptor between non-survivor group and survivor group was analyzed, and then the significant descriptor was selected as the potential indicator. Based on the above analysis, the abnormal range of each descriptor was divided into 4 intervals, assigned corresponding points, diagnostic criteria for MODS was established., Results: Severe infection, major operations, trauma and severe pancreatitis were the main etiological factor for MODS. The mortality of MODS in hospital was 53.5%, and the mortality rate for 28 days hospitalization was 37.3%. The correspondent mortality rate in MODS with 2-6 dysfunction organs was 28.6%-100.0%. The mortality rate of MODS complicated by the dysfunction of brain, cardiovascular system, kidney, and lung was 72.8%, 64.3%, 61.7%, and 54.7% respectively. The frequency of machinery ventilation support was 76.0% and the frequency of hemodialysis was 8.2%. The script of diagnostic criteria for MODS with the illness severity score system was established. The script mainly was involved in the evaluation of seven organs or systems, including respiratory system, cardiovascular system, kidney, hemologic system, liver and alimentary system. Only one parameter was used in each organ, they were FiO(2)/PaO(2), systolic blood pressure (SBP), serum creatinine, platelet count, conscious state and the defecation status. 0-4 scores were endued with each index according to the severity of the illnesses respectively. Every descriptor was 5 points, showing 0 point with normal organ function, and 1-4 scores with organ dysfunction and aggravation., Conclusion: The mortality of MODS in hospitals is 53.5% in Beijing. The main etiological factors for MODS still are severe infection, major operations, trauma and severe pancreatitis. The diagnostic criteria for MODS with the illness severity score and the prognostic evaluation system established might have clinical significance and practicability, but further studies with large samples are still needed.

The fragile X syndrome of mental retardation is related to the number of trinucleotide CGG repeats at the 5'-untranslated region of the FMR1 gene located on the X-chromosome. We have studied X-chromosomes from 649 unaffected Chinese subjects and 324 patients with mild mental retardation. All study subjects were unrelated. The CGG repeat number was analysed by electrophoresis of a polymerase chain reaction followed by gel transfer and hybridisation with a 32P-labeled (CCG)5 probe. The DNA samples having detectable CGG expansion were further analysed by Southern blot analysis with probe StB12.3 after restriction digestion by EcoR I and Eag I. For the unaffected Chinese subjects, a different distribution pattern of CGG allele size from Caucasians was observed. It was a bimodal pattern and the CGG repeat number ranged from 19 to 54. The most common CGG repeat allele was 29 compared with 30 in Caucasians. The second mode appeared at 36 repeats. There was mild statistical difference in the repeat patterns between the mentally retarded patients and unaffected subjects, although the essential features were similar. Among the mentally retarded patients, one male had an unmethylated full mutation and one female had a full mutation. The fragile X prevalence was 0.6%, which is lower than two previous studies in Chinese mentally retarded patients utilising cytogenetic analysis. Our results indicate that a large-scale screening program would be worthwhile to determine the prevalence of the fragile X syndrome in the Chinese population.