Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with primary glomerular disease.

BACKGROUND: Blood pressure is an important and modifiable cardiovascular risk factor. Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. The goal of this study was to investigate whether ambulatory blood pressure is better associated with TOD than clinic blood pressure in patients with primary glomerular disease. METHODS: 1178 patients with primary glomerular disease were recruited in this cross-sectional study. TOD were assessed by the following 4 parameters: left ventricular mass index (LVMI or LVH, left ventricular hypertrophy), estimated glomerular filtration rate (eGFR< 60 ml/min/1.73m2), albumin-to-creatinine ratio (ACR ≥ 30 mg/g) and carotid intima-media thickness (cIMT) or plaque. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to evaluate the relationship between ambulatory or clinic systolic blood pressure (SBP) indexes and TOD. RESULTS: Among 1178 patients (mean age, 39 years,54% men), 116, 458, 1031 and 251 patients had LVH, eGFR < 60 ml/min/1.73m2, ACR ≥ 30 mg/g and cIMT≥0.9 mm or plaque respectively. Area under ROC curves for TOD in ambulatory SBP, especially nighttime SBP, was greater than that in clinic SBP (P < 0.05). Multivariate logistic regression analyses showed that 24 h SBP, daytime SBP and nighttime SBP were significantly associated with LVH, eGFR< 60 ml/min/1.73m2 and ACR ≥ 30 mg/g after adjustment for clinic SBP, while the association of clinic SBP was attenuated after further adjustment for nighttime SBP. CONCLUSIONS: Ambulatory blood pressure, especially nighttime blood pressure, is probably superior to clinic blood pressure and has a significant association with TOD in primary glomerular disease patients.

Effects of Prenatal PM10 Exposure on Fetal Cardiovascular Malformations in Fuzhou, China: A Retrospective Case-Control Study.

BACKGROUND: Maternal exposure to ambient air pollution has been associated with an increased risk of congenital heart defects in offspring; however, the results are inconsistent. OBJECTIVES: We investigated whether there is an association between prenatal exposure to particulate matter with diameter ≤10µm (PM10) during early pregnancy and fetal cardiovascular malformations. METHODS: The gravidae from a hospital-based case­control study in Fuzhou, China, during 2007­2013 were assigned 10-d or 1-mo averages of daily PM10 using an air monitor­based inverse distance weighting method during early pregnancy. A total of 662 live-birth or selectively terminated cases and 3,972 live-birth controls were enrolled. The exposure was considered as a categorical variable. A multivariable logistic regression model was constructed to quantify the adjusted odds ratios (aORs) of the exposure to PM10 and the risks of fetal cardiovascular malformations. RESULTS: PM10 levels were positively associated with the risks of atrial septal defect (aORs ranging from 1.29 to 2.17), patent ductus arteriosus [aORs = 1.54, 1.63; 95% confidence intervals (CIs): 1.17, 2.23; 1.06, 3.24], overall fetal cardiovascular malformations (aOR = 1.28; 95% CI: 1.03, 1.61), ventricular septal defect (aOR = 1.19; 95% CI: 1.00, 1.43), and tetralogy of Fallot (aOR = 1.44; 95% CI: 1.01, 2.19) in the various observed periods scaled by 10 d or 1 mo in the first and second gestation months. The strongest associations were observed for exposure to PM10 in the second quartile, whereas the associations were attenuated when higher concentrations of PM10 in the third and fourth quartiles of the exposure were evaluated. No correlations of PM10 levels with these cardiovascular malformations in the other time periods of gestation were observed. CONCLUSIONS: Our findings suggest some positive associations between maternal exposure to ambient PM10 during the first two months of pregnancy and fetal cardiovascular malformations. https://doi.org/10.1289/EHP289.

[Simulation Study of the Emission of Polycyclic Aromatic Hydrocarbons and Sugar Alcohols from Biomass Burning].

To measure the emission factors of PM2.5 and its associated PAHs and sugar alcohols, Chinese red pine stick and four crop straw including rice, wheat, corn and cotton were burned in a chamber. In addition, the kinetics of certain compounds were obtained through the irradiation of the glass filters with PM2.5 loading by 500 W mercury lamp. The emission factors of PM2.5 were ranged from (2.26 ± 0.60) g x kg(-1) (Chinese red pine stick) to (14.33 ± 5.26) g x kg(-1) (corn straw). Although the emission factors of the total 19 PAHs differed from (0.82 ± 0.21) mg x kg(-1) (Chinese red pine stick) to (11.14 ± 5.69) mg x kg(-1) (cotton straw), 4 ring PAHs showed predominance over other PAHs accounting for 51% - 71% except Chinese red pine in which retene was the predominant compound. The emission factors of 9 sugar alcohols were ranged from (52.34 ± 50.16) mg x kg(-1) (rice straw) to (238.81 ± 33.62) mg x kg(-1) (wheat straw) with levoglucosan accounting for 72% - 96% of the total sugar alcohols. Both the selected PAHs and levoglucosan associated with PM2.5 followed the first order kinetics. The photolysis kinetic coefficient of PAHs (ring number ≥ 4) was decreased with the increase of PAHs loading in filters. Two PAHs source characteristic ratios such as Flua/( Flua + Py) and IP/(IP + BgP) were relative stable during the irradiation. The photolysis kinetic coefficient of levoglucosan (0.004 5 min(-1)) was comparable to benzo[a]anthracene (0.004 1 - 0.005 0 min(-1)).

[Size distribution of particle and polycyclic aromatic hydrocarbons in particle emissions from simulated emission sources].

Particles from cooking lampblack, biomass and plastics burning smoke, gasoline vehicular exhausts and gasoline generator exhausts were prepared in a resuspension test chamber and collected using a cascade MOUDI impactor. A total of 18 polycyclic aromatic hydrocarbons (PAHs) associated with particles were analyzed by GC-MS. The results showed that there were two peaks in the range of 0.44-1.0 microm and 2.5-10 microm for cooking lampblack, and only one peak in the range of 0.44-1.0 microm for straw and wood burning smoke. But there were no clear peak for plastics burning smoke. The peak for gasoline vehicular exhausts was found in the range of 2.5-10 microm due to the influence of water vapor associated with particles, while the particles from gasoline generator exhausts were mainly in the range of < or = 2.5 microm (accounting for 93% of the total mass). The peak in 2.5-10 microm was clear for cooking lampblack and gasoline vehicular exhausts. The peak in the range of 0.44-1.0 microm became more and more apparent with the increase of PAHs molecular weight. The fraction of PAH on particles less than 1.0 microm to that on the total particles increased along with PAH's molecular weight. Phenanthrene was the dominant compound for cooking lampblack and combustion smoke, while gasoline vehicular exhausts and generator exhausts were characterized with significantly high levels of naphthalene and benzo[g, h, i] perylene, respectively. The distribution of source characteristic ratios indicated that PAHs from cooking lampblack and biomass burning were close and they were different from those of vehicular exhausts and generator exhausts.

[Road dust loading and chemical composition at major cities in Fujian Province].

A total of 57 road dust and 16 urban soil samples were collected from four cities, Xiamen, Zhangzhou, Quanzhou and Putian in Fujian Province, China. Twenty-six elements, eight water soluble ions, organic carbon and elemental carbon in the fraction of particulate diameter less than 2.5 microm (PM2.5) derived through a suspension chamber were analyzed. The average loading of road dust with diameter less than 100 microm in the four cities ranged from 6.99 g x m(-2) to 10.11 g x m(-2), while the loading of PM2.5 ranged from 4.0 mg x m(-2) to 12.5 mg x m(-2). Both the soil and road dust samples were characterized with much higher concentrations of Si, Ca, Al, Fe and K. But for the anthropogenic elements such as Cu, Pb, Zn,Cr and Ti, much lower levels were found in the soil PM2.5, than those in the road dust PM2.5. Significantly higher levels of NH4+, NO3- and SO4(2-) were found in the road dust PM2.5 from Zhangzhou in comparison with those from other cities in this study. The calcium ion (Ca2+) content was significantly positively correlated with the Mg2+ content in the road dust PM2.5 from Xiamen, Zhangzhou and Quanzhou. The levels of organic carbon (OC) in the road dust PM2.5 in these four cities were higher than those reported in Ji'nan, Shijiazhuang and Beijing while the levels of elemental carbon (EC) were all lower than those in the urban road dust from Beijing, Significant positive correlation between EC and OC was found in samples from Quanzhou and Putian, suggesting the same and/or similar sources. The result of mass balance indicated that higher percentage compositions were soil and OM in both Quanzhou and Putian. Based on the cluster analysis, the 57 road dust samples were divided into four types: influenced by atmospheric deposition, influenced by soil dust, influenced by atmospheric deposition and soil dust, and influenced by soil and construction dust.

[Effect of airborne particulate matter exposure on pregnancy and fetal development in female mice].

OBJECTIVE: To investigate subacute exposure of airborne particulate matter (PM) on pregnancy and fetal development in female mice. METHODS: Forty female and forty male ICR adult mice were caged separately by 1:1 to get access to pregnancy. The pregnant mice were randomized into control group (A), small (B), middle (C), large (D) or overdose (E) PM challenge groups (n = 8-11), and were administered with 30 µl of phosphate buffered solution (A) or resuspended standard PM SRM 1649a at 0.09 (B), 0.52 (C), 1.85 (D) or 69.2 (E) µg/µl, once per trid from d 0 till d 19 of pregnancy via instillation onto the base of the tongue. Fetal mice were harvested by cesarean section at the time when spontaneous delivery occurred. Body weight of the pregnant mice, gestational days, intrauterine survival and growth, hepatic and pneumonic histopathological changes of the fetal mice were investigated. Lung/body and liver/body weight ratios were calculated. Expressions of mRNA and protein of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were assayed. RESULTS: (1) All of the pregnant mice survived pregnancy throughout the entire experiment. Body weight of the pregnant mice was not significantly different among all the groups at gestational d 1 and 7 (P > 0.05), but significantly lower in group E [(41.8 ± 5.8) and (48.9 ± 8.9) g] than in group A [(45.9 ± 1.8) and (56.2 ± 4.9) g] at gestational d 14 and 18 (P < 0.05). The gestational days were significantly decreased in group E [(19.3 ± 1.3) d] when compared with group A [(20.5 ± 0.7) d; P < 0.05] and were not significantly different among groups A, B, C and D (P > 0.05). Lung/body and liver/body weight ratios of the fetal mice were significantly increased in group E [(1.21 ± 0.18) and (4.68 ± 0.21)%] as compared with groups A, B, C and D (P < 0.05). (2) Mortality rates of the fetuses were significantly higher in group E (23.0%) than in groups A (0.8%), B (0.9%), C (1.7%) and D (3.7%) (P < 0.05), but were not significantly different among groups A, B, C and D (P > 0.05) despite of an increasing tendency. (3) Pathological changes in the liver and lung of the fetuses were conspicuous in group E. The fetal liver injury was histopathologically evidenced by deranged tissue structure, degenerated parenchyma of hepatic cells, and mildly stained cytoplasm. Adipose degeneration was represented by clear-boundary intracytoplasmic vacuoles in most of the liver cells, and cell pyknosis with heavily stained cytoplasm was observed in some of the liver cells. Inflammatory cell infiltration and focal necrosis were occasionally found in the hepatic tissue. The fetal lung exhibited bronchiole with narrow lumina, vascular engorgement in the submucosal layer, interstitial and alveolar edema, thickened alveolar septum, granulocyte and lymphocyte infiltrations within the pulmonary alveoli and around the bronchioles. The above pathological changes were lesser in groups C and D, and were not or least found in groups A and B. (4) Protein expressions of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were significantly increased in group E (1.20 ± 0.40 and 2.55 ± 0.89) when compared with group A (0.77 ± 0.36 and 2.08 ± 0.31) (P < 0.05). mRNA expressions of CYP1A1 in the fetal lung were significantly increased in groups C (0.36 ± 0.12), D (0.41 ± 0.08) and E (0.43 ± 0.11) compared with group A (0.21 ± 0.10), and significantly increased in groups D and E compared with group B (0.28 ± 0.10, P < 0.05). mRNA expressions of CYP1A2 in the fetal liver were significantly increased in groups C (0.37 ± 0.13), D (0.36 ± 0.14) and E (0.43 ± 0.16) compared with group A (0.21 ± 0.03), and significantly increased in group E compared with group B (0.24 ± 0.11, P < 0.05). CONCLUSIONS: PM elicited embryotoxigenicity and resulted in adverse pregnancy outcomes in mice by intrauterine exposure of overdose PM. The expressions of cancer-related genes CYP1A1 and CYP1A2 were up-regulated in organs after the middle- and large-dose subacute exposure of PM, which may have a potential role on the future development.

[Instillation of diesel exhaust particles on the posterior wall of pharynx on reproductive function in female mice].

OBJECTIVE: The present work aims to investigate the effects of subacute exposure to diesel exhaust particles (DEP) on reproductive function in female mice. METHODS: A total of 168 ICR (Institute of Cancer Research) mice were randomly divided into four groups by numeration table method, including the low (B), middle (C), high (D) dose DEP exposure groups and the control group (A). Each group consisted of 42 mice. Mice were inoculated with 30 µl DEP suspension at 0.8 (B), 3.0 (C), 12.0 (D) µg/µl, respectively, or the same volume of phosphate-buffered saline (A) on pharynx posterior wall per triduum for 4 times. The body weight and ovary weight were tested and ovary weight/body weight ratios were calculated. Rates of survival, germinal vesicle breakdown, extrusion of the first polar body, in-vitro fertilization and quantity of mitochondrial DNA for the oocytes were investigated. Ultrastructural changes of the oocytes were observed. RESULTS: The ovary weight/body weight ratios were (15.4 ± 7.3) × 10(-5), (14.1 ± 6.8) × 10(-5), (8.2 ± 0.7) × 10(-5) and (7.2 ± 2.5) × 10(-5) in groups A, B, C and D (F = 3.841, P < 0.05). In groups A, B, C and D at 48 h post-insemination, rates of oocyte survival were 64.3%, 56.8%, 39.5% and 32.9% (χ(2) = 21.575, P < 0.05), rates of extrusion of the first polar body were 75.5%, 65.3%, 37.0% and 27.1% (χ(2) = 52.772, P < 0.05), rates of 2-cell embryos were 27.9%, 39.1%, 17.6% and 12.5% (χ(2) = 20.148, P < 0.05), and rates of embryos over 2 cells were 45.3%, 32.2%, 12.5% and 13.9% (χ(2) = 32.135, P < 0.05), respectively, and were significantly lower in groups C and D compared with group A (P < 0.05). Logarithmic values of mitochondrial DNA copy numbers were 6.54 ± 0.13, 6.48 ± 0.09, 5.57 ± 0.15 and 5.41 ± 0.07 in groups A, B, C and D, respectively, and were significantly lower in groups C and D compared with group A or B (F = 89.241, P < 0.05). A number of mitochondria of the oocytes exhibited tremendous tumescence and vacuolization in groups C and D, which was contrast to a roughly normal appearance in groups A and B. CONCLUSIONS: DEP is noxious to murine female reproduction. Subacute exposure to DEP injures the ovary and oocyte resulting in compromised ovarian function and fertilizability of the oocyte.

[Clinical analysis of 355 patients with bone metastasis of malignant tumors].

OBJECTIVE: To analyze the clinical characteristics of bone metastasis of malignant tumors. METHODS: The clinical data and survival time of 355 patients with bone metastasis of malignant tumors were retrospectively analyzed. RESULTS: The bone metastasis occurred more frequently in men (male:female = 1.45:1). The most common primary tumors were lung cancer in men and breast cancer in women. The thoracic vertebrae, ribs, lumbar vertebrae and pelvic were frequently involved metastatic sites and the multiple bone metastasis was common (83.4%). The main symptom was pain (75.2%). Local masses, disfunctions, pathologic fracture and paraplegia occurred in a few patients while many patients were asymptomatic (22.0%). The most frequent radiographic manifestation was the osteolytic bone destruction (82.2%). Integrated treatments were taken, including chemotherapy, hormonal therapy, biological therapy, radiotherapy, surgery, bisphosphonate analgetics, etc. The clinical benefit rate in pain relief was 98.5% and the effective rate was 72.2% in radiographic imaging. The median survival time was 13.9 months. Among them, it was 34.9 months in prostate cancer and 4.6 months in hepatocellular carcinoma. The survival time was longer in bone metastasis without other organ metastasis. There was no significant difference between the single and multiple bone metastases regarding the survival time. CONCLUSION: It is important to master the clinical features of bone metastasis of malignant tumors for early diagnosis and treatment, and to improve the quality of life and prolong the survival time.