[Risk assessment of lead and cadmium exposure of Nanjing residents through vegetables and edible fungus from 2014 to 2018].

OBJECTIVE: To evaluate the potential risk of lead and cadmium through vegetables and edible fungus in Nanjing City from 2014 to 2018. METHODS: Based on the survey of dietary consumption of residents in Nanjing City, combining with the concentration data of lead and cadmium in vegetables and edible fungus, using @Risk software to simulate and analyze the cumulative dietary exposure in a probabilistic way, and compared with the health guidance value or benchmark dose(BMD) to assess the potential health risks of lead and cadmium for Nanjing residents. RESULTS: The average exposure of lead and cadmium was 0.237 and 0.090 µg/kg, the exposure of cadmium in the general population were lower than the corresponding health guidance value, meanwhile the margin of exposure(MOE) for lead was higher than 1 in 18-49 years old group and over 50 years old group respectively, except for the high-end exposure(P95) in 6-17 years group the MOE for lead was 0.9. The pollution level and the consumption of leafy vegetables, edible fungus and artemisia selengensis were the main factors affecting the exposure of lead and cadmium through vegetables and edible fungus. CONCLUSION: The exposure to lead and cadmium through vegetables is at a relatively safe level, but more attention should be paid to the risk of lead and cadmium exposure in 6-17 years old and over 50 years old group of high-end exposure population.

Sevoflurane protects against ischemia-reperfusion injury in mice after total knee arthroplasty via facilitating RASD1-mediated protein kinase A pathway activation.

This study aimed to explore effects of Sevoflurane on ischemia-reperfusion (I/R) injury after total knee arthroplasty (TKA). To explore potential molecular mechanism, Ras related dexamethasone induced 1 (RASD1), a Protein kinase A (PKA) activator, frequently associated with various models of I/R injury, was also investigated. In vivo mouse models with I/R injury after TKA and in vitro cell models with I/R injury were induced. Contents of creatinine kinase (CK), lactic dehydrogenase (LDH), superoxide dismutase (SOD), and malondialdehyde (MDA), serum levels of inflammatory factors, expression of PKA pathway-related genes and cell proliferation and apoptosis were measured. RASD1 was altered and PKA pathway was inhibited in mice and cells to elucidate the involvement of RASD1 and PKA pathway in Sevoflurane treatment on I/R injury. RASD1 was upregulated in I/R injury after TKA. Sevoflurane treatment or silencing RASD1 reduced RASD1 expression, CK, LDH and MDA contents, inflammation, apoptosis, but increased proliferation, SOD content, cAMP expression, and extents of PKA and cAMP responsive element binding protein (CREB) phosphorylation in skeletal muscle cells of I/R injury. Additionally, PKA pathway activation potentiated the therapeutic effect of Sevoflurane on I/R injury after TKA. Altogether, Sevoflurane treatment confines I/R injury after TKA via RASD1-mediated PKA pathway activation.

Estimated assessment of dietary exposure to artificial sweeteners from processed food in Nanjing, China.

The objective of this study was to measure the concentrations of three intensity sweeteners (Acesulfame-K, cyclamate and saccharin) in different categories of food available on the Nanjing market, and to investigate whether the Nanjing general population was at risk for exceeding the ADI of sweeteners. A set of 1885 foods was collected and analysed using the National Food Safety Standard procedure in order to establish the concentration levels of the sweeteners. Dietary exposure was estimated using probabilistic modelling software and compared directly with each sweetener's ADI. Consumption data from the China National Nutrition and Health Survey (conducted in 2010-2013) and the actual concentrations of sweeteners in the collected food products were used to perform the intake assessment. The results indicated that Acesulfame-K and cyclamate were commonly used in processed food, and processed nuts, preserved fruit, beverages, and bakery products are the main sources of sweeteners in Nanjing. The estimated exposure of sweeteners in Nanjing was well below the ADIs, as relative intakes at the 95th percentile were 29.7% for saccharin, 79.8% for cyclamate, and 35.9% for Acesulfame-K of the respective ADIs. It was concluded that adults were not at risk of exceeding ADIs for these sweeteners, but the intake of cyclamate at the higher percentiles by children may approach or slightly exceed ADI values.

Detection of antibiotics in the urine of children and pregnant women in Jiangsu, China.

Exposure to low concentrations of antibiotics links to multiple health hazards, such as drug resistance of bacteria, and childhood obesity. In this study, seven antibiotics were measured in the urine of 107 children and 126 pregnant women in Jiangsu Province by ultra-performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS). The overall urinary antibiotics detection rate was 38.6%. Most (98.3%) of the participants' antibiotics concentrations were no more than 10 ng/mL. Children had a significantly higher detection rate than pregnant women (47.7% vs. 31.0%, P = 0.009), as well as the concentration (95th percentile: 6.49 vs. 4.08 ng/mL, P = 0.002). The detection rates of individual antibiotics ranged from 0.4% to 15.0%, and the concentrations ranged from lower than the limit of detection (LOD) through up to 31.96 ng/mL individually. Two or more antibiotics were detected in 11.2% of the urines. Tetracyclines were more frequently detected than phenicols (30.9% vs.12.4%). Oxytetracycline was the most frequently detected (15.0%). Multivariate logistic regression showed that consuming puffed food every day was associated with a significantly increased likelihood of detection, and higher concentration of overall antibiotics, and of doxycycline. Children were more likely to be detected of doxycycline and florfenicol, and to have elevated concentration of doxycycline, compared with pregnant women. This study highlights the relatively heavier antibiotics exposure in children, and a possible impact of puffed food on it, which needs to be warranted in future studies.

Fatty acid and mineral contents of Lycium ruthenicum Murr. and antioxidant activity against isoproterenol-induced acute myocardial ischemia in mice.

Dried fruits of black goji were investigated for their fatty acid, mineral contents, and antioxidant activity against isoproterenol-induced acute myocardial ischemia in mice was revealed. It was observed that the key fatty acids from Lycium ruthenicum Murr. (LRM) oil studied included linoleic (59.38%), oleic (20.85%), palmitic (7.07%), linolenic (2.98%), and stearic acids (5.31%), which together comprised 95.59% of the total fatty acids. The key mineral nutrients studied were potassium (17,631.15 mg/kg), calcium (2004.4 mg/kg), and magnesium (1,274.6 mg/kg), while copper, iron, manganese, and zinc were found in trace. Moreover, oral administration of water extraction of LRM exhibited significant reduction of enzyme activities, and MDA level triggered by ISO to be near normal level, while exhibited a significant increase of SOD and GSH activities. Our results provide deep insight on LRM as a potential source of high-value phytochemicals for the development of new functional food and beverage products.

[Theoretical risk assessment for dietary exposure to sodium saccharin among residents in Nanjing City].

OBJECTIVE: To evaluate the potential risk of dietary exposure to sodium saccharin among residents in Nanjing City, and provide scientific evidence for safety surveillance and risk management in processed foods. METHODS: Based on the survey of dietary consumption of residents in Nanjing City, combining with the limits of sodium saccharin in processed foods(GB 2760-2014), using @Risk software to establish the cumulative dietary exposure in a probabilistic way, and compared with the acceptable daily intake(ADI) for risk assessment. RESULTS: The average exposure of sodium saccharin of residents was 0. 69 mg/kg, accounted for 13. 80% of ADI, while high exposure(P97. 5) was 5. 37 mg/kg, and accounted for 107. 36% of ADI. The exposure of sodium saccharin of residents in all age groups exceeded ADI were ranged from 20. 60% to 132. 80%. The intake of sodium saccharin exposure of high exposures(P97. 5) exceeded ADI was 132. 80% and 110. 75% in 18-49 years and 11-17 years people respectively. Cooked nuts, candied fruit and bean products were the main sources of sodium saccharin exposure compared with others. CONCLUSION: Dietary exposure assessment shows that the risk dietary exposure to sodium saccharin is generally safe. Residents who intake these processed foods higher should be paid more attention to reduce the level of sodium saccharin exposure.

[Prevalence and epidemic characteristics of metabolic syndrome among adult residents in Nanjing City in 2010-2013].

OBJECTIVE: To understand the prevalence and epidemic characteristics of metabolic syndrome(MS) among adult residents in Nanjing City. METHODS: In 2010-2013, a total of 4918 adult residents in Nanjing City were surveyed using a multi-stage stratification and population proportional clustering random sampling method. Questionnaires, physical examinations and laboratory examinations were conducted to collect the basic conditions, health history of the subjects and related indicators including height, weight, waist circumference, blood pressure, fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, etc. The 2009 International Joint Interim Statement(JIS) was used to filter patients with metabolic syndrome. RESULTS: Among the 4918 surveyed subjects, 1627 were MS, with a crude prevalence rate of 33. 1% and an age-standardized prevalence rate of 26. 3%, the standardized prevalence rate of MS was 29. 0% in males and 24. 8% in females. Age-standardized prevalence rates between different genders had no significant statistical difference(χ~2=1. 352, P=0. 245). There were significant statistical differences between the crude prevalence rate of MS among subjects of different ages(χ~2=132. 557, P<0. 001), occupations(χ~2=87. 572, P<0. 001)and educational level(χ~2=26. 077, P<0. 001). Patients with a family history of hypertension(χ~2=26. 582, P<0. 001) and a family history of diabetes(χ~2=16. 013, P<0. 001)had a higher prevalence of MS. CONCLUSION: The prevalence of metabolic syndrome in adult residents in Nanjing City in 2010-2013 was relatively high.

Outbreak of Haff disease caused by consumption of crayfish (Procambarus clarkii) in nanjing, China.

CONTEXT: This paper reports a detailed epidemiological investigation of a large Haff disease outbreak in Nanjing, China, including laboratory analysis of water, river sediment, and fish. METHODS: Structured questionnaires were administered to all case-patients. An unmatched case-control study was conducted to identify the factors affecting the incidence of Haff disease. Thirteen samples of crayfish, together with four samples of water and four samples of sediment were collected and sent for laboratory analysis. RESULTS: The disease onset of 494 patients occurred between 2 am on 30 June 2016 and 3 am on 29 August 2016. The median incubation time for onset of symptoms after crayfish ingestion was 7.1 hours (range: 1-20 hours). All patients presented with or developed local or diffuse myalgia. However, no kidney injury was observed. Serum creatinine kinase was elevated in all patients (mean: 4614 U/L, median: 2000 U/L, range: 81-55200 U/L). The average number of crayfish consumed by patients on the day of illness was 20 (2-80). The case-control study revealed that eating a large quantity of crayfish, drinking alcohol, and eating the crayfish head and/or intestines were associated with an increased risk of disease. Chemical analysis of crayfish, river water and sediment did not identify known or novel toxins including anticoccidiosis drugs, niclosamide, organophosphorus pesticides, and microcystins. CONCLUSION: An outbreak of Haff Disease was associated with consumption of crayfish from the Yangtze River and its surrounding water system. Eating a large quantity of crayfish, eating the head and/or intestines, and consuming alcohol with the crayfish were associated with the development of Haff Disease.

An Investigation of an Acute Gastroenteritis Outbreak: Cronobacter sakazakii, a Potential Cause of Food-Borne Illness.

Whole genome sequencing (WGS) has been widely used in traceability of food-borne outbreaks nowadays. Here, an interesting connection between Cronobacter sakazakii and food-borne acute gastroenteritis (AGE) was noticed. In October 2016, an AGE outbreak affecting 156 cases occurred in a local senior high school. Case-control study including 70 case-patients and 295 controls indicated a strong association between eating supper at school canteen of the outbreak onset and AGE, as revealed by the Odds Ratio (OR: 95.32). Six recovered Cronobacter strains were evaluated and compared using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and WGS. A phylogenetic tree of whole genomic single nucleotide polymorphisms (wgSNPs) were generated to traceback the potential contamination source in this outbreak. C. sakazakii isolates S2 from a patient's rectal swab and S4 from leftover food sample shared identical PFGE pattern and sequence type (ST73), and clustered tightly together in the SNP phylogenetic tree. C. sakazakii isolates S5 and S6 from food delivery containers were both ST4 but with different PFGE patterns. Cronobacter isolates S1 and S3 from two patients' rectal swab were sequenced to be C. malonaticus and shared another PFGE pattern (ST567). The interesting feature of this study was the implication of C. sakazakii as a causative agent in food-borne AGE occurring in healthy adults, although C. sakazakii is considered as an opportunistic pathogen and generally affects neonates, infants and immunocompromised adults.

Association of dietary sodium:potassium ratio with the metabolic syndrome in Chinese adults.

Several epidemiological studies have investigated that Na or K intakes might be associated with the metabolic syndrome (MetS). However, little evidence has evaluated the association between Na:K ratio and the MetS. In this study, we assessed the association between the dietary Na:K ratio and the MetS. The cross-sectional study was conducted among adults aged 18 years and older in Nanjing, using a multi-stage random sampling method, which resulted in a sample size of 1993 participants. Dietary Na and K intakes were assessed by 3 consecutive days of dietary recollection combined with condiments weighing method. Health-related data were obtained by standardised questionnaires, as well as physical examinations and laboratory assessments. The prevalence rate of the MetS was 36·5 % (728/1993). After adjusting for various lifestyle and dietary factors of the MetS, participants in the highest quartile of dietary Na:K ratio were at a higher risk of developing MetS (OR=1·602; 95 % CI 1·090, 2·353) compared with those in the lowest quartile. Each 1-sd increase in dietary Na:K ratio was associated with a higher risk of prevalent MetS (OR=1·166; 95 % CI: 1·018, 1·336). Among the components of the MetS, dietary Na:K ratio was positively associated with high blood pressure (quartile 3 v. quartile 1: OR=1·656; 95 % CI 1·228, 2·256) and hypertriacylglycerolaemia (quartile 4 v. quartile1: OR=1·305; 95 % CI 1·029, 1·655) in multivariate analysis. These results revealed that higher dietary Na:K ratio significantly increased the risk of the MetS in Chinese adults. Further studies are needed to verify this association.

Next generation sequencing for the investigation of an outbreak of Salmonella Schwarzengrund in Nanjing, China.

INTRODUCTION: Salmonella Schwarzengrund is most frequently isolated from poultry meat and can cause human infections. S. Schwarzengrund was isolated from diarrheal patients in a food poisoning event in Nanjing, China. METHODS: Three strains isolated from patients were microbiologically confirmed as S. Schwarzengrund. Salmonella strains from spiced donkey meat were also confirmed as S. Schwarzengrund. Epidemiology investigation showed evidence of a correlation between the consumption of spiced donkey meat and those cases. Pulsed field gel electrophoresis, antibiotic susceptibility test and next generation sequencing (NGS) were employed to investigate this food poisoning event. RESULTS: The 3 strains isolated from patients and the strain isolated from the spiced donkey meat showed same results in PFGE, antibiotic susceptibility test and no SNPs were observed between these 4 strains in NGS analysis. DISCUSSION: NGS data could be used in the confirmation of an outbreak and in the tracing of contamination. However, this standard of defining an outbreak with NGS remained a challenge in practice. And the NGS data should be used in combination with other data in epidemiological investigation.

Genetic characterization of emergent GII.17 norovirus variants from 2013 to 2015 in Nanjing, China.

During the 2014/15 winter season, a newly emergent GII.P17-GII.17 variant overwhelmed currently dominant GII.4 viruses, causing outbreaks of acute gastroenteritis in China and Japan. In Nanjing area, this novel GII.17 variant was first identified in a sporadic case of acute gastroenteritis in July 2013, 18 months ahead of reports from other parts of China. In this study, epidemiological features and genotyping of noroviruses from 2013 to 2015 were depicted. Twenty-eight local GII.17 sequences of capsid N-terminus originating from July 2013 to August 2015 were aligned, among which complete genome of seven strains obtained from two outbreaks and five sporadic cases was extensively characterized. The differences of local GII.17 variants led to at least two clusters, with strains from 2013/14 season and those from 2014/15 season grouped differently. Multiple nucleotide and amino acid variations between different clusters of GII.17 were elucidated, including residue substitutions and insertion occurring in or near antigenic and receptor-binding sites of viral protein 1. In addition, sequence hypervariability from residue 279 through 406 of viral protein 2 was identified. The modifications may reveal a distinctive adaptive process which could in part explain the rapid spread of emerging GII.17 variants. Continued monitoring on novel GII.17 is essential.

[Phylogenetic Analyses and Characterization of the VP7 Genes of Serotype G9 Rotaviruses Circulating in Nanjing (China), 2012-2013].

Group-A rotaviruses are recognized as the most common cause of acute diarrhea. Phylogenetic analyses of the VP7 genes of rotaviruses circulating in Nanjing (China) could aid in the development of rotavirus vaccines. A total of 908 stool specimens were collected from patients suffering from acute diarrhea in Nanjing between October 2012 and December 2013, and were tested further for rotaviruses. Fifty rotavirus isolates selected randomly were typed by reverse transcription-polymerase chain reaction using serotype-specific primers for G genotyping. VP7 genes of 19 G9 strains were sequenced for further genetic characterization. Among the 908 stool specimens examined during the surveillance period, 103 (11.34%) were rotavirus-positive. G9 was the most predominant genotype (78.0%), followed by G2, G1 and G3. Sequence and phylogenetic analyses of the VP7 genes of serotype G9 rotaviruses revealed these strains to comprise two lineages (G9-VI, G9-III) and to be dominated by the G9-VI lineage (which belonged to a unique subcluster of Japanese and Chinese G9 strains). Amino-acid sequences of the four antigenic regions (A, B, C or F) were variant among a portion of strains, which may have contributed to the prevalence of G9 rotaviruses in this area.

[Nutrition and health survey of children and youth in Lishui District, Nanjing City].

OBJECTIVE: To investigate the health and nutrition status of children in rural area of Lishui District, Nanjing City. METHODS: Cluster random sampling and the stratified sampling methods were used to recruit participants. Refer to the WHO child growth standards, Z score method was used to evaluate physical growth of the group. Dietary research was conducted by the food frequency questionnaire(FFQ), and referring to the 2002 food composition tables of China to evaluate the daily dietary intakes. RESULTS: BAZ scores showed 0 - 17 years old children obesity prevalence rate was 9. 0%, overweight was 18. 2%, angular and malnutrition were co-existed with the prevalence rates were 9. 1%, 1. 9% respectively. The average cooking oil was (27 ± 7. 3) g, and children daily intakes of vitamin A, vitamin B1, vitamin B2, vitamin C and calcium suitable rates were less than 50% according to the recommendation of Chinese DRIs. CONCLUSION: Rural children suffered from the problems of obesity and emaciated dietary structure is irrational and dietary nutrients intakes do not reached the demands of Chinese DRIs.

[Analysis of the nutrients contents and the blood glucose response of the mixed grains in Chinese people].

OBJECTIVE: To evaluate the nutrients contents and the glycemic index (GI) of the mixed grains and analyze the relationship between the nutrients contents and biological effect. METHODS: The nutrients contents of mixed grains and control food were determined according to the methods of Chinese national standards. Choose 10 volunteers to ingest 50 g glucose and ingest the steamed bread of mixed grains which imply 50 g carbohydrate the second day. Limosis blood glucose and blood glucose levels during the subsequent 3 hours were determined. Calculating the GI according to the Wolver's method. RESULTS: The results showed that 100 g of the mixed grains contained dietary fiber (crude fiber) 13.7 g, vitamin B1 0.40 mg, protein 13.5g, ash2.0g, vitamin B2 0.16 mg, calcium 54 mg, iron 7.1 mg and zinc3.00 mg respectively. The absolute increase of blood glucose and the areas increased under the glycemic curves of mixed grains were less than which of glucose (P < 0.05). The GI of the mixed grains bread was 52.6. CONCLUSION: It was concluded that the high contents of protein, minerals, dietary fiber, VB1, VB2 and the low GI of mixed grains might play an important role in nutritional intervention

[Investigation on prevalence and influencing factors of three chronic diseases in elderly adults].

OBJECTIVE: To find out the prevalence of hyperlipemia, hypertension and diabetes, and explore the primary influence factors. METHODS: The survey consists of questionnaire and health examination on 2120 elderly adults aged above 45 year old. The possible influence factors and the primary factors in 19 factors were analyzed and screened by case-control study and logistic regression analysis. RESULTS: This investigation showed that the prevalence rates of hyperlipemia, hypertension, and diabetes were 50.12%, 44.26% and 8.74% respectively. For hyperlipemia: monthly income, BMI, WHR, coarse food grain were primary factors. For hypertension: age, smoke, intensity, BMI, WHR were primary factors. For diabetes: family history of disease, BMI, WHR, coarse food grain, exercises were primary factors. CONCLUSION: The risk factors of the three chronic diseases were obesity and unhealthy life styles, and the protective factors were coarse food grian and exercises. It's important to decrease prevalence of chronic diseases in community by controlling these risk factors.