Prevalence and Risk Factors for Fall among Rural Elderly: A County-Based Cross-Sectional Survey.

Aim: The aim of the study was to provide evidence for the prevention and reduction of falls in the elderly living in rural areas by analyzing epidemiological data of falls among the rural older people (>65 years old) and identifying the risk and protective factors. Methods: This study analyzed the sociodemographic characteristics, living environment, lifestyle, chronic disease condition, mental health, activities of daily living (ADL), and detailed information of falls of 3752 rural elderly. Rank tests, chi-square tests, and binary logistic regression were used for data analysis. Results: The prevalence of falls was 30.0%, and the 75-84-years age group had the highest fall rate (18.8%). According to the binary logistic regression analysis, six variables, including roughage intake frequency, age, gender, cane use, floor tiles, and IADL, were involved in the fall patterns. Low roughage intake (OR = 2.48, 95% CI 1.24-4.97), female gender (OR = 2.12, 95% CI 1.48-3.05), the use of a cane (OR = 2.11, 95% CI 1.08-4.10), and medium IADL (OR = 2.02, 95% CI 1.89-2.32) were the top four risk factors. Conclusion: The fall in the rural elderly was mainly due to the poor living and working conditions. Routine fall assessment could address several preventable risk factors to reduce the prevalence and mitigate the harm of falls.

The injury mechanisms and injury pyramids among children and adolescents in Zhuhai City, China.

BACKGROUND: The unclear mechanisms and severity of injuries in the injury pyramids for Chinese children and adolescents prevent the prioritization of interventions. This study aimed to describe the injury mechanisms and injury pyramids in this population to provide a priority for injury prevention strategies. METHODS: Death, hospitalization, and outpatient/emergency department visit data from patients aged 0 ~ 17 years with injuries were obtained from January 1, 2013, to December 31, 2017, in Zhuhai City, China. The injury mechanism ratios were calculated, and the injury pyramid ratios were drawn in proportion using injury mortality and the incidence of both injury hospitalizations and outpatient/emergency department injury visits. RESULTS: The top three mechanisms for injuries in children and adolescents treated in outpatient/emergency departments were falls (52.02%), animal bites (14.57%), and blunt injuries (10.60%). The top three mechanisms for injury hospitalizations were falls (37.33%), road traffic injuries (17.87%), and fire/burns (14.29%), while the top three mechanisms for injury deaths were drowning (32.91%), road traffic injuries (20.25%) and falls (13.92%). The incidence rate of outpatient/emergency department injury visits for children and adolescents was 11,210.87/100,000; the incidence rate of injury hospitalization was 627.09/100,000, and the injury death rate was 10.70/100,000. For each injury death, there were 59 injury hospitalizations and 1048 outpatient/emergency injury visits. CONCLUSIONS: The injury mechanisms were different for injury-related outpatient/emergency department visits, hospitalizations, and deaths among children and adolescents. The injury mechanisms by sex at different stages of child development, and interventions should be formulated based on this finding. The ratios of the injury pyramids varied by age, sex, region, and injury mechanisms; minor nonfatal injuries were more common in children and adolescents. The differences in the severity and extent of the injuries suggested that injury interventions in children and adolescents still have a long way to go.

Quantitative Hepatitis B Surface Antigen Predicts Hepatitis B Transmission in Infants Born to e Antigen-positive Mothers.

GOALS: This study aimed to explore whether quantitative surface antigen [hepatitis B surface antigen (HBsAg)] can be used as a surrogate marker of hepatitis B virus (HBV) DNA to predict hepatitis B transmission before the first hepatitis vaccine dose in infants born to hepatitis B e antigen (HBeAg)-positive pregnant women. BACKGROUND: Currently, HBV transmission persistently occurs worldwide, especially in infants born to e antigen (HBeAg)-positive highly viremic mothers. However, due to high cost, the extensive use of viral load testing to identify these high-risk mothers is limited. MATERIALS AND METHODS: In total of 275 HBeAg-positive pregnant women paired with 280 infants were enrolled in this study. Quantitative HBsAg and HBV DNA levels were measured in the third trimester. Spearman rank correlation was used to assess the correlation between HBsAg levels and viral load, and multivariate logistic regression to identify factors related to HBV transmission in infants. RESULTS: Among 280 infants included, 15 (5.4%) infants were infected with HBV. In this study, we observed that quantitative HBsAg was positively correlated with maternal viral load (r=0.70, P<0.001) and highly predicted HBV transmission in infants born to HBeAg-positive mothers with area under the curve of 0.76 (95% confidence interval, 0.71-0.81). The optimum threshold HBsAg levels above 4.6 log10 IU/mL to predict HBV transmission in infants had a sensitivity of 80.0%, specificity of 67.9%. CONCLUSIONS: Quantitative HBsAg could be used as a surrogate marker of HBV DNA levels to predict hepatitis B transmission occurring before the injection of first-dose vaccine in infants born to e antigen-positive mothers.

Comparison of Intentional and Unintentional Injuries Among Chinese Children and Adolescents.

BACKGROUND: The patterns and risk factors of intentional injuries compared to unintentional injuries among Chinese children and adolescents have not been examined in depth. This work comprehensively describes patterns of intentional injuries in China, for which little information has been previously published. METHODS: All cases involving individuals 0-17 years old registered at emergency rooms and outpatient clinics were examined using data submitted to the National Injury Surveillance System from 2006 through 2017. A logistic regression model was performed to explore the risk factors related to intentional injuries compared to unintentional injuries. RESULTS: A total of 81,459 (95.1%) unintentional injuries, 4,218 (4.9%) intentional injuries (4,013 violent attacks and 205 self-mutilation/suicide) cases were identified. Blunt injuries accounted for 59.4% of violent attacks, while cuts and poisoning accounted for 37.1% and 23.4% of injuries involving self-mutilation/suicide, respectively. For unintentional injuries, falls (50.4%) ranked first. Additional risk factors for intentional injuries included being male (odds ratio [OR] 1.6), coming from rural areas (OR 1.9), being staff or workers (OR 2.2), and being a student (OR 1.8). As the age of the patients increased, so did the risk of intentional injuries (OR 5.0 in the 15-17 age group). Intentional injuries were more likely to occur at 00:00-03:00 am (OR 2.0). CONCLUSIONS: Intentional injuries affected more males, rural and older children, school students, and staff or workers. The mechanisms and occurrence times differed according to age group. Preventive measures should be taken to reduce the dropout of rural students, strengthen the school's violence prevention plan, and reduce self-harm.

Maternal age and educational level modify the association between chronic hepatitis B infection and preterm labor.

BACKGROUND: Few studies have investigated whether maternal age and education level modify the association of chronic hepatitis B virus (HBV) infection with preterm labor. We hypothesized that the association of HBV infection with preterm labor is modified by maternal age and education level. METHODS: A retrospective cohort study was conducted on the HBsAg-positive and HBsAg-negative pregnant women delivered from June 2012 to August 2017 at Wuhan Medical Care Center for Women and Children, Wuhan, China. A multivariate regression model was used in this study. RESULTS: This study included 2050 HBsAg-positive pregnant women and 2050 HBsAg negative women. In the stratified analyses, positive HBsAg status was associated with the increased risk of preterm labor in women aged < 30 years, having low educational level, with an odds ratio of 1.65(95% CI 1.07-2.54) and 2.59(95% CI 1.41-4.76), respectively. Breslow-Day test showed that there existed significant differences in the ORs for HBsAg carriage across each stratum of maternal age (p = 0.023), educational level (p = 0.002). After adjusting other co-variables, we observed maternal HBV infection (OR 1.60, 95% CI 1.03-2.49) was still associated with risk of preterm labor in pregnancy women with age < 30. Similarly, the significant association of HBV infection (OR 2.49, 95% CI 1.34-4.63) with preterm labor remained in low educated women. CONCLUSIONS: Our results indicated that HBV infection was associated with high risk of preterm labor, but maternal age and educational level could modify the association between HBV infection and preterm labor.

Incidence and Risk Factors of Intrauterine Transmission Among Pregnant Women With Chronic Hepatitis B Virus Infection.

GOALS: To identify the potential risk factors of hepatitis B virus (HBV) intrauterine transmission and predict the incidence of HBV intrauterine transmission among hepatitis B surface antigen-positive pregnant women with diverse viral load. BACKGROUND: The intrauterine transmission of HBV significantly contributes to the persistence of a high number of patients infected with HBV. However, its risk factors remain unclear. MATERIALS AND METHODS: A prospective study was performed on hepatitis B surface antigen-positive pregnant women who delivered from June 2012 to December 2016 at Wuhan Medical Care Center for Women and Children, Wuhan, China. RESULTS: In total, 1200 women paired with 1219 infants were enrolled. In total, 11 (0.9%) infants were identified with intrauterine transmission. We observed that all infants with intrauterine transmission were born to hepatitis B e antigen-positive mothers who had serum HBV DNA levels >7 log10 copies/mL. Our study suggested that the HBV DNA levels (for each log10 copies/mL increase, odds ratio=5.43; 95% confidence interval, 1.31-22.43; P=0.019) had independent effects on HBV intrauterine transmission in a multivariate logistic regression model. Moreover, cesarean section (odds ratio=0.18; 95% confidence interval, 0.04-0.74; P=0.018) was associated with a reduced risk of HBV intrauterine transmission. The predictive rates of intrauterine transmission were 0.06%, 0.50%, 2.81%, 8.89% in infants with maternal HBV DNA levels of 10, 10, 10, 10 copies/mL, respectively. CONCLUSIONS: Our data confirmed that increasing maternal viral load has the ability to predict intrauterine HBV transmission. Vaginal delivery increased risk of HBV transmission in infants compared with cesarean section. Further studies are warranted to clarify the possible mechanism underlying these associations.

Maternal hepatitis B surface antigen carrier status increased the incidence of gestational diabetes mellitus.

BACKGROUND: The relationship between chronic hepatitis B virus (HBV) infection with gestational diabetes mellitus (GDM) remains unclear. This study aimed to identify the association between maternal HBsAg-positive status and GDM. METHODS: A retrospective cohort study was performed on the pregnant women who delivered from June 2012 to May 2016 at Wuhan Medical Care Center for Women and Children, Wuhan, China. We compared the incidence of GDM between HBsAg-positive pregnant women and HBsAg-negative controls. A multivariate regression model was used to measure the independent association between maternal HBsAg carrier and the risk of developing GDM. RESULTS: In total, 964 HBsAg-positive pregnant women and 964 HBsAg-negative women were included into the study. We observed maternal HBsAg carrier (OR 1.47, 95% CI 1.06-2.03), age (OR 1.05, 95% CI 1.00-1.10) and family history of diabetes (OR 3.97, 95% CI 2.05-7.67) had an independent risk for GDM in multivariable logistical regression model. However, no significant association was found between HBeAg carrier status, other HBV markers or viral load in pregnancy and the incidence of GDM. CONCLUSIONS: Our results indicated that maternal HBsAg carriage is an independent risk factor for GDM, but viral activity indicated by HBeAg status and viral load is not the main reason for this phenomenon. Further studies are warranted to clarify the possible mechanisms behind such association of HBV infection and the additional risk of GDM.

Genetic variations in LTA gene and PDCD1 gene and intrauterine infection of hepatitis B virus: a case-control study in China.

Intrauterine infection with hepatitis B virus (HBV) has been suggested to accounting for most cases of chronic HBV infection, which cannot be blocked by combined immunoprophylaxis. The fact that the genetic background might impact the susceptibility to intrauterine infection of HBV has been identified by recent researches. A case-control study included sixty-nine HBsAg-positive mother-newborn pairs with intrauterine infection as cases compared to 138 mother-newborn pairs without intrauterine infection as controls. We studied the correlations between HBV intrauterine transmission and 15 maternal SNPs in eight genes (LTA, LTBR, TNFSF14, PDCD1, APOBEC3B, CD274, CD40 and CD40LG). There was a substantially significantly decreased risk of intrauterine infection of HBV in mothers with the rs2227981 TT genotype in PDCD1 gene compared to those with the rs2227981 GG genotype (OR 0.11, 95% CI 0.01-0.95, P = 0.045). Under recessive model (OR 0.51, 95% CI 0.26-1, P = 0.050) and additive model (OR 0.50, 95% CI 0.28-0.88, P = 0.017), we also found a marginally significantly decreased risk of intrauterine infection of HBV. Furthermore, under additive model, maternal genotype for rs2239704 in LTA gene was marginally significantly related to an increased risk of intrauterine HBV infection (OR 1.62, 95% CI 1-6.66, P = 0.055). However, there were no statistically significant associations among the remaining 13 SNPs and the risk of intrauterine infection of HBV. The examination implied that hereditary variants of PDCD1 and LTA genes were associated with intrauterine infection of HBV.

Maternal Hepatitis B Virus Infection and Pregnancy Outcomes: A Hospital-based Case-control Study in Wuhan, China.

GOALS: To examine the impact of maternal hepatitis B virus infection on pregnancy outcomes. BACKGROUND: Studies regarding hepatitis B virus infection and pregnancy outcomes are limited with inconsistent results, and none of them have evaluated the effect of maternal viral load in pregnancy on pregnancy outcomes. STUDY: A hospital-based case-control study was conducted. In total, 1728 hepatitis B surface antigen (HBsAg)-positive women who delivered consecutively at Wuhan Women and Children Medical and Healthcare Center, Wuhan, China, from June 2008 to May 2015, were compared with 1497 HBsAg-negative women giving birth in the same hospital during the same period who were randomly identified and selected from the computerized medical record database in parallel. Univariate and multivariate logistic regression models were constructed. RESULTS: After adjusting for confounding variables, maternal HBsAg carriage was associated with increased risk of pregnancy-induced hypertension [adjusted odds ratio (aOR)=2.20; 95% confidence interval (CI), 1.30-3.73], fetal distress (aOR=1.40; 95% CI, 1.09-1.78), cesarean delivery (aOR=1.70; 95% CI, 1.45-1.99), and macrosomia (aOR=1.68; 95% CI, 1.19-2.37). Moreover, maternal viral load in the second trimester was significantly associated with risk of preterm birth (aOR for each log10 copy/mL increase, 1.18; 95% CI, 1.01-1.39) among HBsAg carriers after adjustment for maternal age, employment, parity, history of abortion, and prenatal body mass index. CONCLUSIONS: Maternal HBsAg carriage was associated with several adverse pregnancy outcomes. Furthermore, hepatitis B viral activity in pregnancy might have certain effects on pregnancy outcomes. Careful surveillance of maternal HBsAg status as well as viral activity in the second trimester among HBsAg carriers is warranted.

Efficacy of metformin on pregnancy complications in women with polycystic ovary syndrome: a meta-analysis.

OBJECTIVE: To evaluate the efficacy of metformin administration throughout pregnancy on pregnancy-related complications in women with polycystic ovary syndrome (PCOS). STUDY DESIGN: MEDLINE and ScienceDirect were searched to retrieve relevant trials. The endpoint was the incidence of complications of pregnancy, gestational diabetes mellitus (GDM), pre-eclampsia (PE), miscarriage and premature birth included. RESULTS: Five studies with 502 PCOS patients with metformin administration throughout pregnancy and 427 controls who used metformin just to get conception were included in our meta-analysis. In study group, a significantly lower change of emerging miscarriage and premature birth was observed, the pooled relative risk (RR) was 0.32 (95% confidence interval (CI): 0.19-0.56) for miscarriage and 0.40 (95%CI: 0.18-0.91) for premature birth. No significant difference was demonstrated in emerging GDM and PE. CONCLUSIONS: Metformin therapy throughout pregnancy can reduce the RR of miscarriage and premature birth incidence in PCOS patients with no serious side effects.

[Role of Pediatric Critical Illness Score in evaluating severity and prognosis of severe hand-foot-mouth disease].

OBJECTIVE: To investigate the role of Pediatric Critical Illness Score (PCIS) in evaluating the prognosis and severity of severe hand-foot-mouth disease (HFMD). METHODS: This study included 424 children with severe HFMD, consisting of 390 survivors and 34 deceased patients. Related physiological parameters and clinical data were collected for calculating PCIS scores. The area under receiver operating characteristic curve (AUC) was employed to assess the performance of PCIS in evaluating the complications and outcomes. RESULTS: The median of PCIS scores for survivors was higher than that for deceased patients (P<0.01). Of the 424 children with severe HFMD, only 26 (6.1%) had critical illness according to the severity assessment using PCIS. The AUC (95%CI) of PCIS was 0.74 (0.66, 0.82) in predicting pulmonary edema, 0.82 (0.74, 0.90) in predicting pulmonary hemorrhage, and 0.83 (0.75, 0.92) in predicting death. CONCLUSIONS: PCIS can predict the complications and prognosis in children with severe HFMD. However, the existing scoring system of PCIS cannot fully assess the severity of HFMD.

Hepatitis B surface antigen prevalence among 12,393 rural women of childbearing age in Hainan Province, China: a cross-sectional study.

BACKGROUND: Hepatitis B virus (HBV) infection is highly endemic in China and it threats human health seriously. The hepatitis B surface antigen (HBsAg) prevalence among women of childbearing age plays an important role in mother to child transmission of HBV, as 30%~50% of chronic carriers can be attributed to maternal-infantile transmission. However, there are few studies which have reported on the prevalence of HBsAg among women of childbearing age in China. This study aimed to determine the prevalence of HBsAg and its associated risk factors among rural women of childbearing age in Hainan, which is the highest hepatitis B virus endemic province in China. METHODS: A cross-sectional, population-based study, which included 12,393 rural women aged 15~49 years, enrolled by a multistage stratified cluster sampling, was carried out in Hainan province, China, from November 2007 to December 2008. Blood samples were obtained from each study participant, and screened for HBsAg. RESULTS: The overall HBsAg prevalence of childbearing age women was 9.51%. Risk factors for HBsAg positivity among rural women were: lower education level (OR=1.206), lower family monthly income (OR=1.233), having an HBsAg-positive family member (OR=1.300), without an immunization history (OR=1.243), tattooing (OR=1.190), body piercing (OR=1.293), vaginoscopy history (OR=1.103) and history of induced abortion (OR=1.142). CONCLUSIONS: There is a high HBsAg seroprevalence rate among rural women of childbearing age in Hainan province. Hence, it is necessary to take preventive measures to reduce the seroprevalence of HBsAg and to control its associated risk factors.

Maternal gene polymorphisms involved in folate metabolism and the risk of having a Down syndrome offspring: a meta-analysis.

Down syndrome (DS) is the most common chromosomal abnormality. Many studies have assessed the association between maternal gene polymorphisms involved in folate metabolism and the risk of having a DS offspring, but data are conflicting. Our study aimed to arrive at a more accurate estimation. Therefore, we carried out a meta-analysis of 26, 17, 9, 15, 9 and 6 case-control studies on the relationship between maternal methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, methionine synthase (MTR) A2756G, methionine synthase reductase (MTRR) A66G, reduced folate carrier 1 A80G and cystathionine ß-synthase 844ins68 polymorphisms and the risk of having a DS offspring. The allele contrast and model-free approach were used. Results showed marginal significant associations for MTHFR C677T, overall [odds ratio (OR) = 1.28 (1.22, 1.46) and generalised odds ratio (ORG) = 1.35 (1.16, 1.57)] and in Caucasian [OR = 1.15 (1.03, 1.29) and ORG = 1.20 (1.04, 1.38)], Asian [OR = 1.68 (1.08, 2.63) and ORG = 1.74 (1.08, 2.80)] and Brazilian [OR = 1.22 (1.04, 1.43) and ORG = 1.28 (1.06, 1.55)] populations; for MTRR A66G, overall [OR = 1.22 (1.02, 1.46) and ORG = 1.31 (1.06, 1.62)]; and for RFC1 A80G, overall [OR = 1.16 (1.02, 1.31) and ORG = 1.18 (1.01, 1.37)]. MTHFR A1298C, MTR 12756G and CBS 844ins68 polymorphisms produced non-significant results. Since potential confounders could not be ruled out completely in this meta-analysis, further studies are needed to confirm these results.

Epidemiologic characteristics of birth defects in the Hainan Province from 2000 to 2010, China.

BACKGROUND: Although the prevalence of congenital malformations is high in China, little information is available on the Hainan Province. METHODS: Data used in this study were collected from 2000 to 2010 by monitoring newborns (including both live births and stillbirths) in the Hainan Province. Comparison analyses were conducted by performing χ(2) tests. RESULTS: The data showed an increasing temporal trend of the birth defect prevalence in the Hainan Province; however, the rate of birth defects changed over time. CONCLUSION: The Hainan Province is confronted with the challenge to reduce the prevalence of birth defects. Interventions should focus on the rural areas where a higher prevalence of birth defects is observed.

Agricultural exposures and farm-related injuries among adolescents in rural China.

This cross-sectional study explored the incidence of farm injuries and the relationship between agricultural exposures and injury among 2053 adolescents aged 13-19 years in Macheng, China. A comprehensive self-administered questionnaire was given to adolescents. The cumulative incidence rate of farm injury was 19.8%. Adolescents who were male, aged 10-15 years, left behind, working more days each month and living on the plains, reported higher rates. Specific agricultural exposures, such as large animals, pesticides and operating farm machinery were associated with higher injury rates. Prevention programmes are needed to reduce farm injuries.

Health-related quality of life among pregnant women with and without depression in Hubei, China.

The role of prenatal depression on physical and mental health among women in mainland China has not been previously investigated. The aim of this research was to (a) calculate the prevalence of depression during pregnancy, (b) explore the relationship between depression sample characteristics and quality of life and (c) identify predictors of physical and mental health among pregnant women. This study was designed as a cross-sectional and exploratory survey. A total of 454 pregnant women participated in the study between December 2009 and June 2010 in central China. The data was collected using the Medical Outcomes Study short form 36 v2 and the Edinburgh Postnatal Depression Scale. Participants were recruited at outpatient departments of obstetrics and gynecology. Findings show that almost 40% of pregnant women experience prenatal depression. Depression was significantly associated with physical and mental health-related quality of life (HRQoL). Depression, increased age, higher gestational age, being employed and married were significant predictors of lower physical HRQoL. Depression, lower BMI and having an unintended pregnancy were significant predictors of lower mental HRQoL. Prenatal depression is very common in women from mainland China. Depressed women suffer from impaired physical and mental health; prenatal depression has a negative impact on women's HRQoL. We recommend that antenatal services integrate screening for depression into routine antenatal care.

How to effectively detect and manage people living with HIV/AIDS in China: establishment of a community-based model.

This study explored a novel systemic community-based model for detecting and managing people living with HIV/AIDS (PLWHA). Both quantitative and qualitative research methods were used in this study. A quantitative questionnaire investigation was conducted in a sample of 1192 subjects which were randomly selected from two areas with high HIV prevalence, Xiangfan City and Shiyan City of Hubei Province, China. Twenty-two medical and health service staffs were interviewed by semi-structured questionnaire focusing on awareness, status, problems, and suggestions about community-based Voluntary Counseling and Testing and Provider Initiated Testing and Counseling (VCT/PITC). And they were organized to discuss about the aforementioned issues in Xiangfan City and Shiyan City, respectively. Our results showed that the accessibility and availability of the general VCT/PITC were bad. About 28.3% had known and only 4.9% had made use of VCT/PITC. Developing community-based VCT/PITC had some special advantages that can overcome some existing problems to remedy the aforementioned defects. We are led to conclude that, to maximize the availability and uptake rate of the VCT/PITC, we plan to detect PLWHA by developing the community-based VCT/PITC through 4 paths. Then we establish the community HIV health care center constituted of 8 sectors to provide an overall management. Thus, we can effectively detect and manage the PLWHA with a new systemic community-based model.

Integration of Urine Proteomic and Metabolomic Profiling Reveals Novel Insights Into Neuroinflammation in Autism Spectrum Disorder.

Autism spectrum disorder (ASD) comprises a group of neurodevelopmental disorders whose etiology and pathogenesis are not fully understood. To gain insight into the molecular basis of ASD, we performed comparative integrated proteomic and metabolomic analyses of urine samples from children diagnosed with ASD and healthy children. All 160 samples underwent proteomics analysis and 60 were analyzed by liquid chromatography-mass spectrometry to obtain metabolite profiles. We identified 77 differentially expressed proteins (DEPs; 21 downregulated and 56 upregulated) and 277 differentially expressed metabolites; 31 of the DEPs including glutathione, leukocyte antigens, glycoproteins, neural adhesion factors, and immunoglobulins, have been implicated in neuroinflammation. The proteomic analysis also revealed 8 signaling pathways that were significantly dysregulated in ASD patients; 3 of these (transendothelial leukocyte migration, antigen processing and presentation, and graft vs. host disease) were associated with the neuroimmune response. The metabolism of tryptophan, which is also related to the neuroimmune response, has been found to play a potential role in ASD. Integrated proteome and metabolome analysis showed that 6 signaling pathways were significantly enriched in ASD patients, 3 of which were correlated with impaired neuroinflammation (glutathione metabolism, metabolism of xenobiotics by cytochrome P450 and transendothelial migration of leukocyte). We also found a correlation between prostaglandin (PG) E2 levels and the inflammatory response in ASD. These results underscore the prominent role of the neuroimmune response in ASD and provide potential biomarkers that can be used for diagnosis or as targets for early intervention.

Meta-analyses of the effect of cytochrome P450 2E1 gene polymorphism on the risk of head and neck cancer.

Many studies have investigated the association between the CYP2E1 5'-flanking region (RsaI/PstI) polymorphism and head and neck cancer susceptibility, but the results were conflicting. In this meta-analysis, we assessed 24 published studies involving 12,562 subjects of the association between CYP2E1 RsaI/PstI polymorphism and head and neck cancer risk. Using the fixed effects model, we found significant association between PstI/RsaI polymorphism and head and neck cancer risk [OR=1.11 (95%CI: 1.00-1.22) for c2 allele (P=0.04) and OR=1.57 (95% CI: 1.14-2.15) for c2 homozygous (P=0.006) compared with wild type homozygote]. Significant results were also found in East Asians and Mix populations when stratified by ethnicity. However, no significant associations were found for Caucasians in all genetic models. Stratified analyses according to source of controls, significant associations were found only in hospital base controls. In the subgroup analyses by tumor types, significant association was detected only in oral cancer group, while no significant associations among laryngeal- or pharyngeal- cancer subgroup. This meta-analysis suggests that the CYP2E1 RsaI/PstI polymorphism may be a risk factor for head and neck cancer in Asians and Mix population, and that different carcinogenic processes involved in the genesis of various tumor types may exist.

Effects of air pollution on neonatal prematurity in Guangzhou of China: a time-series study.

BACKGROUND: Over the last decade, a few studies have investigated the possible adverse effects of ambient air pollution on preterm birth. However, the correlation between them still remains unclear, due to insufficient evidences. METHODS: The correlation between air pollution and preterm birth in Guangzhou city was examined by using the Generalized Additive Model (GAM) extended Poisson regression model in which we controlled the confounding factors such as meteorological factors, time trends, weather and day of the week (DOW). We also adjusted the co linearity of air pollutants by using Principal Component Analysis. The meteorological data and air pollution data were obtained from the Meteorological Bureau and the Environmental Monitoring Centre, while the medical records of newborns were collected from the perinatal health database of all obstetric institutions in Guangzhou, China in 2007. RESULTS: In 2007, the average daily concentrations of NO2, PM10 and SO2 in Guangzhou, were 61.04, 82.51 and 51.67 µg/m³ respectively, where each day an average of 21.47 preterm babies were delivered. Pearson correlation analysis suggested a negative correlation between the concentrations of NO2, PM10, SO2, and temperature as well as relative humidity. As for the time-series GAM analysis, the results of single air pollutant model suggested that the cumulative effects of NO2, PM10 and SO2 reached its peak on day 3, day 4 and day 3 respectively. An increase of 100 µg/m³ of air pollutants corresponded to relative risks (RRs) of 1.0542 (95%CI: 1.0080 ~1.1003), 1.0688 (95%CI: 1.0074 ~1.1301) and 1.1298 (95%CI: 1.0480 ~1.2116) respectively. After adjusting co linearity by using the Principal Component Analysis, the GAM model of the three air pollutants suggested that an increase of 100 µg/m³ of air pollutants corresponded to RRs of 1.0185 (95%CI: 1.0056~1.0313), 1.0215 (95%CI: 1.0066 ~1.0365) and 1.0326 (95%CI: 1.0101 ~1.0552) on day 0; and RRs of the three air pollutants, at their strongest cumulative effects, were 1.0219 (95%CI: 1.0053~1.0386), 1.0274 (95%CI: 1.0066~1.0482) and 1.0388 (95%CI: 1.0096 ~1.0681) respectively. CONCLUSIONS: This study indicates that the daily concentrations of air pollutants such as NO2, PM10 and SO2 have a positive correlation with the preterm births in Guangzhou, China.