The effect of sarcopenic obesity on glycaemic status based on fasting plasma glucose and glycated haemoglobin: A prospective cohort study.

AIM: To investigate the effect of sarcopenic obesity on the progression of glycaemic status in middle-aged and older adults without diabetes. MATERIALS AND METHODS: This research involved 4637 participants without diabetes from the China Health and Retirement Longitudinal Study 2011-2015. Sarcopenic obesity at baseline was evaluated based on the Asian Working Group for Sarcopenia 2019 criteria. According to the American Diabetes Association criteria, we used fasting plasma glucose and glycated haemoglobin to define glycaemic status. Cox proportional hazard models were applied to obtain adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The mean age of included participants was 58.98 ± 8.82 years, and 45.35% were men. During 18,497 person-years of follow-up, 1743 (37.59%) cases with glycaemic status progression were identified. Compared with participants without sarcopenia and obesity, participants with sarcopenic obesity, but not sarcopenia only or obesity only, exhibited a higher risk of progression from normoglycaemia to diabetes (HR = 2.11; 95% CI: 1.10-4.04). Moreover, participants with sarcopenic obesity (HR = 1.65; 95% CI: 1.04-2.63), sarcopenia only (HR = 1.78; 95% CI: 1.11-2.86), or obesity only (HR = 2.00; 95% CI: 1.29-3.12) had increased the risk of progression from prediabetes to diabetes. CONCLUSIONS: The effect of sarcopenic obesity on the progression of glycaemic status based on fasting plasma glucose and glycated haemoglobin may be more pronounced than that of sarcopenia only or obesity only.

A turn-on fluorescent probe for detecting and bioimaging of HOCl in inflammatory and liver disease models.

Hypochlorous acid (HOCl) is a common reactive oxygen species (ROS) associated with the development of liver, tumor, inflammatory, and other diseases. In this work, the turn-on fluorescent probe named (WZ-HOCl) with a naphthalimide structure was designed and synthesized to detect endogenous HOCl in disease models. WZ-HOCl can achieve a fast response to HOCl with good linearity in the range of 0-45 µM (LOD = 147 nM). The application of WZ-HOCl in bioimaging was investigated by constructing a series of cellular disease models, and the results showed that WZ-HOCl could sensitively detect endogenous HOCl in inflammatory and liver disease models. It can also be used to differentiate between hepatocytes and hepatoma cells. WZ-HOCl will provide new methods and ideas for fluorescent probes in detecting drug-induced liver injury, alcoholic and non-alcoholic steatohepatitis, and some inflammation-related diseases.

Comparison of the Effects of Tenofovir Disoproxil Fumarate (TDF) and Tenofovir Alafenamide (TAF) on Liver Function in Patients with Hepatitis B: A Meta-analysis.

Objective: This is a meta-analysis comparing the efficacy of Tenofovir disoproxil fumarate (TDF) and Tenofovir alafenamide (TAF) in the treatment of chronic hepatitis B (CHB) so as to provide a reference for clinical medication. Methods: Relevant literature about TDF and TAF in the treatment of CHB was searched in the literature databases, and two researchers two researchers conducted independent cross-screening conducted independent cross-screening according to the inclusion and exclusion criteria. The authors, publication time, research subjects. The literature quality was evaluated by, and outcome measures of the selected literature were extracted. The literature quality was evaluated using the Jadad scale and Cochrane risk-of-bias tool. Meta-analysis was conducted using the RevMan 5.3 software. Results: After screening, 5 references were included, with a total of 5324 subjects. Patients who were treated with TDF and TAF were included in the TDF group and TAF group, respectively. The meta-analysis showed no significant difference in viral suppression between groups after 12 months of treatment (P > .05). Still, the alanine transaminase (ALT) normalization rate was higher, and the incidence of adverse reactions was lower in TAF group versus TDF group at 12 months after treatment (P < .05). Conclusions: Both TAF and TDF are effective in the treatment of CHB, but the former is preferred due to its higher safety profile.

Adverse childhood experiences and depressive symptoms among lesbian and bisexual women in China.

BACKGROUND: Despite the relationship between Adverse childhood experiences (ACEs) and depressive symptoms, which has been well researched in general populations, little is known about homosexual and bisexual populations, especially lesbian and bisexual women in China. This study aims to investigate the prevalence of ACEs and depressive symptoms and to analyze the relationship between them among lesbian and bisexual women in China. METHODS: The eligible participants were aged 16 years or older who report their sexual orientation as homosexual or bisexual. The data was collected through anonymous questionnaires with the help of Lespark in Beijing from July 18 to December 29, 2018, and all participants had informed consent to this study. Univariate analysis and multiple linear regression analyses were performed to explore the relationship between ACEs and depressive symptoms among lesbian and bisexual women. All statistical analyses were conducted by the software of SPSS 22.0. RESULTS: Among 301 lesbian and bisexual women, 81.4% were lesbian, 18.4% were bisexual women, and the majority were 21-30 years. As for ACEs, 51.5% reported at least one ACE, in which emotional neglect (22.6%) and emotional abuse (22.3%) were common ACEs. As for depressive symptoms of lesbian and bisexual women, the detection rate was 56.1%. The multiple linear regression analyses showed that abuse (ß = 2.95, 95%CI:1.07-4.83) and neglect (ß = 3.21, 95%CI:1.09-5.31) were positively associated with depressive symptoms and lesbian and bisexual women with three (ß = 4.11, 95%CI: 0.99-7.22) or more (ß = 6.02, 95%CI: 3.23-8.78) ACEs suffered from more depressive symptoms than others. CONCLUSION: Adverse childhood experiences (ACEs) and depressive symptoms were at high prevalence among lesbian and bisexual women in China. ACEs were associated with depressive symptoms, especially childhood abuse and neglect experiences that have a significant effect on lesbian and bisexual women mental health.

Physicochemical and microstructural mechanisms for quality changes in lightly salted tilapia (Oreochromis niloticus) fillets during frozen storage.

BACKGROUND: Frozen tilapia fillet has become a leading aquatic product. High drip loss, dry and fibrous mouthfeel, and an unappealing appearance are its main problems. It was hypothesized that light salting could improve the quality, and that the preparation conditions would affect the storage stability of frozen tilapia fillets. RESULTS: The quality changes of lightly salted tilapia fillets were evaluated during frozen storage, and the underlying mechanisms were studied from the physicochemicaland microstructural perspectives. Though the salt content was 1.5% in all samples,the amount of ice crystals in frozen tissues decreased with the descending water content and freezing point (P < 0.05). No intracellular voids were observed in the samples prepared under proper salting conditions, and the myofibers were plump and smooth after freezing-thawing, which contributed to the high water-holding capacity of lightly salted fillets. After 28 days,the water-binding capacity of the salted groups was 14.69%-18.62% higher than that of their unsalted counterparts (P < 0.05). The reduced protein solubility in the salted fillets was likely to have occurred because the solubilized and unfolded proteins interacted more easily during frozen storage. The oxidation degree of myofibrillar proteins was also affected by salting condition, and the fillets with less oxidized sulfhydryl groups maintained high springiness after 28 days of frozen storage. CONCLUSION: The salting condition of 9% NaCl solution for 1 h was recommended for the preparation of lightly salted fillets from freshwater fish, taking into account quality, processing efficiency, and storage stability. The enhanced water-holding capacity and texture of lightly salted tilapia fillets were attributed to modified physicochemical and microstructural properties. These results could provide a scientific basis for the processing and storage of high-quality, frozen, lightly salted fillets from freshwater fish. © 2022 Society of Chemical Industry.

Psychosocial characteristics pattern correlated with HIV-related risky sexual behavior among HIV-negative men who have sex with men: a latent profile analysis.

BACKGROUND: Men who have sex with men (MSM) have become a high risk population of HIV infection due to their risky sexual behaviors. The latent pattern of psychosocial characteristics plays an important effect in HIV-related risky behaviors among HIV-negative MSM. METHOD: Participants were recruited from Wuhan, Nanchang, and Changsha city from September 2017 to January 2018. Social support was assessed by the multidimensional scale of social support, Connor-Davidson Resilience scale-10 items for reliance, the assessment of Stigma towards Homosexuality for sexual minority stigma, the Likert subscale of nondisclosure for identity concealment, the ACE questionnaire-Kaiser-CDC for adverse childhood experience, the Centers for Epidemiological Studies Depression Scale for depression. Latent profile analysis (LPA) and multivariate regression were used to analyze the data. RESULTS: Three psychosocial characteristic patterns were revealed by the LPA. "Social support and resilience group" (SR group), "Identity concealment group" (IC group) and "Adverse childhood experience" (ACE group) were identified, respectively. In comparison with "SR group", "IC group" have a higher likelihood of one-night male partners (AOR = 2.74, 95%CI = [1.54, 4.90]), both fixed and one-night male partners (AOR = 2.01, 95%CI = [1.34, 3.01]) and HIV-unsure male partner (AOR = 2.12, 95%CI = [1.44, 3.13]). Similarly, "ACE group" were more likely having inconsistent condom use (AOR = 2.58, 95%CI = [1.41, 4.73]), and having sex with HIV-positive male partner (AOR = 4.90, 95%CI = [1.95, 12.30]) with comparison of "SR group". In addition, we further revealed that "ACE group" had a higher ratio (90.0%) of inconsistent condom use among MSM whose male partners were HIV-positive. CONCLUSIONS: Six important psychosocial factors were divided into three latent pattern classes. Compared with "SR group", "IC group" and "ACE group" were more likely to engage in HIV-related risky sexual behaviors. Further research may pay more attention to "IC group" and "ACE group" for targeted intervention.

Meta-analysis of the association between periodontal disease, periodontal treatment and carotid intima-media thickness.

Periodontal disease is a major threat to oral health and would further contribute to systemic diseases without timely control. We aimed to evaluate the relation between periodontal disease, periodontal treatment and carotid intima-media thickness (CIMT) based on available epidemiological and clinical evidence. PubMed and Scopus were searched for relevant studies through May 2021. Observational studies reporting risk estimates with 95% confidence intervals (95% CIs) for the association between periodontal disease (including periodontitis and gingivitis) and risk of increased CIMT (defined as CIMT value that exceeded the cut-off value of clinical and prognostic significance), as well as interventional studies providing mean values with standard deviations of CIMT before and after periodontal intervention, were included. Random-effect models for meta-analysis were used to calculate the summary effect estimates with 95% CIs. A total of 406 citations were retrieved from electronic databases and 45 full-text articles were screened, leaving 11 articles using ultrasound to measure CIMT with 8744 participants included. Pooled results of seven cross-sectional studies involving 8558 participants indicated that compared to those without periodontitis, patients with periodontitis and those with severe periodontitis had an odds ratio of 1.42 (95% CI: 1.16, 1.75) and 1.70 (95% CI: 1.24, 2.33) for increased CIMT, respectively. Although publication bias was detected in these results, odds ratios corrected by the trim-and-fill method were still statistically significant. Results of four non-randomized controlled trials with 186 patients suggested that periodontal intervention may help reduce CIMT in patients with periodontal disease in the short term. Periodontitis, especially severe periodontitis, was significantly associated with the risk of increased CIMT. Periodontal intervention might help slow the progression of carotid intima-media thickening in patients with periodontal disease in the short term.

Waist circumference, waist-hip ratio, body fat rate, total body fat mass and risk of low back pain: a systematic review and meta-analysis.

PURPOSE: To identify the associations between waist circumference (WC), waist-hip ratio (WHR), body fat rate (BFR), total body fat mass (BFM), and the risk of low back pain (LBP). METHODS: We have searched PubMed through October 2020 for observational studies investigating the associations between WC, WHR, BFR, or total BFM and the risk of LBP. Random-effect models were used to calculate the summary risk estimates and corresponding 95% confidence intervals (95% CIs). RESULTS: A total of fifteen studies with 92,936 participants were included, of which ten were related to WC, five were related to WHR, four were related to BFR, and four were related to total BFM. Pooled results indicated that high WC (odds ratio (OR) = 1.30, 95% CI 1.10-1.54) and WHR (OR = 1.33, 95% CI 1.00-1.76) were associated with an increased risk of chronic low back pain (c-LBP). High WC (OR = 1.18, 95% CI 1.03-1.34) was also associated with an increased risk of non-c-LBP. The risk of non-c-LBP increased by 23% (OR = 1.23, 95% CI 1.01-1.50) for every 10% increase in BFR, and for every 10 kg increase in total BFM, the risk of non-c-LBP increased by 24% (OR = 1.24, 95% CI 1.10-1.39). CONCLUSION: Observational epidemiological evidence suggested that individuals with increased WC, WHR, BFR, or total BFM tended to have an increased risk of LBP, regardless of whether their body mass indexes were normal. Excessive fat mass was the essence of the process.

[Preparation and effect against cervical cancer invasion in vitro of harmine-loaded photosensitive liposomes].

Despite the development of HPV vaccines and screening programs, cervical cancer is still a serious threat to women's health. Early-stage cervical cancer is mainly treated by surgery. However, considering the serious complications after surgery, hyperthermia is recommended to enhance the effect of chemotherapy, retain the integrity of cervix, improve the treatment effect, which provides a therapeutic basis for the early treatment of cervical cancer. The photosensitive liposomes containing harmine and dye IR-780 were prepared by thin-film dispersion method and separated by Sephadex G-50 dextran gel column. The preparation conditions were optimized as the mass ratio of phospholipid to cholesterol membrane material being 8∶1 and that of drug to lipid being 1∶20. The results of HPLC showed that the encapsulation efficiency of harmine was 55.6%±0.18%. The prepared photosensitive liposomes were round and evenly distributed under transmission electron microscope, with the particle size of(125.2±0.62) nm determined by Marvin particle size analyzer and the Zeta potential of(-2.55±0.76) mV. Additionally, the photosensitive liposomes had the photothermal conversion efficiency, an important property of photothermal agent, of 27.1%±0.86%. The photosensitive liposomes stored at 4 ℃ showed stable encapsulation efficiency in the first 14 days without flocculation. The sulforhodamine B(SRB) assay was employed to determine the inhibitory effect of the liposomes on the proliferation of HeLa cells under near-infrared(NIR) irradiation or not, which showcased stronger inhibitory effect under NIR irradiation. The results of Transwell assay indicated that the prepared liposomes significantly inhibited the invasion and migration of HeLa cells in vitro. The findings of this study provide a basis for the treatment of cervical cancer with harmine.

[Effect of Sishen Pills and its split prescriptions on Tfr/Tfh9/Tfh17 cells in colitis mice].

This study aims to investigate the regulatory effect of Sishen Pills(SSP) and its split prescriptions Ershen Pills(EP) and Wuweizi Powder(WP) on T follicular helper(Tfh) cell subset in the dextran sodium sulfate(DSS)-induced colitis mice and the mechanism. A total of 60 male SPF BALB/c mice were used, 10 of which were randomly selected as the normal group. The rest 50 were induced with 3% DSS solution for colitis modeling. After modeling, they were randomized into 5 groups: model group, SSP group, EP group, WP group, and mesalazine group. Body mass, colon mass, colon mass index, colon length, and unit colon mass index in each group were observed. After hematoxylin-eosin(HE) staining, the pathological injury of colon tissue was scored. The expression levels of molecules related to the STAT/SOCS signaling pathway in colon tissues were analyzed by Western blot. Differentiation levels of Tfh cells such as CD4~+CXCR5~+IL-9~+(Tfh9), CD4~+CXCR5~+IL-17~+(Tfh17), and CD4~+CXCR5~+Foxp3~+(Tfr) in peripheral blood of mice were detected by flow cytometry. The results showed each treatment group demonstrated significant increase in body mass and colon length, decrease in colon mass, colon mass index, unit colon mass index, and histopathological score(P<0.05, P<0.01), reduction of the expression of p-STAT3, STAT3, p-STAT6, and STAT6(P<0.05, P<0.01), rise of the expression of SOCS1 and SOCS3(P<0.05, P<0.01), decrease of Tfh9 and Tfh17 cells, and increase of Tfr cells(P<0.05, P<0.01) compared with the model group. These results indicated that SSP and the split EP and WP may alleviate ulcerative colitis by inhibiting the activation of STAT/SOCS signaling pathway and regulating the balance of Tfr/Tfh9/Tfh17 cells.

The utility of competency-oriented clinical laboratory teaching combined with case-based learning (CBL).

OBJECTIVES: This study aimed to evaluate the effectiveness and efficiency of competency-oriented clinical laboratory teaching combined with case-based learning (CBL) and improve the examination of students' competence of laboratory medicine. METHODS: A total of 107 medical laboratory medicine interns at the Affiliated Hospital of Xuzhou Medical University from June 2017 to July 2019 volunteered to participate in the study and were randomly assigned into a control group with training of the traditional teacher-centered method, and an experimental group under a CBL teaching program. Student basic theory tests and skill assessment were designed to evaluate what the students gained from their internship when they completed their studies at the Affiliated Hospital of Xuzhou Medical University. RESULTS: Compared to students in the control group taught with the teacher-centered method, those in the CBL teaching program had significantly higher theory test scores and skill assessment scores on average. Competencies with particularly significant improvement included identification and processing of instrument alarm information, analysis of test results, identification and solution of the problem, as well as identification and reporting of the critical value and clinical communication. CONCLUSIONS: The competency-oriented teaching method combined with CBL is an effective method for improving students' professional knowledge, increasing language expression, and enhancing interpersonal relationship and teamwork, which is worthy of being promoted in laboratory medicine teaching.

Study of the variations in apparent electrical resistivity of activated sludge during the electro-dewatering process.

The high energy consumption of high apparent electrical resistivity (AER) in sludge during the later stages of the electro-dewatering (EDW) process is a difficult problem; however, analysis of sludge AER may contribute to a reduction in energy consumption. In this study, the variations in the AER of activated sludge and potential mechanisms related to sludge properties were systematically examined. First, a sludge cake was divided into four horizontal layers, in order to investigate the sludge AER in each layer. Then, the effects of variations in water distribution, oxidation-reduction potential (ORP), pH, metal ions, sludge conductivity, zeta potential, temperature, and sludge microstructure on the AER in each layer were explored. The results showed that the sludge AER began to increase from the bottom layers to the top layers when the moisture content (MC) was decreased to 60%. The formation of nonionic chemical systems and the gas barrier layer could increase the AER in the top layers, and the increase in sludge AER in the bottom layers was due to the decrease in MC and sludge conductivity. In addition, electrolyte release and electromigration had a significant effect on the sludge AER. This work identifies potential causes for the increase in AER, and provides a reference for solving problems related to high AER in sludge during the later stages of the EDW process.

Impact of exposure to noise on the risk of hypertension: A systematic review and meta-analysis of cohort studies.

OBJECTIVE: We aimed to synthesize available cohorts about the relationship between various types of noise and hypertension, and to explore the potential dose-response relationship between them in an updated meta-analysis. METHODS: PubMed and Embase were searched through October 2019 to identify cohort studies that met predetermined inclusion criteria. A random-effects model was used to combine the results of included studies. Dose-response meta-analysis was conducted to examine the potential dose-response relationship. RESULTS: Eleven cohort studies involving 224,829 participants were included in this systematic review. Pooled result showed that living or working in environment with noise exposure was significantly associated with increased risk of hypertension (RR: 1.18; 95% CI: 1.06 to 1.32), with low heterogeneity (P = 0.098, I2 = 42.1%). We found no evidence of a nonlinear association of elevated noise with hypertension risk (P = 0.443). The summary risk ratio of hypertension for an increment of per 10 dB(A) of noise was 1.13 (95% CI: 0.99 to 1.28), with moderate heterogeneity (P = 0.003, I2 = 72.1%). CONCLUSIONS: Integrated evidence from cohort studies supports the hypothesis that exposure to noise may be a risk factor of hypertension.

General practitioners' perspectives of the integrated health care system: a cross-sectional study in Wuhan, China.

BACKGROUND: In recent years, the Chinese government has introduced a new system called the integrated health care system to deepen health care reform and enhance the capacity of the primary health care services. OBJECTIVE: We aimed to investigate the perceptions and opinions of general practitioners (GPs) on the integrated health care system. METHODS: A cross-sectional investigation involving 764 GPs in Hubei province of China was conducted. We used a self-designed questionnaire to collect information on demographics, GPs' knowledge and attitude of the integrated health care system. Data on 749 GPs with completed questionnaires were analysed descriptively. We conducted Spearman rank correlation analysis to test correlation of grade data. RESULTS: 60.92% of the 749 GPs were familiar with the integrated health care system. 88.25% of the GPs were apt to support its development and 70.09% thought it could promote downward referral of patients. The GPs' familiarity with the integrated health care system was significantly related to professional guidance from doctors in higher hospitals (P < 0.05), but not job titles of GPs (P > 0.05). 78.0% of GPs thought that the main benefit of the integrated health care system was the reduction of patients' health care costs; 70.1% believed that the most difficulty was insufficient publicity. CONCLUSIONS: The GPs' general cognition of the integrated health care system was general. Most of the GPs supported the integrated health care system and believed that it contributed to decrease the patients' health care costs. Insufficient publicity and the incomplete two-way referral mechanism were regarded to be the main obstacles to its development.

Association between dietary patterns and cognitive ability in Chinese children aged 10-15 years: evidence from the 2010 China Family Panel Studies.

BACKGROUND: Limited information is available concerning the association between dietary patterns and cognitive ability during adolescence, especially in regards to the epidemiological studies in China. Therefore, this study aimed to analyze the association between dietary patterns and cognitive ability in Chinese children aged 10-15 years. METHODS: The dietary information, cognitive ability and sociodemographic data of 2029 children were retrieved from the 2010 China Family Panel Studies. Dietary patterns were assessed by principal component analysis. Ordinal logistic regression models were used to determine the association between dietary patterns and cognitive ability in these children. RESULTS: Three dietary patterns were identified, namely, 'High protein', 'High fat' and 'High salt-oil'. Following adjustment for gender, age, nationality, household registration, school type, parental education level, family learning environment, annual household income and family size, we found that an increase in 'High protein' pattern score was significantly associated with higher mathematics test scores (OR = 1.62, CI: 1.23 ~ 2.15; P = 0.001), but not with vocabulary test scores (OR = 1.21, CI: 0.93 ~ 1.58; P = 0.149). On the contrary, an increase in 'High fat' pattern score was significantly associated with lower scores of mathematics (OR = 0.76, CI: 0.59 ~ 0.98; P = 0.031) and vocabulary (OR = 0.77, CI: 0.61 ~ 0.97; P = 0.029) tests. However, there was no significant association between 'High salt-oil' pattern and the scores of mathematics (OR = 0.99, CI: 0.77 ~ 1.27; P = 0.915) and vocabulary (OR = 0.93, CI: 0.73 ~ 1.18; P = 0.544) tests. CONCLUSION: The findings of this study demonstrated that 'High protein' pattern was positively associated with cognitive ability in Chinese children, while 'High fat' pattern exhibited a negative association.

The wound severity of animal bite victims visiting rabies prevention clinics and the influencing factors in Central China: a cross-sectional investigation.

BACKGROUND: Animal bites are a major public health problem. The more serious the bite wound is, the higher the risk of developing rabies is. This study aimed to investigate the severity of wounds among animal bite victims and identify the influencing factors in Wuhan, China. METHODS: A cross-sectional study was conducted among 1015 animal bite victims visiting rabies prevention clinics. We performed a face-to-face interview to collect information on the exposure category of the bite wound, the type of the offending animal, exposure-to-risk situations, etc. Factors associated with exposure categories were identified by multivariate logistic regression analysis. RESULTS: Five hundred and sixty-four (55.57%) cases were category III exposures, 418 (41.18%) were category II exposures, and 33 (3.25%) were category I exposures. People who were hurt by their own domestic animals (odds ratio [OR] = 1.55, 95% confidence interval [CI]: 1.14-2.10), and those exposed to animals unvaccinated against rabies (OR = 1.45, 95% CI: 1.08-1.95) had a higher risk for category III exposures. Respondents who did not know the fatality of rabies were more likely to be injured seriously compared to those who knew that rabies is fatal, and the OR was 1.40 (95% CI, 1.05-1.86). CONCLUSIONS: This study showed that factors associated with the severity of bite wounds mainly included types of the offending animal, vaccination status of the animal, and knowledge of rabies fatality. Educational programs and awareness-raising campaigns should be provided to decrease severe animal bites, especially targeting pet owners and those with limited rabies knowledge.

Investigation on the variations of sludge water holding capacity of electro-dewatering process.

Since the effect of electro-dewatering (EDW) on sludge water holding capacity was unknown, tests were conducted in this study to investigate the water holding capacity of EDW sludge and the potential mechanism related to the sludge physicochemical characteristics, EPS properties and sludge structure. Sludge was dewatered to the average moisture content (AMC) of 80%, 70% and 60% with different applied voltages at 20, 30 and 40V in EDW, respectively. Then the dewatered sludge near the anode and cathode were rewatered. The variation of sludge water holding capacity in EDW process was evaluated in terms of filterability and saturated moisture content (SMC), and the filterability was assessed by the specific resistance to filtration (SRF) of rewatered sludge. The results indicated that SRF of rewatered sludge near the cathode increased greatly. The proteins/polysaccharides (PN/PS) of loosely bound extracellular polymeric substances (LB-EPS) was significantly positively correlated with SRF (r = 0.891, p < 0.01). Moreover, the exposure of hydrophobic sites or groups in PN near the cathode improved the surface hydrophobicity of sludge, which reduced the filterability. In addition, higher voltage could destroy the sludge structure near the anode at the later stage of EDW process, leading to the decrease of SRF and SMC. These results expanded the knowledge about changes in sludge properties and water holding capacity during EDW process.

Involvement of Cholesterol Metabolic Pathways in Recovery from Noise-Induced Hearing Loss.

The objective of this study was to explore the molecular mechanisms of acute noise-induced hearing loss and recovery of steady-state noise-induced hearing loss using miniature pigs. We used miniature pigs exposed to white noise at 120 dB (A) as a model. Auditory brainstem response (ABR) measurements were made before noise exposure, 1 day and 7 days after noise exposure. Proteomic Isobaric Tags for Relative and Absolute Quantification (iTRAQ) was used to observe changes in proteins of the miniature pig inner ear following noise exposure. Western blot and immunofluorescence were performed for further quantitative and qualitative analysis of proteomic changes. The average ABR-click threshold of miniature pigs before noise exposure, 1 day and 7 days after noise exposure, were 39.4 dB SPL, 67.1 dB SPL, and 50.8 dB SPL, respectively. In total, 2,158 proteins were identified using iTRAQ. Both gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) database analyses showed that immune and metabolic pathways were prominently involved during the impairment stage of acute hearing loss. During the recovery stage of acute hearing loss, most differentially expressed proteins were related to cholesterol metabolism. Western blot and immunofluorescence showed accumulation of reactive oxygen species and nuclear translocation of NF-κB (p65) in the hair cells of miniature pig inner ears during the acute hearing loss stage after noise exposure. Nuclear translocation of NF-κB (p65) may be associated with overexpression of downstream inflammatory factors. Apolipoprotein (Apo) A1 and Apo E were significantly upregulated during the recovery stage of hearing loss and may be related to activation of cholesterol metabolic pathways. This is the first study to use proteomics analysis to analyze the molecular mechanisms of acute noise-induced hearing loss and its recovery in a large animal model (miniature pigs). Our results showed that activation of metabolic, inflammatory, and innate immunity pathways may be involved in acute noise-induced hearing loss, while cholesterol metabolic pathways may play an important role in recovery of hearing ability following noise-induced hearing loss.

The value of multidisciplinary team in syncope clinic for the effective diagnosis of complex syncope.

BACKGROUND: Syncope is a perplexing challenge that often receives thorough evaluation, yet the diagnosis remains unclear. Usually, the emergency department is the first point at which patients present with syncope. However, diverse medical factors, including low diagnostic rates and inconsistent management by doctors, add to healthcare costs and delay diagnosis for syncope patients. METHODS: Patients who had been to the emergency department at least once but were not given a clear diagnosis of syncope were recruited into our study at the time they visited syncope clinic staffed by a multidisciplinary team. Complete medical histories and clinical examinations were conducted by both experienced cardiologists and neurologists. If patients were not given a conclusive diagnosis at the syncope clinic on the basis of outpatient examinations, they were admitted for further evaluation. RESULTS: A total of 209 consecutive patients claiming "syncope" visited the syncope clinic, yet only 167 patients were formally diagnosed with syncope. For these 167 patients, the mean age was 55.93 ± 17.40 years old, and 41.3% were male. The proportions of cardiac syncope, reflex syncope, orthostatic hypotension (OH), and syncope of uncertain etiology were 19.8%, 64.1%, 7.8%, and 8.4%, respectively. The diagnostic rate was 91.6%, and the hospitalization rate was 23.4%. Patients with reflex syncope and OH were younger than patients with cardiac syncope. Cardiac syncope tends to occur more frequently in males, while reflex syncope is more likely in females. CONCLUSIONS: The cooperation of professional cardiologists and neurologists will play an important role in improving diagnostic rates, lowering admission rates, and reducing medical costs.

Long-term exposure to PM2.5 and stroke: A systematic review and meta-analysis of cohort studies.

BACKGROUND: Stroke is one of the world's leading causes of death. Many studies have checked the relationship between short-term exposure to particulate matter (PM) and stroke, but few have focused on the effect of long-term exposure to PM2.5 (particulate matters with an aerodynamic diameter of ≤2.5 µm). This study aimed to quantitatively examine the relationship of long-term exposure to PM2.5 with stroke incidence and mortality. METHODS: We identified relevant studies by searching the PubMed, EMBASE and MEDLINE. After the systematical review of pertinent studies, random-effect meta-analysis was conducted to investigate the association between long-term exposure to PM2.5 and stroke. RESULTS: Our meta-analysis included 16 cohort studies with more than 2.2 million people and above 49 149 endpoint events (incident stroke and death from stroke). The pooled hazard ratio (HR) for each 5 µg/m3 increment in PM2.5 was 1.11 (95% CI: 1.05, 1.17) (CI for confidence interval) for incidence of stroke and 1.11 (95% CI:1.05, 1.17) for mortality of stroke. In the region-specific analysis, significant association between PM2.5 and incidence of stroke was found in North America (HR=1.09, 95% CI:1.05, 1.14) and Europe (HR=1.07, 95% CI:1.05, 1.10), while the pooled result of Asia showed no significance (HR=2.31, 95% CI:0.49, 10.95). CONCLUSIONS: Long-term exposure to PM2.5 is an important risk factor for stroke. Since air quality is intimately related to everyone, policies aimed at reducing particulate matters will benefit public health a lot.