Prevalence of thalassemia-carrier couples and fertility risk assessment.

Thalassemia is a highly prevalent hematologic disease in Guizhou, China. This study aimed to determine the epidemiological characteristics of thalassemia in couples at childbearing age and assess the neonatal risk of thalassemia in this subpopulation. A cohort of 4481 couples at childbearing age were recruited for thalassemia carrier screening by both traditional hematological tests and next-generation sequencing. Of them, 1314 (14.66%) thalassemia carriers were identified, including 857 (9.76%) α-thalassemia, 391 (4.36%) ß-thalassemia, and 48 (0.54%) composite α and ß-thalassemia. A total of 12 α-globin gene alterations and 16 ß-globin mutations were detected, including four novel thalassemia mutations. SEA was the most common α-thalassemia genotype (26.86%), CD41-42 the most common ß-thalassemia genotype (36.57%), and αα/- α3.7 + CD41-42 the most common composite α- and ß-thalassemia genotype (18.75%). Ethnically, the Zhuang had the highest rate of thalassemia gene carriers among the ethnic groups. Geographically, Qiannan had the highest rate of thalassemia gene carriers. In addition, 38 of the 48 couples with composite α- and ß-thalassemia were high-risk thalassemia carriers, and 4 carrying the -SEA/αα gene needed fertility guidance.

Evaluation of bioequivalence between generic and brand-name clozapine in Chinese schizophrenic patients: A randomized, two-period, crossover study.

OBJECTIVE: Clozapine is the most effective therapy for schizophrenia. This study compared the bioequivalence of a generic formulation of clozapine (ChangZhou Pharmaceutical Factory Co. Ltd. Jiangsu, China) to the brand name formulation (Clozaril, HLS Therapeutics, Inc., Philadelphia, PA, USA) after multiple doses in Chinese schizophrenic patients. MATERIALS AND METHODS: This was a randomized, open-label, multiple-dose, 2-way crossover study in which patients with schizophrenia received the generic clozapine or Clozaril 100 mg twice daily for 10 days before crossing over to the alternate formulation for the next 10 days. Blood samples were collected at regular intervals during each treatment period, and plasma concentration of clozapine was determined by high-performance liquid chromatography. RESULTS: 26 patients were enrolled, of whom 24 completed the study and were included in the steady-state analyses. The mean AUC0-12 was 6,003.29 h×ng/mL for generic clozapine and 6,347.53 h×ng/mL for Clozaril. The mean Cmax,ss was 698.52 ng/mL for generic clozapine and 739.75 ng/mL for Clozaril. The ratio of the adjusted geometric means and its 90% CI of the ratios for AUC0-12 was 96.24% (89.60 - 103.36%), and for Cmax,ss was 95.90% (88.91 - 103.44%). A total of 66 adverse events were reported by 22 (84.62%) subjects. Among them, 34 occurred in 17 (65.38%) patients during dosing of generic clozapine, and 32 occurred in 16 (61.54%) patients during dosing of brand-name clozapine. CONCLUSION: The result demonstrated that the generic clozapine was bioequivalent to brand-name clozapine (Clozaril). This would provide physicians with reassurance that patients who receive the studied generic clozapine will achieve similar plasma drug concentrations to those of brand-name clozapine (Clozaril).

Potential of Mobile Technology to Relieve the Urgent Mental Health Needs in China: Web-Based Survey.

BACKGROUND: With the rapid development of information technology and mobile devices, an increasing number of mobile medical services and platforms have emerged. However, China's current mental health situation necessitates further discussion and research on how to provide more patient-centered services in the face of many challenges and opportunities. OBJECTIVE: This study aims to explore the attitudes and preferences of mental health service stakeholders regarding mobile mental health services and discuss the challenges and opportunities faced by mobile technology developers in China. METHODS: A web-based survey was conducted by following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) checklist. A total of 586 valid questionnaires were collected. Respondents included 184 patients or their family members, 225 mental health professionals, and 177 people from the general population. Data analysis was completed using SPSS 24.0. RESULTS: Among the various problems perceived regarding the current mental health medical environment, difficulty in finding appropriate psychologists and limited visit times ranked highest. Social media (n=380/586, 64.9%) was the most preferred platform among all participants, whereas professionals showed a higher preference for smartphone apps (n=169/225, 75.1%). Professional instruction, psychological consultation, and mental health education (ranked top 3) were the most commonly identified needs. Mental health professionals generally emphasized more on treatment-related mobile mental health service needs, especially medication reminders (χ22=70.7; P<.001), symptom monitoring (χ22=24.0; P<.001), and access to mental health resources (χ22=38.6; P<.001). However, patients and their family members focused more on convenient web-based prescriptions (χ22=7.7; P=.02), with the general population interested in web-based psychological consultation (χ22=23.1; P<.001) and mental health knowledge (χ22=9.1; P=.01). Almost half of the participants regarded mobile mental health services as highly acceptable or supported their use, but less than 30% of participants thought mobile mental health services might be very helpful. Concerns about mobile mental health mainly focused on information security. Service receivers also suspected the quality and professionalism of content, and mental health professionals were worried about time and energy consumption as well as medical safety. CONCLUSIONS: In terms of service flow, mobile services could be used to expand service time and improve efficiency before and after diagnosis. More individualized mobile mental health service content in more acceptable forms should be developed to meet the various needs of different mental health stakeholders. Multidisciplinary training and communication could be incorporated to facilitate the integration and cooperation of more well-rounded service teams. A standard medical record system and data format would better promote the development of future intelligent medical care. Issues such as ensuring service quality, solving safety risks, and better integrating mobile services with regular medical workflows also need to be addressed.

Disease burden of schizophrenia patients visiting a Chinese regional mental health centre.

Aim & methods: A decision-analytic model was constructed to simulate a real-world cohort of Chinese patients visiting a Chinese regional mental health center for long-term health outcomes and direct medical costs. Results: When compared with age and gender-matched general population, the Chinese patients with schizophrenia were associated with reduced overall survival by 20.6 years (27.6 vs 48.2 years) and reduced quality-adjusted life years (QALY) by 18.4 QALY (18.4 vs 36.8 QALY), respectively, and increased lifetime direct medical costs by about three-times (US$84,324 vs 33,387 as of 31 December 2017) on average. Conclusion: The burden of schizophrenia was mainly driven by the mortality associated with relapsed schizophrenia and direct medical costs for schizophrenia in local mental health rehabilitation institutes.

Fluoride in tea from Shandong Province, China and exposure assessment.

In this study fluoride in 170 tea samples from Shandong province (China) was determined using a selective ion electrode. The fluoride concentrations ranged from 31.2 to 338 mg/kg with an average of 119 mg/kg. The mean fluoride concentrations were 164, 121, 98.7 and 96.8 mg/kg, which corresponded to Pu'erh tea, green tea, oolong tea and black tea, respectively. Moreover, 4.7% of the analysed samples exceed the legal limit of 200 mg/kg recommended by China. The estimated daily intake of fluoride via drinking tea for an adult was between 0.655 and 1.07 mg/person/day, which were lower than the provisional maximum tolerable daily intake value of 3.5 mg/person/day set by the National Health and Family Planning Commission of the People's Republic of China. In future, maintaining a surveillance programme to monitor the trend of fluoride in tea is necessary for food safety and human health.

Occurrence and dietary exposure assessment of multiple mycotoxins in corn-based food products from Shandong, China.

This study was designed to investigate the occurrence and exposure assessment of multiple mycotoxins in corn-based food products from Shandong Province, China. Results demonstrated that the mean level of total mycotoxins in test samples was 197.2 µg/kg. The most frequently found mycotoxins were deoxynivalenol (96.7%) and fumonisin B1 (94.4%), with mean contamination levels of 65.24 and 128.2, respectively. Among these corn-based food products, thin corn pancake had the highest mean contamination (886.7 µg/kg), followed by wotou (143.7 µg/kg), corn cake (135.4 µg/kg) and mantou (63.73 µg/kg). The average exposure values to total fumonisins and deoxynivalenol were 0.05 and 0.02 µg/kg bw/day, which were lower than the provisional maximum tolerable daily intake values of 2 and 1 µg/kg bw/day, respectively, as established by the Joint FAO/WHO Expert Committee on Food Additives. In the future strict control and systematic monitoring are needed to secure food safety and human health.

Dioxin-like polychlorinated biphenyls in marine fish from Shandong, China, and human dietary exposure.

The occurrence and human dietary exposure of 12 dioxin-like polychlorinated biphenyls (DL-PCBs) in 41 marine fish samples from Shandong Province of China were investigated. The DL-PCB congeners were extracted using automated Soxhlet extraction, purified via a composite column clean-up procedure and analysed by gas chromatography-triple quadrupole mass spectrometry. DL-PCB congeners were found in all analysed samples, with a mean concentration of 0.887 ng/g ww (wet weight). The TEQ concentrations of DL-PCBs in individual fish samples ranged from 0.011 to 9.214 pg WHO TEQ/g ww. The mean dietary intake for all fish species was 36.5 pg TEQ/kg bw/month, which was lower than the provisional tolerable monthly intake of 70 pg TEQ/kg bw/month set by the Joint FAO/WHO Expert Committee on Food Additives. To monitor the trend of DL-PCBs in fish for food safety control, it is necessary to maintain a surveillance programme.

Assessment of serum CX3CL1/fractalkine level in Han Chinese girls with anorexia nervosa and its correlation with nutritional status: a preliminary cross-sectional study.

The chemokine (C-X3-C motif) ligand 1 (CX3CL1), also named fractalkine (FKN), has been implicated in psychiatric disorders and functions as a novel adipocytokine. However, no attention has been paid to the role of FKN in anorexia nervosa (AN). The current study was performed to explore FKN levels in AN to determine its role in the involvement of AN. A total of 96 girls aged 11-18 years with AN (n=34), healthy controls (HC; n=32) and simple obesity (OB, n=30) were enrolled in the cross-sectional study. Blood samples were collected during the fasting state. Serum FKN concentrations were determined using ELISA. The skinfold thickness (TSF) of the biceps and triceps as well as mid-arm muscle circumference (MAMC) were used to determine the nutritional status. Our results showed that serum FKN levels were significantly lower in the AN group than in the control and OB groups. After adjusting for body mass index (BMI), FKN concentrations in the AN group were statistically higher than in the HC and OB groups. Significant correlations between serum FKN and body weight, BMI, Cole index and serum insulin were observed. In addition, serum FKN levels were positively related to TSF and MAMC in all subjects. Serum FKN concentrations are attenuated in girls with AN compared with healthy adolescents and are positively related to nutritional status. The lower FKN levels may be regulated by nutrition status and response to starvation. After adjusting for BMI, higher FKN levels may reflect that persistent inflammation is present in patients with AN.

Mycotoxins in wheat flour and intake assessment in Shandong province of China.

In the present study, the occurrence and contamination levels of eight mycotoxins were investigated in wheat flour samples (n = 359) from Shandong Province of China. Samples were determined using a multi-mycotoxin method based on isotope dilution ultrahigh performance liquid chromatography-tandem mass spectrometry. The results indicated that the most frequently found mycotoxins were deoxynivalenol (DON) (97.2%), nivalenol (40.4%) and deoxynivalenol-3-glucoside (33.4%), and mean contamination levels in positive samples were 86.7, 3.55 and 3.34 µg kg(-1), respectively. The obtained data were further used to estimate the daily intake of the local population, and indicated that wheat flour consumption contributes little to DON exposure. However, with the aim to keep the contamination levels under control and to establish a more precise evaluation of the mycotoxin burden in Shandong Province, more sample data from different harvest years and seasons are needed in the future.

Quantitative analysis and health risk assessment of polycyclic aromatic hydrocarbons in edible vegetable oils marketed in Shandong of China.

This work studies on the quantitative analysis and health risk assessment of polycyclic aromatic hydrocarbons (PAHs) in edible vegetable oils in Shandong, China. The concentrations of 15 PAHs in 242 samples were determined by high performance liquid chromatography coupled with fluorescence detection. The results indicated that the mean concentration of 15 PAHs in oil samples was 54.37 µg kg(-1). Low molecular weight PAH compounds were the predominant contamination. Especially, the carcinogenic benzo(a)pyrene (BaP) was detected at a mean concentration of 1.28 µg kg(-1), which was lower than the limit of European Union and China. A preliminary evaluation of human health risk assessment for PAHs was accomplished using BaP toxic equivalency factors and the incremental lifetime cancer risk (ILCR). The ILCR values for children, adolescents, adults, and seniors were all larger than 1 × 10(-6), indicating a high potential carcinogenic risk on the dietary exposed populations.

Fumonisins B1, B2 and B3 in corn products, wheat flour and corn oil marketed in Shandong province of China.

In this study a total of 522 samples were collected from Shandong province of China in 2014 and analysed for the occurrence of fumonisin B1 (FB1), FB2 and FB3 by isotope dilution ultrahigh performance liquid chromatography-tandem mass spectrometry. Fumonisins were detected in 98.1% of the corn products, with the average total level of 369.2 µg kg(-1). The individual average values of FB1, FB2 and FB3 in corn products were 268.3, 53.7 and 47.2 µg kg(-1), respectively. The simultaneous occurrence of FB1, FB2 and FB3 was observed in 76.7% of the corn products. Especially, the results demonstrated that the difference in the contamination levels for fumonisins in these three types of corn products was apparent. In addition, 6.2% of the wheat flour samples were contaminated with FB1, with concentrations ranging from 0.3 to 34.6 µg kg(-1). No FB2 or FB3 was detected in wheat flour. In corn oil samples no fumonisins were detected.