Exposure level of neonicotinoid pesticides and their metabolites in pregnant women in the suburb of Shanghai / 中华预防医学杂志

In 2021, a total of 151 pregnant women were selected from the suburb of Shanghai. A questionnaire survey was conducted to obtain data about maternal age, gestational week, total annual household income, education level and passive smoking among pregnant women and one spot urine was collected. The concentrations of eight neonicotinoid pesticides and four metabolites in urine were measured by ultra-high performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry. The differences in detection frequencies and concentrations of neonicotinoid pesticides and their metabolites among pregnant women with different characteristics were compared, and the influencing factors of the detection of neonicotinoid pesticides in urine were analyzed. The results showed that at least one neonicotinoid pesticide was detected in 93.4% (141 samples) of urine samples. The detection frequencies of N-desmethyl-acetamiprid, clothianidin, thiamethoxam, and N-desmethyl-clothianidin were high, about 78.1% (118 samples), 75.5% (114 samples), 68.9% (104 samples), and 44.4% (67 samples), respectively. The median concentration of the sum of all neonicotinoid pesticides was 2.66 μg/g. N-desmethyl-acetamiprid had the highest detection concentration with a median concentration of 1.04 μg/g. A lower urinary detection frequency of imidacloprid and its metabolites was seen in pregnant women aged 30-44 years [OR (95%CI): 0.23 (0.07-0.77)]. A higher detection frequency of clothianidin and its metabolites was seen in pregnant women with per capita annual household income≥100 000 yuan [OR (95%CI): 6.15 (1.56-24.28)]. There was widespread exposure to neonicotinoid pesticides and their metabolites in pregnant women from the suburb of Shanghai, which might pose potential health risks to pregnant women, and maternal age and household income were potential influencing factors of the exposure to neonicotinoid pesticides.

Pollution， human exposure and harmful effects of neonicotinoid pesticides / 上海预防医学

Neonicotinoid is a kind of neuroactive pesticide， and it has become the most widely used pesticide in the world. In recent years， neonicotinoid has been detected in the environment and food， suggesting that human can be exposed to this kind of pesticide through drinking water， ingestion and respiration， which poses potential health hazards to human. However， there is no comprehensive report on the pollution level of neonicotinoid pesticides in the environment and food and the impact on human health. In this paper， the pollution status， population exposure level and potential health risks of neonicotinoid pesticides in water， air and food were reviewed. We found that neonicotinoid residues are widespread in fruits and vegetables， of which imidacloprid has the highest detection rate. Except for a few samples with excessive neonicotinoid detection， the detection level in most samples did not exceed national food safety standards. A variety of neonicotinoid pesticides have been detected in the air， surface water， tap water and drinking water. External exposure studies in the population have shown that ingestion is the main route of exposure to neonicotinoid， and the external exposure level is much lower than its chronic reference dose. The internal exposure study mainly detected the concentration of neonicotinoid pesticides and their metabolites in urine. A variety of neonicotinoid pesticides and their metabolites are detected in urine， and the concentration range is ng/ml level. Internal exposure studies found that the detection rate of thiamethoxam and dinotefuran in urine is higher， and the detection rate of neonicotinoid in Asian countries is higher than that in European and American countries. Occupational exposure studies found that neonicotinoid exposure levels increased after pesticide spraying， and the exposure levels in rural areas where pesticides were commonly used were higher than those in neighboring urban areas. Animal experiments have found that neonicotinoid pesticides have reproductive toxicity， genetic toxicity， neurotoxicity， immunotoxicity， liver toxicity and nephrotoxicity to non-target organisms. Cell experiments suggest that neonicotinoid is an endocrine disruptor. The symptoms of acute exposure in humans are related to the exposure dose， route and physical condition of the exposed person， which ranges from mild symptoms （nausea， vomiting， headache and diarrhea） to death. Population epidemiological studies have shown that chronic exposure to neonicotinoid pesticides is associated with adverse health effects in humans such as neonatal tetralogy of Fallot， anencephaly， and adverse mental symptoms.

An investigation of a family COVID-19 cluster / 上海预防医学

Objective To investigate epidemic characteristics of a family cluster of COVID-19, and to provide reference in improving the criteria for exclusion diagnosis and medical observation of close contacts. Methods Field epidemiological method was used to investigate the cases and close contacts of a family cluster of COVID-19 in Pudong New Area.Descriptive analysis was conducted on epidemiological data.Real-time fluorescence quantitative RT-PCR was used to detect 2019-nCoV nucleic acid in the respiratory tract specimens. Results There were two confirmed cases and one suspected case in the family cluster.The source of infection was Case 1 with a living history in Wuhan, Hubei Province.Case 2 and Case 3, as close contacts, received 14-day medical observation in a centralized isolation site.Case 2 showed symptoms 4 days after the onset of Case 1, and the diagnosis of COVID-19 was excluded after two negative nucleic acid tests during the isolation period.However, after the expiration of isolation, Case 2 was diagnosed positively for COVID-19 and Case 3 was suspected first and then excluded. Conclusion Daily close contact is critical for COVID-19 transmission and is the major cause of family clustering.Once the close contacts show symptoms, diagnosis should be made by combining the results of nucleic acid test, chest CT test, serological test, etc.We suggest to grade the risk of infection for close contacts, and to strengthen the standard of medical observation for close contacts with high risk of infection.

Viral etiology of 363 elderly people with influenza-like illness and severe acute respiratory infections in Pudong New Area, Shanghai / 上海预防医学

Objective To understand the epidemiological characteristics of common respiratory viruses among influenza-like illness (ILI) and severe acute respiratory infections (SARI) in Pudong New Area, Shanghai , so as to help estimate the disease burden and conduct the valuable control strategies . Methods Respiratory specimen ( throat swab or sputum ) from cases older than 65 years old with ILI/SARI were collected from outpatient and inpatient settings in four sentinel hospitals in Pudong New Area . Each specimen was tested by multiplex PCR for eight target viral etiologies , including influenza virus , human rhinoviruses ( HRV ) , human para-influenza virus ( PIV ) , adenoviruses ( ADV ) , respiratory syncytial virus ( RSV ) , human metapneumovirus ( hMPV ) , human coronavirus ( hCoV ) and human bocavirus ( hBoV) .Chi-square tests or Fisher's Exact Test were used to compare and analyze . Results From January 1st, 2014 to June 30st, 2016, a total of 363 elderly cases with ILI/SARI were enrolled, with 202 (55.65%) male and a median age of 70 years old.142(39.12%) patients were detected posi-tive for any one of the eight viruses.Influenza was the predominant virus (20.94%, 76/363), with the positive proportion of ( 29 .83%) among ILI cases and ( 12 .09%) among SARI cases .The Influenza infection presented two seasonal peaks in winter ( December to February ) and summer ( July to September ) . Conclusion Influenza is identified as the leading viral pathogen both among ILI and SARI cases older than 65 years old, and two seasonal epidemic peaks areobserved in Shanghai .Influenza vacci-nation strategy should be advocated for the elderly population in Shanghai .

Meta-analysis of supplemented Zhenwu decoction for treating congestive heart-failure / 中国中药杂志

The paper was to systematically evaluate the clinical efficacy of supplemented Zhenwu decoction for treating congestive heart-failure. Three foreign language databases including the Cochrane Library, PubMed, EMbase and four Chinese databases including CBM, CNKI, VIP and Wanfang Database were retrieved from their establishment to July 2016 for all randomized control trials(RCTs) on supplemented Zhenwu decoction in treatment of congestive heart-failure. The references in the included RCTs were also traced. Literature selection and information extraction was completed and screened by two independent reviewers, and Meta-analysis was performed by using RevMan 5.3 software. Totally 13 clinical RCTs were included in this study, involving 982 patients. Meta-analysis results showed that as compared with western medicine alone, the total effective rate of heart function could be improved by applying supplemented Zhenwu decoction based on the western medicine[RR=1.16, 95%CI (1.10, 1.22)], with increased ejection fraction[MD=7.12, 95%CI= (3.98,10.27)], increased cardiac activity index[MD=6.92, 95%CI (5.21, 8.62)], increased stroke volume [MD=11.18, 95%CI (6.04, 16.33)], and increased heart index[MD=0.50, 95%CI (-0.29, 1.30)]. Supplemented Zhenwu decoction combined with routine treatment could improve the clinical symptoms of congestive heart-failure. However, due to the low quality in methodology and reports as well as small sample size of included RCTs in this study, more randomized double-blind trials with a large sample size are still required to verify the efficiency of supplemented Zhenwu decoction for treating congestive heart-failure.

A case-control study on association of SULT1A1 polymorphism, smoked meat intake with breast cancer risk / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the association of smoked meat intake, SULT1A1 polymorphism as well as their combined effects with breast cancer risk.</p><p><b>METHODS</b>A total of 400 newly diagnosed breast cancer cases from a cancer hospital in Sichuan province and 400 healthy controls from participants of physical examination in a hospital in Chengdu city were recruited from May 2007 to July 2009. A valid questionnaire was designed to collect their demographic characteristics and breast cancer risk factors. Daily intake of foods was collected using semi-quantitative frequency questionnaire and then the daily intake of smoked meat was calculated and transformed to energy-adjusted smoked meat intake by the residual method. Gene sequencing was used to analyze SULT1A1 Arg213His genotypes. Multivariable conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95%CIs).</p><p><b>RESULTS</b>The energy-adjusted daily intake of smoked meat (Median (P₂₅, P₇₅)) was 8.65 (3.63, 18.44) g/d in cases and 4.44 (0.19, 8.71) g/d in controls. The frequency of SULT1A1 variant allele was 14.75% (59/400) among cases and 12.75% (51/400) among controls. High energy-adjusted daily intake of smoked meat (≥ 4.44 g/d) was significantly associated with breast cancer risk among premenopausal (OR = 2.31, 95%CI: 1.46 - 3.66) and postmenopausal subjects (OR = 3.13, 95%CI: 1.89 - 5.17). High energy-adjusted daily intake of smoked meat combined with carrying SULT1A1 variant allele elevated breast cancer risk among premenopausal (OR = 3.31, 95%CI: 1.66 - 6.62) and postmenopausal subjects (OR = 3.81, 95%CI: 1.79 - 8.10).</p><p><b>CONCLUSION</b>High smoked meat intake contributes to high risk of breast cancer. SULT1A1 variant allele increases breast cancer risk among subjects who were exposed to high smoked meat intake.</p>

Polymorphic catechol-O-methyltransferase gene, soy isoflavone intake and breast cancer in postmenopausal women: a case-control study / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Genetic polymorphism Val158Met of catechol-O-methyltransferase (COMT) may contribute to estrogen-induced carcinogenesis of breast cancer. Soy isoflavones possesses chemical structure similar to endogenous estrogen and may promote the carcinogenesis of breast cancer. This study was to investigate the relationship between the polymorphism of COMT, soy isoflavones, and breast cancer in postmenopausal women.</p><p><b>METHODS</b>In total, 176 patients newly diagnosed histopathologically with breast cancer were recruited from May 2007 to July 2009, and 176 age-matched cancer-free women as controls were selected from a community-based physical check-up population at the same period. The food-frequency questionnaire was used to collect information on soy food intake. Allele-specific polymerase chain reaction (AS-PCR) was employed to analyze genetic polymorphism Val158Met of COMT. Adjusted odd ratios (aORs) and 95% confidence intervals (95% CI) were estimated by multivariable nonconditional logistic regression.</p><p><b>RESULTS</b>The proportion of susceptible genotype (COMT-LL) in breast cancer patients was significantly higher than that in the controls. After adjusting selected risk factors, the aOR and 95% CI of COMT-LL were 3.14 (1.48-6.66) as compared with those of COMT-HH genotype. The intake of soy isoflavones had a negative correlation with breast cancer in a dose-dependent manner (Chi2 = 28.26, P < 0.001). The women with high intake of soy isoflavones (> or = 16.26 mg/d) and carrying susceptible genotype (COMT-LL), as compared with the women carrying the COMT-HH + COMT-HL genotypes and consuming low level of soy isoflavones (< 16.26 mg/d), had no significantly increased risk for breast cancer [ aOR (95% CI) = 1.66 (0.52-5.24)].</p><p><b>CONCLUSIONS</b>In postmenopausal women, carrying COMT-LL genotype may increase the risk for breast cancer, and soy isoflavones intake may protect them from breast cancer. But there may be no interaction between intake of soy isoflavones and COMT-LL genotype.</p>

Relationship between estrogen-biosynthesis gene (CYP17, CYP19, HSD17beta1) polymorphisms and breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the relationship between the polymorphism of estrogen-biosynthesis genes (CYP17, CYP19, HSD17beta1) and risk of breast cancer.</p><p><b>METHODS</b>A matched case-control study was designed. From May 2007 to July 2008, 200 pairs of subjects with and without breast cancer were enrolled, who were matched by age and menstruation status. Demographical characteristics, dietary factors and reproductive factors were investigated by questionnaire. CYP17 locus 1931 (T-->C), CYP19 codon 264 (Arg-->Cys) and HSD17beta1 locus 1954 (A-->G) were identified by AS-PCR (allele-specific PCR). The gene-gene interaction were analyzed with the MDR model (multifactor dimensionality reduction). Based on the results of MDR model, an unconditional logistic regression model was simulated to estimate the ORs of interaction factors and other risk factors.</p><p><b>RESULTS</b>The main effect of CYP17, CYP19 and HSD17beta1 susceptible genotypes were not correlated to breast cancer (OR approximately 1, P > 0.05). The positive interaction effect between CYP17 (T 1931C) and HSD17beta1 (A1954G) was discovered by MDR model with a statistically significant difference (Sign test, P = 0.05). The model's testing balance accuracy was 56.00%, and crossing validation consistency was 10/10. Multivariable unconditional logistic regression showed that after adjusting BMI, intake of estrogen, age of first birth, number of abortion and period of breast feeding, the interaction item of CYP17 (T1931C) and HSD17beta1 (A1954G) was strongly and positively correlated to breast cancer (OR = 2.52, 95%CI = 1.54 to 4.11).</p><p><b>CONCLUSION</b>The estrogen-biosynthesis genes CYP17 (T1931C) and HSD17beta1 (A1954G) polymorphism may jointly increase the risk of breast cancer.</p>