Road Injuries Associated With Cellular Phone Use While Walking or Riding a Bicycle or an Electric Bicycle: A Case-Crossover Study.

Vulnerable road users (pedestrians, bicyclists, and motorcyclists) account for an increasing proportion of traffic injuries. We used a case-crossover study design to examine the association between cell-phone usage and traffic injuries among pedestrians, bicyclists, and electric bicycle riders during the course of their travel. We studied 643 pedestrians, bike riders, and electric bike riders aged 10-35 years who were involved in a road injury, visited the emergency department in one of the 3 hospitals in Shanghai, China, in 2019, and owned a cell phone. Half of the participants (n = 323; 50.2%) had used a cell phone within 1 minute before the injury happened. A pedestrian's or rider's use of a mobile phone up to 1 minute before a road injury was associated with a 3-fold increase in the likelihood of injury (odds ratio = 3.00, 95% confidence interval: 2.04, 4.42; P < 0.001). The finding was consistent across subgroups by sex, occupation, reason for travel, mode of transportation, and location of injury. Use of a cell phone when walking or riding was associated with an increased risk of road injury. Measures should be taken to make people aware of this detrimental impact on the risk of road injury.

Increasing burden of stroke in China: A systematic review and meta-analysis of prevalence, incidence, mortality, and case fatality.

BACKGROUND: The epidemiology of stroke is evolving in China as the population undergoes demographic, lifestyle, and economic transitions. An updated review is pertinent to providing feedback on current, and in planning future, prevention and management strategies. AIMS: To identify high-quality epidemiological studies for quantifying the prevalence, incidence, mortality, and case fatality for stroke in China. METHODS: A search was undertaken across a range of bibliographic databases on 30 November 2021 without time limitation. Assessments were made of the risk of bias of the included studies. The outcomes were synthesized using a random-effects model. Subgroup analysis and meta-regression models were used to define the source of heterogeneity. RESULTS: Of 9407 identified records, 26 population-based studies were included. Due to significant heterogeneity across the studies, the original range for crude rates of indices was wide. The pooled annual prevalence was 1329.5/100,000 (95% confidence interval (CI) 713.6-2131.9, p < 0.001), incidence 442.1/100,000 (327.6-573.8, p < 0.001), mortality 154.1/100,000 (52.6-308.8, I2 = 100%, p < 0.001), and case fatality 35.8% (26.1% to 46.1%, I2 = 97%, p < 0.001). The prevalence and incidence of stroke have increased, but stroke-related case fatality has declined in China over recent decades. There are significant regional and rural-urban differences in incidence rates. CONCLUSION: Despite improved public health policies and healthcare delivery, the burden of stroke remains high in China. Further coordinated efforts are required in prevention and community care to offset the likelihood of further expansion in the absolute number of stroke cases in this large population.

CCL5 Suppresses Klotho Expression via p-STAT3/DNA Methyltransferase1-Mediated Promoter Hypermethylation.

Background: Enhanced inflammation and reduced Klotho are common features in chronic kidney disease (CKD). Inflammation induces DNA hypermethylation. This study assessed the performance of inflammatory marker C-C motif chemokine 5 (CCL5) in epigenetic regulation of Klotho expression. Methods: Fifty CKD patients and 25 matched controls were enrolled, and serum CCL5 level, sKlotho level, and DNA methylation were evaluated in these subjects. A renal interstitial fibrosis (RIF) model with CKD was induced in mice via unilateral ureteral obstruction (UUO) in vivo and human proximal tubular epithelial (HK-2) cells treated with CCL5 in vitro. 5-aza-2'-deoxycytidine (5-Aza), a DNA methyltransferase inhibitor was given to UUO mice. Hematoxylin and eosin (HE) and Masson trichrome staining were adopted to evaluate renal pathological changes. Methylation-specific PCR was performed to assess DNA methylation of Klotho promoter in the peripheral blood leucocytes (PBLs) from CKD patients and obstructive kidney from UUO mice. CCL5, Klotho, and DNA methyltransferases (DNMTs) were determined by ELISAs, immunofluorescence, or western blotting. HK-2 cells were exposed to CCL5 with or without 5-Aza and stattic, a p-signal transducer and activator of transcription 3 (STAT3) inhibitor, and expressions of p-STAT3, DNMT1, and Klotho were determined by western blotting. Results: CCL5 upregulation concomitant with Klotho downregulation in serum and global DNA methylation in PBLs were observed in CKD samples. UUO contributed to severe renal interstitial fibrosis and enhanced expressions of fibrotic markers. Moreover, UUO increased the CCL5 level, induced Klotho promoter methylation, suppressed Klotho level, activated p-STAT3 signaling, and upregulated DNMT1 level. A similar observation was made in HK-2 cells treated with CCL5. More importantly, 5-Aza inhibited UUO-induced Klotho hypermethylation, reversed Klotho, downregulated p-STAT3 expressions, and ameliorated RIF in vivo. The consistent findings in vitro were also obtained in HK-2 cells exposed to 5-Aza and stattic. Conclusion: The CCL5/p-STAT3/DNMT1 axis is implicated in epigenetic regulation of Klotho expression in CKD. This study provides novel therapeutic possibilities for reversal of Klotho suppression by CKD.

An efficient Fe2+ assisted UV/electrogenerated-chlorine process for carbamazepine degradation: The role of Fe(IV).

To improve the performance and solve the restrictions of UV/chlorine process (e.g., the narrow pH application range and high disinfection by-products (DBPs) formation), a Fe2+ assisted advanced oxidation process with electrochemically generated chlorine (UV/E-Cl/Fe2+) was proposed for carbamazepine (CBZ) degradation, which eliminated CBZ (5 mg/L) within 4 min under the optimal conditions. Compared with UV/electro-generated chlorine (UV/E-Cl) and anodic oxidation-chlorination/Fe2+ (AO-Cl/Fe2+) processes, the apparent first-order kinetics constant in UV/E-Cl/Fe2+ increased by 2.56 and 3.18 times respectively, and the energy consumption was lower (1.15 kWh/m3-log). Simultaneously, the pH application range could be expanded to 9, and DBPs formed in this process were 17.1% less than those in UV/E-Cl. Through quenching tests, electron paramagnetic resonance (EPR) experiments, measurement of •OH concentration, quantification of methyl phenyl sulfoxide (PMSO) and benzosulfone (PMSO2) and processes comparison, possible CBZ degradation pathways and mechanism of UV/E-Cl/Fe2+ were proposed, in which Fe(IV) played the dominant role in the early stage, while the production of radicals (i.e., •OH and Cl•) was enhanced with the increase of chlorine generation, accelerating the CBZ removal. Furthermore, this process demonstrated wide application prospect in treating various contaminants and real wastewaters. In conclusion, this study offers an effective and energy-efficient method for organic pollutants degradation.

Correlation Between Soluble Klotho and Vascular Calcification in Chronic Kidney Disease: A Meta-Analysis and Systematic Review.

Background: The correlation between soluble Klotho (sKlotho) level and vascular calcification (VC) in patients with chronic kidney disease (CKD) remains controversial. Using meta-analysis, we aimed to address this controversy and assess the feasibility of applying sKlotho as a biomarker for VC. Methods: Medical electronic databases were thoroughly searched for eligible publications on the association between sKlotho level and VC in CKD patients. Effectors, including correlation coefficients (r), odds ratios (ORs), hazard ratio (HR) or ß-values, and 95% confidence intervals (CIs) were extracted and combined according to study design or effector calculation method. Pooled effectors were generated using both random-effects models and fixed-effects models according to I 2-value. Origin of heterogeneity was explored by sensitivity analysis and subgroup analysis. Results: Ten studies with 1,204 participants from a total of 1,199 publications were eligible and included in this meta-analysis. The combined correlation coefficient (r) was [-0.33 (-0.62, -0.04)] with significant heterogeneity (I 2 = 89%, p < 0.001) based on Spearman correlation analysis, and this significant association was also demonstrated in subgroups. There was no evidence of publication bias. The combined OR was [3.27 (1.70, 6.30)] with no evidence of heterogeneity (I 2 = 0%, p = 0.48) when sKlotho was treated as a categorical variable or [1.05 (1.01, 1.09)] with moderate heterogeneity (I 2 = 63%, p = 0.10) when sKlotho was treated as a continuous variable based on multivariate logistic regression. No significant association was observed and the pooled OR was [0.29 (0.01, 11.15)] with high heterogeneity (I 2 = 96%, p < 0.001) according to multivariate linear regression analysis. There was an inverse association between sKlotho and parathyroid hormone levels. The combined coefficient (r) was [-0.20 (-0.40, -0.01)] with significant heterogeneity (I 2 = 86%, p < 0.001), and without obvious publication bias. No significant association was found between sKlotho and calcium or phosphate levels. Conclusion: There exists a significant association between decreased sKlotho level and increased risk of VC in CKD patients. This raises the possibility of applying sKlotho as a biomarker for VC in CKD populations. Large, prospective, well-designed studies or interventional clinical trials are required to validate our findings.

Comprehensive treatment of marine aquaculture wastewater by a cost-effective flow-through electro-oxidation process.

The effective treatment of marine aquaculture wastewater is of great significance to protect marine environment and marine organisms. This study validated the feasibility of the comprehensive removal of NH4+-N, NO2--N, COD and P, as well as disinfection and antibiotics removal from marine aquaculture wastewater by electrochemical oxidation (EO), comparing the performance and energy consumption with that by electro-peroxone (EP) and electro-Fenton (EF) process. Due to the formation of more free chlorine, the removal of NH4+-N and COD was in order of EO â‰« EP > EF. A new flow-through EO reactor was adopted, which was found enhanced the formation rate of free chlorine and degradation rate of pollutants, and thus performed better than that of flow-by reactor and batch reactor. By this flow-through EO process, the removal of NH4+-N and NO2--N could reach >90% and their concentrations after treatment both meet the Water Drainage Standard for Sea Water Mariculture (SC/T 9103-2007). Meanwhile, the process had a good bactericidal performance with a lg(c/c0) of -5.6. At the same time, antibiotics such as sulfadimidine (SMT) and norfloxacin (NOR) could be completely removed. The energy consumption was only 0.054 kWh/g NH4+-N (0.27 kWh/m3), which was far more cost-effective than other oxidative processes. The new flow-through EO process has great practical application prospects for the comprehensive removal of multiple pollutants and sterilization from marine aquaculture wastewater.

The protective effect of hydrogen sulfide on systemic sclerosis associated skin and lung fibrosis in mice model.

BACKGROUD: Systemic sclerosis (SSc) caused fibrosis can be fatal and it still lack of effective treatment. Hydrogen sulfide (H2S) appears to be an attractive therapeutic candidates. This study aimed to investigate the protective effect of H2S on SSc-associated skin and lung fibrosis. METHODS: We developed a model of SSc by subcutaneous injecting BLM to female C3H mice. The mice received daily subcutaneous injections of NaHS (56 and 112 µg/kg), an H2S donor. On days 7, 28, and 42, the mice were killed and blood samples were collected to measure the plasma H2S concentration, the skin and lung tissues was harvested for microscopic examination, immunohistochemistry and quantify biological parameters (hydroxyproline content, RT-qPCR and Western blot). RESULTS: In model group, the dermis of skin tissues at different time points gradually thickened, collagen deposition increased. The lung tissues presented pathological changes such as obvious inflammatory cell infiltration, increased collagen deposition and the plasma H2S concentrations points significantly decreased. Administration of NaHS markedly decreased the biomarkers of fibrosis such as α-smooth muscle actin, collagen-I, collagen-III, fibronectin, transforming growth factor-ß1, Smad2/3 phosphorylation and inflammation including the marker protein of monocyte/macrophage and monocyte chemoattractant protein-1 in the lung. Compared to the low dose group, the expression in the high dose group have decreased trend, but the difference was not significant. CONCLUSION: We demonstrate the beneficial effects of H2S on SSc-associated skin and lung fibrosis. H2S may be a potential therapy against this intractable disease.

Hydrogen Sulfide: A Therapeutic Candidate for Fibrotic Disease?

Fibrotic diseases including chronic kidney disease, liver cirrhosis, idiopathic pulmonary fibrosis, and chronic disease account for 45% mortality in the developed countries and pose a great threat to the global health. Many great targets and molecules have been reported to be involved in the initiation and/or progression of fibrosis, among which inflammation and oxidative stress are well-recognized modulation targets. Hydrogen sulfide (H2S) is the third gasotransmitter with potent properties in inhibiting inflammation and oxidative stress in various organs. Recent evidence suggests that plasma H2S level is decreased in various animal models of fibrotic diseases and supplement of exogenous H2S is able to ameliorate fibrosis in the kidney, lung, liver, and heart. This leads us to propose that modulation of H2S production may represent a promising therapeutic venue for the treatment of a variety of fibrotic diseases. Here, we summarize and discuss the current data on the role and underlying mechanisms of H2S in fibrosis diseases related to heart, liver, kidney, and other organs.

Extraction and antioxidant activity of flavonoids of Morus nigra.

Morus nigra has a long history of medicinal use in Chinese medicine, but the study on it is limited, the flavonoids are one of the main biological active substances. In this study, the Morus nigra flavonoids were extracted by ultrasonic and antioxidant activities both in vitro and in vivo were measured. The results showed that hydroxyl radicals clearance rate and superoxide radical anion clearance rate in vitro increased with the concentration of the total flavonoids in the range of 0-1.05 mg/mL and the maximum clearance rate was 80.33% and 87.69%, respectively. After mice were treated with flavonoids, the content of malonaldehyde (MDA) in serum and liver decreased; the activities of superoxide dismutase (SOD) in serum and liver, catalase (CAT) in liver and glutathione peroxidase (GSH-PX) in blood and liver increased; Langhans cells increased in spleen. These results revealed that the Morus nigra flavonoids possessed strong antioxidant activity.

Research progress on assessment of parental ability to prevent child injury / 中国学校卫生

Objective@#To review the articles evaluating parental ability on child injury prevention and to provide suggestions for developing assessment index for parental ability on child injury prevention.@*Methods@#Relevant studies were retrieved from the Chinese Biomedical Literature Database (CBM), Wanfang, CNKI, VIP, PubMed, Medline, Springer, and Web of Science, and were reviewed based on instruments, contents, as well as reliability and validity of instruments.@*Results@#A total of 47 articles were included for analysis. The methods for assessment mainly include quantitative and qualitative investigation, mainly quantitative surveys through scales or questionnaires. Assessment contents mainly included parental knowledge, attitudes and practice on child injury prevention(44 papers), as well as home safety(3 papers).The evaluation object mainly concentrated on parents of preschool children. A small part of studies tested the reliability and validity of the instruments in quantitative investigations.The reliability test indexes included retest reliability and Kronbach coefficient, and the validity test indexes included content validity, structure validity and scale validity.@*Conclusion@#There is a lack of assessment tools for evaluating parents ability on child injury prevention in Chinese background. The development of corresponding assessment tools should consider the characteristics of children in different age groups, injury types, as well as its reliability and validity.

Development of Index System for Assessing Parent s Ability on Child Injury Prevention by Delphi consultation / 中国学校卫生

Objective@#To construct and determine the weight of Index System for Assessing Parent s Ability on Child Injury Prevention, and to provide the basis for childhood injury intervention in family.@*Methods@#Twenty four experts majored in related fields were invited to participate in Delphi consultation. The final index system was constructed according to the consulting results and the weight of primary and secondary indicators were calculated.@*Results@#The final index system consisted of 5 subscales corresponding to 5 age groups: 0,1-2,3-5,6-11 and 12-17 years old. Each scale included 4 primary indicators and 11 secondary indicators. The weight of primary indicators obtained by analytic hierarchy process is 0.28 for "environment", 0.16 for "product", 0.31 for "behaviors and skills", and 0.25 for "psychology". The highest weight of secondary indicators for "environment", "product" and "behaviors and skills" was "water area", while the top secondary indicators for "psychology" included "parental style""emotional control" "family atmosphere", with all indicators weighted higher than 0.2.@*Conclusion@#The Index System for Assessing Parent s Ability on Child Injury Prevention by Delphi consultation is comprehensive in content, and with the focus on parental behaviors and skills on injury prevention.

Dose-response relationship between emotional state and anxiety disorder among primary students / 中国学校卫生

Objective@#To explore the dose-response relationship between duration of emotional experience of primary school students and the intensity of anxiety disorders, and to understand the risk of anxiety disorders corresponding to different emotional state levels.@*Methods@#A total of 7 152 primary students from grade 3 to 5 were investigated with questionnaire survey from 16 public primary schools, by using the Screen for Child Anxiety Related Emotional Disorder (SCARED) and Positive Affect and Negative Affect Scale.@*Results@#The prevalence of anxiety disorders was 19.91%, among which the prevalence rates of anxiety disorders in boys and girls were 19.41% and 20.43%, respectively. After adjusting for gender, grade, household register, the only child, parental marital status, parental occupation, parental educational level, family financial level, serving as a class leader, receiving special training or counseling in sports and art, and being bullied, the risk of anxiety disorder in children with positive emotions lasting for 7-16 days, 17-24 days and >24 days was lower compared to those with positive emotions lasting for less than 6 days(P<0.05); the risk of anxiety disorder in children with negative emotions lasting for 0.27-0.93 day, 0.94-2 days and >2 days was higher compared to those with negative emotions lasting less than 0.26 day(P<0.05). Restricted cubic spline analysis showed that the duration of emotional state and anxiety disorder showed a significant non-linear dose-response relationship (non-linear test, P<0.01), that is, as the number of days of positive emotions increases, the risk of anxiety disorder continues to decrease, and as the number of days of negative emotions increases, the risk of anxiety disorder continues to increase.@*Conclusion@#There is a significant dose-response relationship between the duration of the emotional state of primary school students and the prevalence of anxiety disorders. Acquirement and maintain positive emotions m be an important entry point for mental health promotion among primary school students.