Unveiling causal connections: Long-term particulate matter exposure and type 2 diabetes mellitus mortality in Southern China.

Evidence of the potential causal links between long-term exposure to particulate matters (PM, i.e., PM1, PM2.5, and PM1-2.5) and T2DM mortality based on large cohorts is limited. In contrast, the existing evidence usually suffers from inherent bias with the traditional association assessment. A prospective cohort of 580,757 participants in the southern region of China were recruited during 2009 and 2015 and followed up through December 2020. PM exposure at each residential address was estimated by linking to the well-established high-resolution simulation dataset. Hazard ratios (HRs) were calculated using time-varying marginal structural Cox models, an established causal inference approach, after adjusting for potential confounders. During follow-up, a total of 717 subjects died from T2DM. For every 1 µg/m3 increase in PM2.5, the adjusted HRs and 95% confidence interval (CI) for T2DM mortality was 1.036 (1.019-1.053). Similarly, for every 1 µg/m3 increase in PM1 and PM1-2.5, the adjusted HRs and 95% CIs were 1.032 (1.003-1.062) and 1.085 (1.054-1.116), respectively. Additionally, we observed a generally more pronounced impact among individuals with lower levels of education or lower residential greenness which as measured by the Normalized Difference Vegetation Index (NDVI). We identified substantial interactions between NDVI and PM1 (P-interaction = 0.003), NDVI and PM2.5 (P-interaction = 0.019), as well as education levels and PM1 (P-interaction = 0.049). The study emphasizes the need to consider environmental and socio-economic factors in strategies to reduce T2DM mortality. We found that PM1, PM2.5, and PM1-2.5 heighten the peril of T2DM mortality, with education and green space exposure roles in modifying it.

Dynamics of binding interactions of TDP-43 and RNA: An equally weighted multiscale elastic network model study.

Transactive response DNA binding protein 43 (TDP-43), an alternative-splicing regulator, can specifically bind long UG-rich RNAs, associated with a range of neurodegenerative diseases. Upon binding RNA, TDP-43 undergoes a large conformational change with two RNA recognition motifs (RRMs) connected by a long linker rearranged, strengthening the binding affinity of TDP-43 with RNA. We extend the equally weighted multiscale elastic network model (ewmENM), including its Gaussian network model (ewmGNM) and Anisotropic network model (ewmANM), with the multiscale effect of interactions considered, to the characterization of the dynamics of binding interactions of TDP-43 and RNA. The results reveal upon RNA binding a loss of flexibility occurs to TDP-43's loop3 segments rich in positively charged residues and C-terminal of high flexibility, suggesting their anchoring RNA, induced fit and conformational adjustment roles in recognizing RNA. Additionally, based on movement coupling analyses, it is found that RNA binding strengthens the interactions among intra-RRM ß-sheets and between RRMs partially through the linker's mediating role, which stabilizes RNA binding interface, facilitating RNA binding efficiency. In addition, utilizing our proposed thermodynamic cycle method combined with ewmGNM, we identify the key residues for RNA binding whose perturbations induce a large change in binding free energy. We identify not only the residues important for specific binding, but also the ones critical for the conformational rearrangement between RRMs. Furthermore, molecular dynamics simulations are also performed to validate and further interpret the ENM-based results. The study demonstrates a useful avenue to utilize ewmENM to investigate the protein-RNA interaction dynamics characteristics.

aPRBind: protein-RNA interface prediction by combining sequence and I-TASSER model-based structural features learned with convolutional neural networks.

MOTIVATION: Protein-RNA interactions play a critical role in various biological processes. The accurate prediction of RNA-binding residues in proteins has been one of the most challenging and intriguing problems in the field of computational biology. The existing methods still have a relatively low accuracy especially for the sequence-based ab-initio methods. RESULTS: In this work, we propose an approach aPRBind, a convolutional neural network-based ab-initio method for RNA-binding residue prediction. aPRBind is trained with sequence features and structural ones (particularly including residue dynamics information and residue-nucleotide propensity developed by us) that are extracted from the predicted structures by I-TASSER. The analysis of feature contributions indicates the sequence features are most important, followed by dynamics information, and the sequence and structural features are complementary in binding site prediction. The performance comparison of our method with other peer ones on benchmark dataset shows that aPRBind outperforms some state-of-the-art ab-initio methods. Additionally, aPRBind can give a better prediction for the modeled structures with TM-score≥0.5, and meanwhile since the structural features are not very sensitive to the refined 3D structures, aPRBind has only a marginal dependence on the accuracy of the structure model, which allows aPRBind to be applied to the RNA-binding site prediction for the modeled or unbound structures. AVAILABILITY AND IMPLEMENTATION: The source code is available at https://github.com/ChunhuaLiLab/aPRbind. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Unilateral biportal endoscopic laminectomy with lateral mass screw fixation for treating cervical spinal stenosis.

BACKGROUND: The unilateral biportal endoscopic (UBE) technique is less invasive and has a faster recovery time than open surgery. Compared with the uniportal technique, the biportal technique has a larger field of vision and a wider operation range. METHOD: We attempted the posterior UBE approach for cervical stenosis at the C4-C6 levels. UBE decompression of C4-C6 with unilateral lateral mass screw fixation at the C4-C5 levels was performed under general anesthesia. CONCLUSIONS: We successfully performed cord decompression at the C4-C6 levels using the UBE technique. This approach could be used as an alternative method to treat cervical stenosis with instability.

Analyses on clustering of the conserved residues at protein-RNA interfaces and its application in binding site identification.

BACKGROUND: The maintenance of protein structural stability requires the cooperativity among spatially neighboring residues. Previous studies have shown that conserved residues tend to occur clustered together within enzyme active sites and protein-protein/DNA interfaces. It is possible that conserved residues form one or more local clusters in protein tertiary structures as it can facilitate the formation of functional motifs. In this work, we systematically investigate the spatial distributions of conserved residues as well as hot spot ones within protein-RNA interfaces. RESULTS: The analysis of 191 polypeptide chains from 160 complexes shows the polypeptides interacting with tRNAs evolve relatively rapidly. A statistical analysis of residues in different regions shows that the interface residues are often more conserved, while the most conserved ones are those occurring at protein interiors which maintain the stability of folded polypeptide chains. Additionally, we found that 77.8% of the interfaces have the conserved residues clustered within the entire interface regions. Appling the clustering characteristics to the identification of the real interface, there are 31.1% of cases where the real interfaces are ranked in top 10% of 1000 randomly generated surface patches. In the conserved clusters, the preferred residues are the hydrophobic (Leu, Ile, Met), aromatic (Tyr, Phe, Trp) and interestingly only one positively charged Arg residues. For the hot spot residues, 51.5% of them are situated in the conserved residue clusters, and they are largely consistent with the preferred residue types in the conserved clusters. CONCLUSIONS: The protein-RNA interface residues are often more conserved than non-interface surface ones. The conserved interface residues occur more spatially clustered relative to the entire interface residues. The high consistence of hot spot residue types and the preferred residue types in the conserved clusters has important implications for the experimental alanine scanning mutagenesis study. This work deepens the understanding of the residual organization at protein-RNA interface and is of potential applications in the identification of binding site and hot spot residues.

Association between body weight status and suicidal ideation among Chinese adolescents: the moderating role of the child's sex.

PURPOSE: Suicidality (ranging from suicidal ideation to suicidal attempts and completed suicide) is a major and preventable public health concern, and body weight is considered a modifiable factor which might be helpful to the early risk assessment of suicidal ideation. This study aimed to comprehensively evaluate the association of body weight status with suicidal ideation across sex among Chinese adolescents. METHODS: Data were drawn from the 2015 National School-based Chinese Adolescents Health Survey, and 54,640 students' questionnaires were completed and qualified for the survey. Body mass index z scores were calculated and categorized into four levels: underweight (less than the 5th percentile for sex and age), normal weight (between the 5th and 85th percentile), overweight (between the 85th and 95th percentile), and obese (above the 95th percentile). RESULTS: Of the total sample, 47.3% (25,852) were boys. The weighted prevalence of suicidal ideation among Chinese adolescents is 15.7% (14.6% in boys and 17.3% in girls). After adjusting for demographics, smoking, drinking, and depressive symptoms, our final multivariate logistic regression models demonstrated that only boys identified as underweight (Adjusted odds ratio [AOR] = 1.23, 95% CI = 1.06-1.44) or obese (AOR = 1.19, 95% CI = 1.02-1.38) were at a higher risk of suicidal ideation. Additionally, the association between weight status and suicidal ideation among boys might be moderated by academic pressure, smoking, and depressive symptoms. CONCLUSIONS: There was a significant J-shaped association between relative body weight and suicidal ideation in boys. The child's sex should be taken into consideration when developing interventions against unhealthy weight and suicidal ideation.

Liposome-loaded thermo-sensitive hydrogel for stabilization of SN-38 via intratumoral injection: optimization, characterization, and antitumor activity.

Main challenges of the clinical use of 7-ethyl-10-hydroxycamptothecin (SN-38) are its facile transition between the active lactone form (SN-38 A) and the inactive carboxylate form (SN-38I) under physiological conditions and its low solubility. The purpose of this study was to develop a thermo-sensitive hydrogel system with acidic SN-38 liposomes (SN-38-Lip-Gel) for local chemotherapy to solve these problems and to evaluate its antitumor activity and tissue distribution in tumor-bearing mice. A study of structural conversion between SN-38I and SN-38 A under various pH conditions indicated that acidic solution could inhibit the conversion. Namely, a preparation with low pH was essential to stabilize lactone form of SN-38. SN-38-Lip-Gel had an appropriate gelation time (GT) at 25/37 °C. The particle size of SN-38-Lip-Gel was similar to that of SN-38-Lip. SN-38-Lip-Gel showed a slower release than SN-38-Lip in vitro. SN-38-Lip-Gel suggested pH-dependent stability, the percentage of SN-38 A remaining decreased along with the increasing pH. In vivo studies SN-38-Lip-Gel showed better antitumor efficacy and lower systemic toxicity compared with other groups at the same drug dose. In conclusion, SN-38-Lip-Gel could improve the effective use of SN-38 by stabilizing the lactone form, extending the drug release, providing a high local drug concentration, and reducing systemic toxicity.

Effects of online family health education on myopia prevention in children by parental myopia: a randomized clinical trial.

CLINICAL RELEVANCE: Online family health education may be effective for myopia prevention in children, and the effects may be different between children with myopic and non-myopic parents. BACKGROUND: Myopia is a common cause of vision loss. The aims of this study were to evaluate the effects of online family health education on preventing the development of myopia in children, and to estimate whether the effects vary according to parental myopia. METHODS: A cluster randomised trial including grade 1 and grade 2 children from 12 primary schools was conducted in Guangzhou, China. Weekly online family health education messages were sent to parents in the intervention group. Data collection included eye examinations of children and questionnaires completed by parents. RESULTS: Among the 3123 children included at baseline (1703 boys [54.5%]; mean [SD] age, 6.83 [0.73] years), 2376 completed the follow-up after 3 years. The differences in the incidence of myopia and myopic shift between the study groups were not significant in total. However, the 3-year cumulative incidence rate of myopia in the intervention group (125 of 445 [28.1%]) was significantly lower than that in the control group (225 of 603 [37.3%]; difference, 9.2% [95% CI, -14.9% to -3.5%]; P = 0.001) among children with non-myopic parents. In parallel, among children with non-myopic parents, the mean myopic change in SER was less for the intervention group than for the control group (-1.10 D vs. -1.24 D; difference, 0.13 D [95% CI, 0.03 to 0.23 D]; P = 0.01). CONCLUSIONS: Compared with children with myopic parents, online family health education was more effective in children with non-myopic parents. The incidence of myopia and myopic shift in refraction have been reduced in children with non-myopic parents. Further studies are needed to assess these differences by parental myopia.

Contribution of diversity of social participation on the mental health of humanitarian migrants during resettlement.

AIMS: By the end of 2022, an estimated 108.4 million individuals worldwide experienced forced displacement. Identifying modifiable factors associated with the mental illness of refugees is crucial for promoting successful integration and developing effective health policies. This study aims to examine the associations between the changes in the diversity of social participation and psychological distress among refugees throughout the resettlement process, specifically focusing on gender differences. METHODS: Utilizing data from three waves of a longitudinal, nationally representative cohort study conducted in Australia, this study involved 2399 refugees interviewed during Wave 1, 1894 individuals interviewed during Wave 3 and 1881 respondents during Wave 5. At each wave, we assessed psychological distress and 10 types of social participation across 3 distinct dimensions, including social activities, employment and education. The primary analysis employed mixed linear models and time-varying Cox models. Gender-stratified analyses and sensitivity analyses were performed. RESULTS: Refugees engaging in one type or two or more types of social participation, compared with those not engaging in any, consistently had lower psychological distress scores (ß = -0.62 [95% confidence interval (CI), -1.07 to -0.17] for one type of social participation; ß = -0.57 [95% CI, -1.04 to -0.10] for two or more types of social participation) and a reduced risk of experiencing psychological distress (hazard ratio [HR] = 0.81 [95% CI, 0.65-0.99] for one type of social participation; HR = 0.77 [95% CI, 0.61-0.97] for two or more types of social participation) during the resettlement period. When stratifying the results by gender, these associations in the adjusted models only remained significant in male refugees. Moreover, three specific types of social participation, namely sporting activities, leisure activities and current employment status, were most prominently associated with a reduced risk of psychological distress. CONCLUSIONS: The findings of this cohort study suggest that social participation was consistently associated with reduced risks of psychological distress among male refugees during resettlement. These findings highlight the significance of promoting meaningful social participation and interaction may be an effective strategy to improve the mental health of refugees and facilitate their successful integration into society, especially among male refugees.

Residential greenness and chronic obstructive pulmonary disease in a large cohort in southern China: Potential causal links, risk trajectories, and mediation pathways.

INTRODUCTION: Residential greenness may influence COPD mortality, but the causal links, risk trajectories, and mediation pathways between them remain poorly understood. OBJECTIVES: We aim to comprehensively identify the potential causal links, characterize the dynamic progression of hospitalization or posthospital risk, and quantify mediation effects between greenness and COPD. METHODS: This study was conducted using a community-based cohort enrolling individuals aged ≥ 18 years in southern China from January 1, 2009 to December 31, 2015. Greenness was characterized by normalized difference vegetation index (NDVI) around participants' residential addresses. We applied doubly robust Cox proportional hazards model, multi-state model, and multiple mediation method, to investigate the potential causal links, risk trajectories among baseline, COPD hospitalization, first readmission due to COPD or COPD-related complications, and all-cause death, as well as the multiple mediation pathways (particulate matter [PM], temperature, body mass index [BMI] and physical activity) connecting greenness exposure to COPD mortality. RESULTS: Our final analysis included 581,785 participants (52.52% female; average age: 48.36 [Standard Deviation (SD): 17.56]). Each interquartile range (IQR: 0.06) increase in NDVI was associated with a reduced COPD mortality risk, yielding a hazard ratio (HR) of 0.88 (95 % CI: 0.81, 0.96). Furthermore, we observed per IQR (0.04) increase in NDVI was inversely associated with the risk of multiple transitions (baseline - COPD hospitalization, baseline - death, and readmission - death risks), especially a declined risk of all-cause death after readmission (HR = 0.66 [95 %CI: 0.44, 0.99]). Within the observed association between greenness and COPD mortality, three mediators were identified, namely PM, temperature, and BMI (HR for the total indirect effect: 0.773 [95 % CI: 0.703, 0.851]), with PM showing the highest mediating effect. CONCLUSIONS: Our findings revealed greenness may be a beneficial factor for COPD morbidity, prognosis, and mortality. This protective effect is primarily attributed to the reduction in PM concentration.

Association between serum interleukin-6 concentration and mortality in patients with coronary artery disease.

OBJECTIVES: To evaluate whether serum interleukin-6 (IL-6) is associated with increased risk of mortality in coronary artery disease (CAD) patients. METHODS: We performed a prospective cohort study of 718 CAD patients from the Guangzhou Cardiovascular Disease Cohort (GCDC) study. Multivariable-adjusted Cox proportional hazards regression analyses were used to examine the association between serum IL-6 with all-cause and cardiovascular mortality. RESULTS: During the 1663 person-years of followup, the cumulative all-cause mortality and cardiovascular mortality were 6.5% (n = 47) and 3.3% (n = 24), respectively. The mean length of followup was 2.32 ± 0.81 years. In the multivariable analyses, a one-SD increment in log-transformed serum IL-6 was positively associated with an increased risk of all-cause and cardiovascular mortality, with hazard ratios (HR) of 2.93 (95% CI, 2.11-4.08) and 2.04 (95% CI, 1.34-3.68) within the patients combined and 2.98 (95% CI, 2.12-4.18) and 3.10 (95% CI, 1.98-4.85) within males, respectively. Patients in the highest serum IL-6 tertile versus the lowest tertile were at higher risk of all-cause and cardiovascular mortality, with HR of 17.12 (95% CI 3.11-71.76) and 8.68 (95% CI, 1.88-37.51), respectively. CONCLUSIONS: In hospitalized patients with CAD, serum IL-6 is significantly associated with all-cause and cardiovascular mortality.

Association of DNA methylation of vitamin D metabolic pathway related genes with colorectal cancer risk.

BACKGROUND: Vitamin D might have anti-tumor effect, which is affected by the genes related to vitamin D metabolic pathway. Epigenetic mechanism may affect the expression level of vitamin D metabolic pathway related genes, then plays an important role in the occurrence and development of colorectal cancer. To date, no study has reported on the association between blood-based DNA methylation level of vitamin D metabolic pathway related genes and colorectal cancer risk. METHODS: A case-control study was conducted including 102 colorectal cancer cases and 102 sex- and age-frequency-matched controls in Guangzhou, China. CpG islands in the VDR, CYP24A1, CYP27B1 and CYP2R1 genes were chosen for DNA methylation analysis by MethylTarget sequencing. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of DNA methylation levels for colorectal cancer. Taking the point with the largest Youden index as the boundary value, the cumulative methylation levels of vitamin D metabolic pathway related genes were divided into hypomethylation and hypermethylation. Unconditional multivariable logistical regression model was used to calculate the adjusted odds ratio (aOR) and 95% confidence intervals (95% CIs) after adjusting for potential confounders. RESULTS: Among 153 CpG sites, 8 CpG sites were significantly different between the cases and the controls. The cumulative methylation level of all CpG sites in CYP2R1 was inversely associated with the risk of colorectal cancer (aOR, 0.49; 95% CI, 0.26-0.91). However, no significant association was found between cumulative methylation levels of all CpG sites in VDR, CYP24A1 and CYP27B1 and colorectal cancer risk. Significant inverse association was observed between cumulative methylation level of significant CpG sites in VDR (aOR, 0.28; 95% CI, 0.16-0.51) and CYP24A1 (aOR, 0.19; 95% CI, 0.09-0.40) and colorectal cancer risk. There were no significant associations between cumulative methylation levels of significant CpG sites in CYP2R1 and CYP27B1 and colorectal cancer risk. CONCLUSIONS: This study indicated that the cumulative methylation levels of significant CpG sites in VDR and CYP24A1 and all CpG sites in CYP2R1 were inversely associated with colorectal cancer risk.

The gut-joint axis mediates the TNF-induced RA process and PBMT therapeutic effects through the metabolites of gut microbiota.

The gut-joint axis, one of the mechanisms that mediates the onset and progression of joint and related diseases through gut microbiota, and shows the potential as therapeutic target. A variety of drugs exert therapeutic effects on rheumatoid arthritis (RA) through the gut-joint axis. However, the anti-inflammatory and immunomodulatory effect of novel photobiomodulatory therapy (PBMT) on RA need further validation and the involvement of gut-joint axis in this process remains unknown. The present study demonstrated the beneficial effects of PBMT on RA, where we found the restoration of gut microbiota homeostasis, and the related key pathways and metabolites after PBMT. We also discovered that the therapeutic effects of PBMT on RA mainly through the gut-joint axis, in which the amino acid metabolites (Alanine and N-acetyl aspartate) play the key role and rely on the activity of metabolic enzymes in the target organs. Together, the results prove that the metabolites of amino acid from gut microbiota mediate the regulation effect on the gut-joint axis and the therapeutic effect on rheumatoid arthritis of PBMT.

Relationship between Arterial Stiffness and Renal Function Determined by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Equations in a Chinese Cohort Undergoing Health Examination.

Background: The association between arterial stiffness and cardiovascular risk in CKD and ESRD patients is well established. However, the relationship between renal function estimation and properties of large arteries is unclear due to the four different methods used to quantify glomerular filtration. This study investigated the relationship between carotid-femoral pulse wave velocity (c-fPWV), as a measure of arterial stiffness, and accepted metrics of renal function. Methods: This cross-sectional study was conducted in 431 health examination individuals in China, enrolled from January 2017 to June 2019. c-fPWV and blood pressure were measured, and blood samples were obtained for all participants. Four different methods were used to determine the estimated glomerular filtration rate (eGFR) as described by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations: (i) CKD-EPISCr formula based on SCr, (ii) CKD-EPICysC formula based on CysC, (iii) CKD-EPISCr/CysC formula based on Cr and CysC, and (iv) MDRD. Results: Of all of the study participants (average age 53.1 ± 13.0 years, 68.1% male), 23.7% had diabetes mellitus and 66.6% had hypertension. The average eGFR values determined by the CKD-EPISCr, CKD-EPICysC, CKD-EPISCr/CysC, and MDRD equations were 91.9 ± 15.6, 86.8 ± 21.4, 89.6 ± 18.3, and 90.7 ± 16.6 ml/min/1.73m2, respectively. c-fPWV was significantly and negatively correlated with eGFR determined by CKD-EPISCr (r = -0.336, P < 0.001), CKD-EPICysC (r = -0.385, P < 0.001), CKD-EPISCr/CysC (r = -0.378, P < 0.001), and MDRD (r = -0.219, P < .001) equations. After adjusting for confounding factors, c-fPWV remained significantly and negatively correlated with eGFR determined by the CKD-EPICysC equation (ß = -0.105, P = 0.042) and significantly and positively correlated with age (ß = 0.349, P ≤ 0.01), systolic pressure (ß = 0.276, P ≤ 0.01), and hypoglycemic drugs (ß = 0.101, P = 0.019). Conclusion: In a health examination population in China, c-fPWV is negatively correlated with eGFR determined by four different equations; however, only the metric of eGFR determined by the equation for CKD-EPICysC showed an independent relation with c-fPWV.

Low-Carbohydrate Diets and Mortality in Older Asian People: A 15-Year Follow-Up from a Prospective Cohort Study.

The long-term effects of a low-carbohydrate diet (LCD) on mortality, accounting for the quality and source of the carbohydrate, are unclear. Hence, we examined the associations of LCDs with all-cause and cause-specific mortality in a prospective cohort study. A total of 20,206 participants (13.8% diabetes) aged 50+ years were included. Overall, vegetable-based and meat-based LCD scores were calculated based on the percentage of energy as total and subtypes of carbohydrates, fat, and protein. Cox regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). During 294,848 person-years of follow-up, 4624 deaths occurred, including 3661 and 963 deaths in participants without and with diabetes, respectively. In all participants, overall LCD score was not associated with all-cause and cause-specific mortality, after multivariable adjustment. However, for the highest versus the lowest quartiles of vegetable-based LCD, the adjusted HRs (95%CIs) of all-cause and CVD mortality were 1.16 (1.05-1.27) and 1.39 (1.19-1.62), respectively. The corresponding values for highest versus lowest quartiles of meat-based LCD for all-cause and CVD mortality were 0.89 (0.81-0.97) and 0.81 (0.70-0.93), respectively. Similar associations were found in participants without diabetes. In patients with diabetes, the adjusted HR (95%CI) of CVD mortality for the highest versus the lowest quartiles of vegetable-based LCD was 1.54 (1.11-2.14). Although there were no significant associations with overall LCD score, we found that the vegetable-based LCD score was positively, whereas the meat-based LCD score was negatively, associated with all-cause and CVD mortality in older Asian people.

Correlation between anti-Mullerian hormone levels and antral follicle counts in polycystic ovary and metabolic syndromes.

Anti-Mullerian hormone (AMH) is expressed by the granulosa cells of the pre-antral and small antral follicles in the ovary. AMH serum levels are significantly higher in women with polycystic ovary syndrome (PCOS) due to an increased antral follicle counts (AFC) and a higher production of AMH per antral follicle. This research is a cohort study design with a sample size of 60 female patients with (n = 30) and without PCOS (n = 30) in which the relationship between AMH serum level and other hormonal markers was explored. The following measurements were taken from the patients on the fifth day of the menstrual cycle: AMH, glucose, index of insulin resistance (HOMA/IR), body mass index (BMI), testosterone and cholesterol, lipoproteins, and triglycerides. The study proposes diagnostic criteria for PCOS. A twofold increase in the AMH serum levels was observed in the PCOS group when compared to the control group. The following incremental increases were seen in AMH serum levels: testosterone (18.4%); fasting blood glucose (18%); fasting insulin (83.86%); HOMA/IR (64.23%); mean cholesterol (30%); mean triglycerides (17%); and BMI (26.75%). All differences were considered significant at p ˂ 0.005. The results from the study concluded that monitoring the level of AMH allows for the prediction of ovarian hyperstimulation syndrome (OHSS) during ovulation induction and assisted reproductive technology cycles. Monitoring of anti-Mullerian hormone levels may provide an additional marker for determining treatment strategies when presented with additional risks associated with overweight, hirsutism, type II diabetes, infertility, and cardiovascular disease.

Infection status and risk factors of HIV, HBV, HCV, and syphilis among drug users in Guangdong, China--a cross-sectional study.

BACKGROUND: China has witnessed a remarkable increase in sexually transmitted infections (STIs) and HIV. The study is to assess the prevalence of HIV, HBV, HCV and syphilis and related risk factors among drug users in mandatory detoxification center Qingyuan, Guangdong, China. METHOD: A cross-sectional study on drug use behaviors, sex behaviors, and presence of antibodies to HIV, HCV, Treponema pallidum, and surface antigen of HBV (HBsAg) was conducted among drug users recruited from 3 detoxification centers in Qingyuan, Guangdong, China. Risk factors for each of four infections were analyzed with logistic regression model. RESULTS: A total of 740 subjects were recruited, the median age was 31 years old (range 24-38). The seroprevalence rates of HIV, HBsAg, HCV and syphilis were 4.6%, 19.3%, 71.6% and 12.6%, respectively. Risk factors for HIV were intravenous drug use and co-infection with syphilis. Having a regular sexual partner who was a drug user was considered to be a risk factor for HBV. Intravenous drug use was a risk factor for HCV. However, the consistent use of condoms with commercial sex partners was protective for HCV infection. Compared to drug users living in urban area, those living in rural areas were more likely to be infected with syphilis, and there was an association between commercial sex and syphilis. CONCLUSION: The prevalence of HIV, HBV, HCV and syphilis were high among drug users in detoxification centers in Qingyuan, thus, risk reduction programs for the drug user population is urgently required.

Behavioural development of school-aged children who live around a multi-metal sulphide mine in Guangdong province, China: a cross-sectional study.

BACKGROUND: The deleterious biological effects of low-level, long-term exposure to heavy metals are well known, and children are the most susceptible population. Dabaoshan Mine in the southeast of Guangdong Province is at high risk of discharging multi-metals pollutants into a local river (Hengshihe) and the surrounding area. The present study aimed to estimate relationships between measured multi-metal exposures and the presence of behavioural problems for the school-aged children in the polluted area. METHODS: A cross-sectional study was performed. Children aged 7-16 years living in three villages of the Hengshihe area with different degrees of heavy-metal pollution participated in this study. Local environmental samples (water and crops) and children's hair were collected, and concentrations of heavy metals were determined. The Child Behaviour Check-list (CBCL) was used to assess the presence of behaviour problems. General linear regression was used to analyze the contribution of hair metals to each CBCL subscale with adjustment for socio-demographic confounding factors. RESULTS: Multiple regression analyses revealed significant effects of hair lead, cadmium and zinc levels on CBCL subscales. Log-transformed hair lead, cadmium and zinc levels accounted for an incremental of 8% to 15% variance in anxious/depressed, withdrawn, somatic complaints, social problems, thought problems, attention problems, delinquent behaviour and aggressive behaviour. The concurrent log-transformed hair lead and zinc levels were strongly associated with all subscales while the concurrent log-transformed hair cadmium was only significantly associated with withdrawn, social problems and attention problems. CONCLUSION: This study reveals that heavy metal exposure was associated with increased risk of behavioral problems for school-aged children.

Cross-sectional study on influence of the family environment on the lifetime non-medical use of prescription drugs among Chinese adolescents in Guangdong: an analysis of sex differences.

OBJECTIVES: This study aimed to assess if adolescents had used any prescription drugs non-medically, to explore the associations between the family environment and non-medical use of prescription drugs (NMUPD) and to investigate whether there are any sex differences in the aforementioned associations. DESIGN: A population-based cross-sectional study. SETTING: A secondary analysis of the cross-sectional data collected from high school students in Guangdong who were sampled using a multistage, stratified-cluster, random-sampling method in the 2015 School-based Chinese Adolescents Health Survey. PARTICIPANTS: A total of 21 774 students aged 12-20 years. DATA ANALYSIS: Multilevel logistic regression models were used to explore the univariable and multivariable relationship between family environment and NMUPD among adolescents. Adjusted ORs and corresponding 95% CI were calculated. OUTCOME MEASURES: Questions regarding to adolescent' NMUPD (including sedative, opioid and stimulant) were surveyed in the study. RESULTS: A total of 6.3% students reported lifetime NMUPD in this study. The most commonly used drugs were opioids (3.9%), followed by sedatives (3.2%) and stimulants (2.5%). Multilevel analyses indicated that living arrangements, family economic status, parental relationships, parental education levels, monthly pocket money, parental drinking and drug problems were significantly correlated to the NMUPD among all students. Among boys, living arrangements, family economic status, maternal education levels, monthly pocket money, parental drinking and drug problems were significantly related to different types of NMUPD. The same factors were related to girls' NMUPD, except for maternal education levels. Parental relationships and paternal education levels were also associated with girls' NMUPD. CONCLUSION: The family environment exerts an important influence on adolescents' NMUPD. Interventions targeted at families are highly recommended considering the negative effects of NMUPD. In addition, the child's sex might be taken into consideration when developing and implementing preventive strategies.

Cardiovascular risk factors in overweight and obese Chinese children: a comparison of weight-for-height index and BMI as the screening criterion.

BACKGROUND: Childhood obesity is a widespread and growing problem in the world. Body mass index (BMI) and weight-for-height criterion have been used to determine childhood obesity. No data was available to evaluate cardiovascular risk factors in overweight and obese Chinese children screened by weight-for-height index and Chinese newly developed BMI criterion. AIM OF THE STUDY: To evaluate cardiovascular risk factors in overweight and obese Chinese children by using Chinese BMI and weight-for-height index as screening criterion. METHODS: A total of 215 children aged 7.5-13 years were recruited from 3 primary schools in Guangzhou, PR China. Measurements included body weight, height, waist and hip circumference, fasting serum glucose, insulin, total triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (apo A), apolipoprotein B (apo B). Chinese BMI and weight-for- height criterion were used to classify overweight and obesity. RESULTS: According to Chinese BMI criterion, 65 from 108 obese children originally identified by weight-for-height were reclassified as obese and other 41 children were classified as overweight. Compared with non-obese children, obese children screened by Chinese BMI and weight-for-height index had increased levels of TG, LDL-C, apo B, insulin; decreased levels of HDL-C, apo A; and significantly higher prevalence of hypertriglyceridemia and high LDL-C. Children identified as overweight by Chinese BMI criterion had also shown high TG, LDL-C, apo B, insulin levels, low HDL-C, apo A levels, and significantly higher prevalence of hypertriglyceridemia than the normal weight children. CONCLUSIONS: Our study reveals that overweight and/or obesity screened by both Chinese new BMI and weight-for-height criterion are associated with increased levels of cardiovascular risk factors (e.g., elevated serum TG, LDL, apo B, and reduced HDL-C, apo A levels). Using Chinese BMI criterion may underestimate the prevalence of childhood obesity but it could be adopted as a unique tool for screening children's overweight in population-based screening programs.