Association between age at arrival, duration of migration, and overweight/obesity in Chinese rural-to-urban migrants: the Yi migrant study.

BACKGROUND: Urbanization in China is rapidly proceeding, but rural-to-urban migration and its association with overweight and obesity is not well studied. This study aimed to explore the age at arrival, duration of migration, and the corresponding association with overweight/obesity in Yi migrants in China. METHODS: A cross-sectional study was conducted in rural and urban areas in 2015 in Sichuan province, China. Demographic characteristics, lifestyle factors, and anthropometry were collected. General linear regression models were used to assess the effect of duration of migration (1-10, 11-20, 21-30, and >30 years) on body mass index (BMI). Multi-variable logistic regression was used to examine the association between duration of migration and overweight/obesity (BMI ≥ 25 kg/m2). RESULTS: A total of 3056 Yi people (1894 Yi farmers and 1162 Yi migrants) aged 20 to 80 years were enrolled. After adjusting for age, sex, and other potential confounders, Yi migrants had 1.71 kg/m2 (95% confidence interval [CI]: 1.36-2.06) higher BMI and a 2.13-fold (95% CI: 1.71-2.65) higher risk of overweight/obesity than Yi farmers. In Yi migrants, stratified by age at arrival, no significant association between duration of migration and overweight/obesity was observed in those who were 0 to 20 years old at arrival. In comparison, in migrants >20 years old at arrival, compared with the reference group (1-10 years), long-term migration (>30 years) was found to be associated with overweight/obesity after adjustment (odds ratio: 1.85, 95% CI: 1.04-3.29). CONCLUSIONS: Yi migrants were observed to have greater risk of overweight/obesity than Yi farmers. In Yi migrants, the risk of overweight/obesity increased according to the duration of migration, especially in those who were older upon their arrival.

Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals.

INTRODUCTION: Patient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China. METHODS: A national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated. MAIN RESULTS: A total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661, P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75), P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40), P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37), P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100), P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77), P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80), P = 0.1075). CONCLUSIONS: The relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality.

[Acceptability status of early antiretroviral therapy among HIV-positive men who have sex with men].

OBJECTIVE: To assess the acceptability and influence factors of early antiretroviral therapy (ART) among HIV-positive men who have sex with men (MSM) . METHODS: From June to August 2012, through convenience sampling, HIV-positive MSM who were willing to cooperate with the survey were selected from the Hangzhou and Ningbo AIDS prevention and control database. A total of 280 HIV-positive MSM who did not receive ART participated in the study.Using self-designed questionnaire, general demographic information, awareness of AIDS knowledge, sexual behavior, use of condom, current physical condition, awareness and attitude towards early ART were investigated.Excluding 60 HIV-infected MSM whose CD4(+)T count didn't meet the inclusion criteria, a total of 220 subjects were included in the analysis. Chi-square was used to compare the difference of early ART acceptance among subjects with different characteristics.Non-conditional logistic regression was used to analyze the influence factors of the acceptability of early ART. RESULTS: The acceptance rate of early ART among HIV-infected MSM was 62.7% (138/220). Delaying the disease development, preventing partners from infection, not worrying others to suspect them of having HIV, and partners unknowing the HIV-infected status were the factors which had a relatively higher acceptance rate of early ART. Correspondingly, the acceptance rate was 68.8% (130/189), 68.7% (103/150), 78.4% (69/88) and 72.5% (74/102) respectively and the acceptance rate among subjects with opposite opinions or characteristics was 24.1% (7/29) , 50.0% (30/60), 52.7% (68/129) and 45.8% (58/107) respectively (chi-square values were 21.46, 6.43, 14.84 7.55, all P values <0.05).Logistic regression analysis showed that delaying the disease development (OR = 11.50, 95%CI:3.29-40.22) and preventing partners from infection (OR = 3.72, 95%CI:1.53-9.03) were inclined to the acceptance of early ATR.While concerning others' suspection of them having HIV (OR = 0.19, 95%CI:0.08-0.48) and partners knowing the HIV-infected status were inclined to unacceptance of ART(OR = 0.31, 95%CI:0.13-0.70). CONCLUSION: The acceptability of early ART among HIV-positive MSM is high. The recognition of early ART and concern of privacy leak are the major influence factors which can stimulate the acceptance of early ART.

Localization of the ATP-sensitive K(+) channel regulatory subunits SUR2A and SUR2B in the rat brain.

ATP-sensitive K(+) (K(ATP)) channel subunits SUR2A and SUR2B in the rat brain were investigated by RT-PCR assay, western blot analysis, in situ hybridization histochemistry, and immunohistochemical staining. The results show that the mRNA and protein of SUR2A and SUR2B are expressed in whole rat brain extracts and selected regions. SUR2 mRNA is widely expressed in many neurons and glial cells as revealed by in situ hybridization histochemistry. Immunohistochemical staining shows SUR2A to be widely expressed in neurons of the brain, especially in the large pyramidal neurons and their main dendrites in the neocortex and in the Purkinje cells of the cerebellar cortex. In contrast to SUR2A, SUR2B is potently expressed in small cells in the corpus callosum and cerebellar white matter, but is also weakly expressed in some neurons. Double immunostaining shows SUR2B to be localized in astrocytes and oligodendrocytes, while SUR2A is only localized in oligodendrocytes. These results suggest that SUR2A might be mainly a regulatory subunit of the K(ATP) channel in most neurons and part of oligodendrocytes, while SUR2B might be mainly a regulatory subunit of the K(ATP) channel in astrocytes, oligodendrocytes, and some neurons.

Different localization of ATP sensitive K+ channel subunits in rat testis.

ATP sensitive K(+) (K(ATP) ) channels are important linkage of cell membrane excitability to its cellular bioenergetic state. These channels are composed of pore-forming subunits and regulatory subunits. The present study focused on the cellular expressions and localizations of these subunits in rat testis. RT-PCR analysis showed that rat testis contained five K(ATP) channel subunits, Kir6.1, Kir6.2, SUR1, SUR2A and SUR2B. Immunoblot assay showed that proteins of Kir6.1, Kir6.2, SUR2A and SUR2B were expressed in rat testis. Immunohistochemistry revealed these K(ATP) channel subunits were positive in different localizations of spermatogenic cells, Sertoli cells and Leydig cells, which implies these subunits playing important roles in spermatogenesis. Co-localization of Kir6.2 with SUR2B was determined in acrosome or head cap of spermatids by double immunofluorescence analysis by indicating K(ATP) channel might be formed by Kir6.2 and SUR2B in acrosome of spermatids. Different localizations of the K(ATP) channel subunits in the cell membrane and membranous organelles of spermatogenic cells and Sertoli cells indicated the complex and multiple functions of K(ATP) channels in rat testis.

Localization of ATP-sensitive K+ channel subunits in rat submandibular gland.

ATP-sensitive K(+) (K(ATP)) channel subunits were investigated in rat submandibular gland (SMG). RT-PCR detected the presence of mRNA transcripts of the Kir6.1, Kir6.2, SUR2A, and SUR2B in the SMG, whereas SUR1 mRNA was barely detected. Western blot analysis provided the evidence that these four K(ATP) channel subunits are expressed in rat SMG. Immunostaining detected that these four K(ATP) channel subunits are widely distributed, with different intensities, in myoepithelial cells, epithelial cells of intercalated ducts, granular convoluted tubules, striated ducts, and excretory ducts. Immunofluorescence double staining showed that Kir6.1 and Kir6.2 colocalized with SUR2A in the myoepithelial cells, granular convoluted tubules, striated ducts, and excretory ducts. Kir6.1 and Kir6.2 also colocalized with SUR2B, mainly in the duct system, e.g., the granular convoluted tubules, striated ducts, and excretory ducts. Taken together, these results indicate that the K(ATP) channels in SMG may consist of Kir6.1, Kir6.2, SUR2A, and SUR2B, with various combinations of colocalization with each other, and may play important roles in rat SMG during salivary secretion.

Localization of the sulphonylurea receptor subunits, SUR2A and SUR2B, in rat renal tubular epithelium.

ATP-sensitive K+ (K(ATP)) channels in the kidney are considered to play roles in regulating membrane potential according to changes in the intracellular ATP concentration. They are composed of two types of subunits; the pore subunits (Kir6.1, Kir6.2), which are members of the inwardly rectifying K+ channel family, and the regulatory subunits, the sulphonylurea receptors, which belong to the ATP-binding cassette (ABC) superfamily. The sulphonylurea receptors (SURs) are receptors of sulphonylureas widely used for the treatment of type 2 diabetes mellitus. The SURs are divided into two isoforms, SUR1 and SUR2, the latter was further divided into SUR2A and SUR2B. In the present study, we have investigated the mRNA expression by RT-PCR assay, and protein expression profiles by immunoblotting, immunohistochemistry, and immunoelectron microscopy with anti SUR2A and anti SUR2B antibodies. RT-PCR detected the presence of mRNA transcripts of the SUR2A and SUR2B, while SUR1 mRNA was barely detected. In immunoblotting, SUR2A protein was detected distinctly in the microsomal fraction, weakly in the mitochondrial fraction and at negligible level in the cell membrane fraction. In contrast, the SUR2B protein was detected intensely in the microsomal fraction, with a low level in the mitochondrial fraction and scarcely in the cell membrane fraction. In immunohistochemistry SUR2A and SUR2B proteins were widely distributed in renal tubular epithelial cells, glomerular mesangial cells, and the endothelium and the smooth muscle of blood vessels. In immunoelectron microscopy, the immunoreactivity was localized in the endoplasmic reticulum and mitochondria throughout the epithelial cells for SUR2A, and dominantly in the apical cytoplasm of the cells for SUR2B. In conclusion, the regulatory subunits of the K(ATP) channel in the rat kidney are SUR2A and SUR2B; they also are candidate regulatory subunits for the mitochondrial K(ATP) channel.

Localization of sulfonylurea receptor subunits, SUR2A and SUR2B, in rat heart.

To understand the possible functions and subcellular localizations of sulfonylurea receptors (SURs) in cardiac muscle, polyclonal anti-SUR2A and anti-SUR2B antisera were raised. Immunoblots revealed both SUR2A and SUR2B expression in mitochondrial fractions of rat heart and other cellular fractions such as microsomes and cell membranes. Immunostaining detected ubiquitous expression of both SUR2A and SUR2B in rat heart in the atria, ventricles, interatrial and interventricular septa, and smooth muscles and endothelia of the coronary arteries. Electron microscopy revealed SUR2A immunoreactivity in the cell membrane, endoplasmic reticulum (ER), and mitochondria. SUR2B immunoreactivity was mainly localized in the mitochondria as well as in the ER and cell membrane. Thus, SUR2A and SUR2B are not only the regulatory subunits of sarcolemmal K(ATP) channels but may also function as regulatory subunits in mitochondrial K(ATP) channels and play important roles in cardioprotection.

ATP-sensitive K+-channel subunits on the mitochondria and endoplasmic reticulum of rat cardiomyocytes.

ATP-sensitive K(+) (K(ATP)) channel subunits on the subcellular structures of rat cardiomyocytes were studied with antibodies against Kir6.1 and Kir6.2. According to the results of Western blot analysis, Kir6.1 was strongly expressed in mitochondrial and microsome fractions, and faintly expressed in cell membrane fraction, whereas Kir6.2 was mainly expressed in the microsome fraction and weakly in cell membrane and mitochondrial fractions. Immunohistochemistry showed that Kir6.1 and Kir6.2 were expressed in the endocardium, atrial and ventricular myocardium, and in vascular smooth muscles. Immunoelectron microscopy revealed that Kir6.1 immunoreactivity was mainly localized in the mitochondria, whereas Kir6.2 immunoreactivity was mainly localized in the endoplasmic reticulum and a few in the mitochondria. Both Kir6.1 and Kir6.2 are candidates of mitochondrial K(ATP) channel subunits. The data obtained in this study will be useful for analyzing the composition of K(ATP) channels of cardiomyocytes and help to understanding the cardioprotective role of K(ATP) channels during heart ischemia.

Distributions of lesions in hanging suicide brains.

We found a morphological similarity in the distribution of vascular lesions in five hanging suicide brains. The overall findings on the lesions remind us of the venous origin but not of the arterial origin of the blood supply. Morphometric evaluations did not reveal any valuable conclusion. The results of this pathological research may be of clinical importance for the treatment of hanging patients.