[Efficiency analysis on functional protection of nerve plane-oriented laparoscopic total mesorectal excision].

Objective: Using previous total mesorectal excision with pelvic autonomic nerve preservation (PANP+TME) and simple total mesorectal excision (TME) without emphasis on retained nerves as control, we explore the advantages of nerve plane-oriented laparoscopic total mesorectal excision (NPO+LTME) on urinary and sexual function. Methods: A retrospective cohort study was carried out. Case inclusion criteria: (1) male patients with pathologically confirmed middle and low rectal adenocarcinoma (4 to 11 cm from the anus); (2) stage T1-2tumor; (3) normal sexual life before operation. Exclusion criteria: (1) no pathological diagnosis before surgery; (2) local recurrence or distant metastasis; (3) preoperative neoadjuvant chemoradiotherapy; (4) opensurgery and laparoscopic surgery conversionto open; (5) no follow-up data. According to the above criteria, clinical data of 173 male patients with low and middle rectal adenocarcinoma who underwent radical operation for laparoscopic rectal cancer from July 2003 to July 2018 at the Department of Gastrointestinal Surgery, Wuhan University People's Hospital were collected. According to different surgical methods, patients were divided into TME group (58 cases), PANP+TME group (63 cases) and NPO+LTME group (52 cases). There were no significant differences in the baseline data including age, body mass index and pathological examination between the 3 groups (all P>0.05). The nerve plane referred to the nerve, the adipose tissue, the extremely finecapillaries around the nerve with overlying fine membranous tissue. NPO+LTME referred to the process of laparoscopic TME guided by the nerve plane, performing in the loose connective tissue between the nerve plane and the rectal properfascia, in order to ensure the integrity of the nerve plane, and maximally protect the patient's urinary and reproductive functions. The operation time, intraoperative blood loss, urinary catheter removal time, urinary function grading, postoperative first erection time, and erectile function and ejaculation function were observed and compared among the 3 groups at 3- and 6-month after operation. Results: In the NPO+LTME group, the PANP+TME group and the TME group, the operation time was (181.9±24.5) minutes, (176.7±29.2) minutes and (137.7±16.2) minutes, respectively (F=54.868, P<0.001); the intraoperative blood lost was (6.0±1.4) ml, (6.5±1.8) ml and (12.8±4.6) ml, respectively (F=95.016, P<0.001); the time to postoperative removal of the catheter was (2.4±1.1) days, (3.7 ±1.7) days and (6.5±2.4) days, respectively (F=79.409, P<0.001); the first postoperative erection time was (1.6±0.6) days, (8.9±2.7) days and (15.9±6.8) days (F=177.677, P<0.001), respectively, whose differences were all statistically significant (all P<0.01). In comparison of urinary function grading, the proportion of grade I (normal function, no urinary dysfunction) in the NPO+LTME, the ANP+TME group and the TME group was 84.1% (53/63), 39.7% (23/58) and 19.2% (10/52), respectively, and the difference was statistically significant (H=52.915, P<0.001). At postoperative 3- and 6-month, proportion of patients with grade I erectile function (normal erectile function) was 77.8% (49/63) and 85.7% (54/63), 44.8% (26/58) and 53.4% (31/58), 28.8% (15/52) and 48.1% (25/52) in the NPO+LTME group, the PANP+TME group, and the TME group, respectively. The differences were statistically significant (H=91.709, P<0.001; H=79.692, P<0.001). The proportion of patients with grade I ejaculation function (with ejaculation, no abnormalities in routine semen examination before and after surgery) at 3- and 6-month after surgery in the NPO+LTME group, the PANP+TME group and the TME group was 82.5% (52/63) and 87.3% (55/63), 53.4% (31/58) and 60.3% (35/58), 28.8% (15/52) and 46.1% (24/52), respectively. The differences were statistically significant as well (H=86.543, P<0.001; H=78.667, P<0.001). Patients in the NPO+LTME group had no grade III erections and ejaculation disorders. Conclusion: The surgical procedure of NPO+LTME can promote the recovery of postoperative neurological function and preserve urination and sexual function better.

[Study on the relationship of thallium exposure and outcomes of births].

Objective: To investigate the relationship of thallium exposure and outcomes of births. Methods: A total of 3 236 mothers who had visited in Ma'anshan Maternal and Child Health-Care Hospital between May 2013 and September 2014 were included in this study and their thallium concentrations measured from samples of maternal and umbilical cord blood by inductively coupled plasma mass spectrometry. The results were correlated and evaluated with birth outcomes of the infants, using the multiple linear regression method. Results: The median (P(25)-P(75)) of thallium levels in first trimester, second trimester and umbilical cord blood were 61.7 (50.8-77.0), 60.3 (50.8-75.2) and 38.5 (33.6-44.1) ng/L, respectively. After adjustment for potential confounders, the thallium levels showed an inversely significant association with birth head circumference (unstandardized ß coefficient=-0.41, 95%CI: -0.76- -0.06) in the first trimester blood, and associated with reduced birth length (unstandardized ß coefficient=-0.65, 95%CI: -1.25- -0.05) in umbilical cord blood. However, there appeared no significantly associations with birth weight, length and head circumference (P>0.05) in second trimester. On stratification by sex, in girls but not in boys, the thallium levels were adversely associated with birth head circumference (unstandardized ß coefficient=-0.53, 95%CI: -1.05--0.01) in the first trimester and were associated with decreased birth weight (unstandardized ß coefficient=-277.08, 95%CI: -485.13- -69.03) and length (unstandardized ß coefficient=-1.39, 95%CI: -2.26- -0.53) in umbilical cord blood thallium. Conclusions: Thallium exposure appeared a gender difference in newborn birth outcomes. In the first trimester, it was negatively associated with the birth head circumference, in the umbilical cord blood, and reduced birth weight and length in girls.

Development of an empirical model to predict malaria outbreaks based on monthly case reports and climate variables in Hefei, China, 1990-2011.

Malaria remains a significant public health concern in developing countries. Drivers of malaria transmission vary across different geographical regions. Climatic variables are major risk factor in seasonal and secular patterns of P. vivax malaria transmission along Anhui province. The study aims to forecast malaria outbreaks using empirical model developed in Hefei, China. Data on the monthly numbers of notified malaria cases and climatic factors were obtained for the period of January 1st 1990 to December 31st 2011 from the Hefei CDC and Anhui Institute of Meteorological Sciences, respectively. Two logistic regression models with time series seasonal decomposition were used to explore the impact of climatic and seasonal factors on malaria outbreaks. Sensitivity and specificity statistics were used for evaluating the predictive power. The results showed that relative humidity (OR = 1.171, 95% CI = 1.090-1.257), sunshine (OR = 1.076, 95% CI = 1.043-1.110) and barometric pressure (OR = 1.051, 95% CI = 1.003-1.100) were significantly associated with malaria outbreaks after adjustment for seasonality in Hefei area. The validation analyses indicated the overall agreement of 70.42% (sensitivity: 70.52%; specificity: 70.30%). The research suggested that the empirical model developed based on disease surveillance and climatic conditions may have applications in malaria control and prevention activities.

[The effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction: a cohort study].

Objective: To investigate the effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women who took their first antenatal care and willing to undergo their prenatal care and delivery in Ma 'anshan Maternity and Child Care Centers were recruited in the cohort study. Excluding subjects without weight data before delivery (n=54), pregnancy termination (n=162), twins live births (n=39), without fetal birth weight data (n=7), 3 212 maternal-singleton pairs were enrolled for the final data analysis. Demographic information of pregnant woman, pregnancy history, disease history, height and weight were collected. In the 24(th)-28(th), 32(nd)-36(th) gestational week and childbirth, three follow-up visits were undertaken to collect data of pregnancy weight, pregnancy vomiting, gestational hypertension, gestational diabetes mellitus, newborn gender and birth weight. χ(2) test was used to compare the detection rate of fetal growth restriction in different groups. Multivariate unconditional logistic regression model and spreadsheet were used to analyze the independent and interaction effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Results: The incidence of fetal growth restriction was 9.7%(311/3 212). The incidence of fetal growth restriction in pre-pregnancy underweight group was 14.9% (90/603), higher than that in normal pre-pregnancy weight group (8.7% (194/2 226)) (χ(2)=24.37, P<0.001). The incidence of fetal growth restriction in inadequate increase of gestational weight group was 17.9% (50/279), higher than the appropriate increase of weight group (11.8% (110/932)) (χ(2)=36.89, P<0.001). Multivariate unconditional logistic regression analysis showed that compared with normal pre-pregnancy weight group, pre-pregnancy underweightwas a risk factor for fetal growth restriction, with RR (95%CI) at 1.76 (1.34-2.32); Compared with the appropriate increase of gestational weight group, inadequate weight increase during pregnancy was a risk factor for fetal growth restriction, with the RR (95%CI) at 1.70 (1.17-2.48). No additive model interaction [relative excess risk of interaction, attributable proportions of interaction, the synergy index and their 95%CI were 0.75 (-2.14-3.63), 0.21 (-0.43-0.86) and 1.43 (0.45-4.53), respectively] or multiplication model interaction (RR (95%CI): 1.00 (0.44-2.29)) existed between pre-pregnancy underweight and inadequate increase of gestational weight on fetal growth restriction. Conclusion: Pre-pregnancy underweight and inadequate increase of gestational weight would increase the risk of fetal growth restriction without interaction.

Impacts of ambient temperature on the burden of bacillary dysentery in urban and rural Hefei, China.

Bacillary dysentery continues to be a major health issue in developing countries and ambient temperature is a possible environmental determinant. However, evidence about the risk of bacillary dysentery attributable to ambient temperature under climate change scenarios is scarce. We examined the attributable fraction (AF) of temperature-related bacillary dysentery in urban and rural Hefei, China during 2006-2012 and projected its shifting pattern under climate change scenarios using a distributed lag non-linear model. The risk of bacillary dysentery increased with the temperature rise above a threshold (18·4 °C), and the temperature effects appeared to be acute. The proportion of bacillary dysentery attributable to hot temperatures was 18·74% (95 empirical confidence interval (eCI): 8·36-27·44%). Apparent difference of AF was observed between urban and rural areas, with AF varying from 26·87% (95% eCI 16·21-36·68%) in urban area to -1·90% (95 eCI -25·03 to 16·05%) in rural area. Under the climate change scenarios alone (1-4 °C rise), the AF from extreme hot temperatures (>31·2 °C) would rise greatly accompanied by the relatively stable AF from moderate hot temperatures (18·4-31·2 °C). If climate change proceeds, urban area may be more likely to suffer from rapidly increasing burden of disease from extreme hot temperatures in the absence of effective mitigation and adaptation strategies.

[Research progress of health effect of polybrominated diphenyl ethers].

Polybrominated diphenyl ethers (PBDEs) was one of the most common brominated flame retardants, it has been widely used in products such as furnitures, polymer and plastical material, textiles, electronic products and building materials. PBDEs have potential effect such as neurodevelopmental toxicity, reproductive toxicity, thyroid toxicity, immunological toxicity, embryo toxicity, liver toxicity, teratogenicity and potential carcinogenicity. This paper was aimed to review the environmental exposure way, current level, neurotoxicity, neurodevelopmental toxicity and reproductive toxicity of PBDEs. In recent years, PBDEs has been detected in environment, wildlife animal and human body around the world, there were the significant differences of exposure levels of PBDEs. The most abundant congener were tetra-BDE or BDE-47, hexa-BDE or BDE-153, and deca-BDE or BDE-209. Prenatal exposure to PBDEs has great impact on the infants' neurodevelopmental function, induces changes in neuropsychological developmental behavior, decreases of congnition, motivation and attention. High levels of PBDEs have positive relationship with Luteinizing hormone levels, testis disfunction and children's cryptorchidism, and have negative relationship with sperm number and testis size.

[Relationship between hypertension and percentage of body fat, in children of Anhui province].

OBJECTIVE: To study the situation of hypertension among children in Anhui province and to analyze its association with the percentage of body fat. METHODS: A total of 8 890 aged 7-17 years old children, were tested for blood pressure and thickness of skin fold in Anhui province. Hypertension in children was diagnosed referring to the 2010 Chinese guidelines for the management of hypertension (revised in 2010). The percentage of body fat was calculated according to the thickness of skin fold and specific formulas. METHODS used for statistics analysis would include t test, χ(2) test while logistic regression was used to analyze the relationship between percentage of body fat in children and adolescents. In total, 8 890 subjects aged 7-17 years were recruited, in Anhui province. RESULTS: The prevalence of hypertension in Children aged 7-17 was 13.6%, with the total number of hypertension as 1 210, in Anhui province. There were significant differences in the prevalence of hypertension among urban and rural children. Both prevalence of hypertension among boys and girls in urban area appeared higher than those in the rural area. In the urban areas, the prevalence rates of hypertension in both boys and girls were higher than the ones in rural area (χ(2) values were 36.36, 7.79, 42.10 and 13.77, respectively, and P<0.01). Differences of the percentage of body fat between boys and girls from the rural or urban areas were both significant.OR values of the boys and girls of group P(40)- and P(60)-were 1.65 and 1.75, respectively. Risks of hypertension in boys and girls showed significantly increase by P(40) and P(60), respectively. The prevalence of hypertension in both boys and girls increased along with the increase of the percentage on body fat. CONCLUSION: Since higher percentage of body fat could increase the risk of hypertension, reduction of body fat content would be beneficial to the success of prevention and control of hypertension in children.

Unusual parotid gland lesions: a pictorial review.

This is a pictorial essay of unusual parotid gland lesions that may be encountered in routine clinical practice.

Association between excess bodyweight and intake of red meat and vegetables among urban and rural adult Chinese in Nanjing, China.

The objective of this study was to examine the association of red meat and vegetable consumption with excess bodyweight. This is a cross sectional study, conducted between October 2000 and March 2001. Participants included 23,316 local residents aged 35 and above from 45 administrative villages randomly selected from urban and rural areas of Nanjing, China, with a population of 5.6 million. The response rate was 90.1%. Logistic regression model was used for the analysis. The prevalence of excess body weight, overweight and obesity was 34.1%, 28.2% and 6.0%, respectively. After adjustment for age, educational attainment, family average income, occupational and leisure-time physical activity, smoking, drinking, consumption of white meat, consumption of rice and cooking oil as well as fruits, participants in the moderate or higher level of red meat consumption were more likely to have excess body weight (OR: 1.13 (95% CI =1.02, 1.26) and 1.15 (1.02, 12.9) for males; 1.11 (0.98, 1.25) and 1.25 (1.10, 1.42) for females respectively), compared with those in the lower level of red meat consumption. There was no statistically significant association for consumption of vegetables. Consumption of more red meat was suggested to be a factor contributing to body weight gain in China. For residents who want to have healthy body weight, it is important to consume less red meat in the process of socioeconomic transition.

Analysis of three marine fish cell lines by rapd assay.

We tested the applicability of the random amplified polymorphic deoxyribonucleic acid (RAPD) analysis for identification of three marine fish cell lines FG, SPH, and RSBF, and as a possible tool to detect cross-contamination. Sixty commercial 10-mer RAPD primers were tested on the cell lines and on samples collected from individual fish. The results obtained showed that the cell lines could be identified to the correspondent species on the basis of identical patterns produced by 35-48% of the primers tested; the total mean similarity indices for cell lines versus correspondent species of individual fish ranged from 0.825 to 0.851, indicating the existence of genetic variation in these cell lines in relation to the species of their origin. Also, four primers, which gave a monomorphic band pattern within species/line, but different among the species/line, were obtained. These primers can be useful for identification of these cell lines and for characterization of the genetic variation of these cell lines in relation to the species of their origin. This supported the use of RAPD analysis as an effective tool in species identification and cross-contamination test among different cell lines.

[Multiplication of the shrimp baculovirus HHNBV with primary cell cultures from lymphoid organ of Penaeus chinensis].

The hypodermal and hematopoietic necrosis baculovirus HHNBV has been confirmed to be the causative agent for the explosive epidermic disease of farmed shrimp Penaeus chinensis since 1993. The virus was isolated and multiplied successfully in the primary cell cultures from the lymphoid organ of the shrimp. A cell monolayer was formed in three days in the medium MPS and could be maintained for 1-3 months as the medium replaced every 4-5 days. The cytopathic effect occurred in 5 days after inoculation of the tissue extract from the diseased shrimp. The transmission electron microscopy showed many rod-shaped virions of HHNBV in the nuclei of infected cells.

Lifetime low-level exposure to environmental lead and children's emotional and behavioral development at ages 11-13 years. The Port Pirie Cohort Study.

The Port Pirie Cohort Study is the first study to monitor prospectively the association between lifetime blood lead exposure and the prevalence of emotional and behavioral problems experienced by children. Lead exposure data along with ratings on the Child Behavior Checklist were obtained for 322 11-13-year-old children from the lead smelting community of Port Pirie, Australia. Mean total behavior problem score (95% confidence interval (CI)) for boys whose lifetime average blood lead concentration was above 15 microg/dl was 28.7 (24.6-32.8) compared with 21.1 (17.5-24.8) in boys with lower exposure levels. The corresponding mean scores (95% CI) for girls were 29.7 (25.3-34.2) and 18.0 (14.7-21.3). After controlling for a number of confounding variables, including the quality of the child's HOME environment (assessed by Home Observation for Measurement of the Environment), maternal psychopathology, and the child's IQ, regression modeling predicted that for a hypothetical increase in lifetime blood lead exposure from 10 to 30 microg/dl, the externalizing behavior problem score would increase by 3.5 in boys (95% CI 1.6-5.4), and by 1.8 (95% CI -0.1 to 11.1) in girls. Internalizing behavior problem scores were predicted to rise by 2.1 (95% CI 0.0-4.2) in girls but by only 0.8 (95% CI -0.9 to 2.4) in boys.

Tributyltin distribution in the coastal environment of Peninsular Malaysia.

The occurrence of tributyltin (TBT) is reported in the coastal waters of a few selected sites in Peninsular Malaysia. Water, bivalves and sediment samples collected were analysed specifically for TBT using sensitive analytical methods which involved a solvent extraction procedure with appropriate clean-up followed by graphite furnace atomic absorption spectrometric measurements. The levels of TBT in the seawater in unexposed areas were found in the range from <3.4 to 20 ng litre(-1) as compared to coastal areas with high boat and ship activities where TBT levels in seawater were generally above 30 ng litre(-1), with the highest level found at 281.8 ng litre(-1). TBT levels in the tissues of random cockle and soft-shell clam samples from local markets were found in the range from <0.5 to 3.7 ng g(-1) wet weight. The levels of TBT found in green mussel samples both from the market (23.5 ng g(-1) wet weight) and those from a mussel farm (14.2 ng g(-1) wet weight) indicate slight accumulation of TBT. In sediments, TBT levels were found ranging from <0.7 ng g(-1) dry weight in unexposed coastal sites to as high as 216.5 ng g(-1) dry weight for a site within a port area.

Effects of maternal smoking upon neuropsychological development in early childhood: importance of taking account of social and environmental factors.

Data from a prospective study of 548 children followed from birth to 4 years of age were analysed to determine whether maternal smoking during and/or after pregnancy affects children's neuropsychological development. The differences in mean developmental test scores between children whose mothers smoked and those of mothers who did not smoke were slight, with subscale scores only 2.4 to 4.1% lower in children whose mothers smoked. These differences were not statistically significant after adjustment for socio-economic status, quality of home environment and mother's intelligence, suggesting that the social and environmental factors are major confounders of the association of exposure to maternal smoking and neuropsychological development in childhood. In order to gain a better understanding of this area, more precise measures of exposure to environmental tobacco smoke and comprehensive consideration of confounders will be required.

Environmental exposure to lead and children's intelligence at the age of seven years. The Port Pirie Cohort Study.

BACKGROUND: Exposure to lead in early childhood is thought to result in delayed neuropsychological development. As yet there is little longitudinal evidence to establish whether these effects persist into later childhood. METHODS: We measured IQ scores in 494 seven-year-old children from the lead-smelting community of Port Pirie, Australia, in whom developmental deficits associated with elevated blood lead concentrations had already been reported at the ages of two and four years. Exposure to lead was estimated from the lead concentrations in maternal blood samples drawn antenatally and at delivery and from blood samples drawn from the children at birth (umbilical-cord blood), at the ages of 6 and 15 months and 2 years, and annually thereafter. Data relating to known covariates of child development were collected systematically for each child throughout the first seven years of life. RESULTS: We found inverse relations between IQ at the age of seven years and both antenatal and postnatal blood lead concentrations. After adjustment by multiple regression for sex, parents' level of education, maternal age at delivery, parents' smoking status, socioeconomic status, quality of the home environment, maternal IQ, birth weight, birth order, feeding method (breast, bottle, or both), duration of breast-feeding, and whether the child's natural parents were living together, the relation with lead exposure was still evident for postnatal blood samples, particularly within the age range of 15 months to 4 years. For an increase in blood lead concentration from 10 micrograms per deciliter (0.48 mumol per liter) to 30 micrograms per deciliter (1.45 mumol per liter), expressed as the average of the concentrations at 15 months and 2, 3, and 4 years, the estimated reduction in the IQ of the children was in the range of 4.4 points (95 percent confidence interval, 2.2 to 6.6) to 5.3 points (95 percent confidence interval, 2.8 to 7.8). This reduction represents an approximate deficit in IQ of 4 to 5 percent. CONCLUSIONS: Low-level exposure to lead during early childhood is inversely associated with neuropsychological development through the first seven years of life.

Sociodemographic factors modifying the effect of environmental lead on neuropsychological development in early childhood.

A long-term prospective cohort study was conducted to examine the association between prenatal and postnatal exposure to environmental lead and childhood neuropsychological development. The possible interactive effects of blood lead and some covariates on early development were explored in this study. Our data suggest that gender of the child modifies the effect of lead on the neuropsychological development during early childhood. At the ages of 2 and 4 years, girls appear to be more sensitive than boys to the neuropsychological effects of lead. However, there is no significant modification of the effect of lead by some other covariates, such as parental smoking, socioeconomic status, home environment, birth weight, and the kind of infant feeding. Evidence of interactions between environmental lead exposure and other covariates in the causation of neuropsychological deficits in childhood underscores the desirability of considering both main effects and interactions in this area of research. Such effects, if confirmed, may have implications for public health intervention strategies.

Determinants of blood lead concentrations to age 5 years in a birth cohort study of children living in the lead smelting city of Port Pirie and surrounding areas.

Sources of variation and some principal determinants of blood lead concentration (PbB) were investigated in a cohort of children, followed to age 5 y, who were born near a lead smelter in Port Pirie, South Australia. The child's age and place of residence were the two variables most strongly predictive of PbB. A sharp increase in PbB occurred between 6 and 15 mo of age and was followed by a peak concentration that occurred at approximately 2 y of age, after which PbB steadily and consistently declined. Irrespective of age, the PbBs in children who lived in Port Pirie were significantly higher than levels identified in children who resided outside the city. There was no significant difference in PbB between boys and girls. Elevated PbB at each specific age was associated mainly with increased lead concentrations in the topsoil of the local residential area, employment of the father in the lead industry, parental smoking, and behaviors likely to cause ingestion of dirt. Blood samples taken from children at certain ages and during the warmer months contained more lead than samples obtained during the cooler months. The effects of these determinants on PbB during early childhood were basically consistent in both single and multivariable analyses.

Genetic variance and heritability of serum cholesterol and triglycerides among Chinese twin neonates.

In order to examine the genetic variance and heritability of serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides, a total of 349 pairs of same-sexed twin neonates born in four major general teaching hospitals in Taipei City were studied. Based on the placental pattern and 12 red blood cell antigens, 271 monozygotic (MZ) and 78 dizygotic (DZ) twin pairs were identified. There was a significant genetic variance for total cholesterol, HDL-C, LDL-C, and triglycerides both unadjusted and adjusted for sex, gestational age and placentation. The unadjusted heritability of total cholesterol, HDL-C, LDL-C, and triglycerides was 0.59, 0.30, 0.25 and 0.75, respectively; while the corresponding adjusted heritability was 0.74, 0.38, 0.31, and 0.49, respectively. Intrapair variance of serum lipids was not significantly different between monochorionic and dichorionic MZ twins.