Heat exposure and hospitalizations for chronic kidney disease in China: a nationwide time series study in 261 major Chinese cities.

BACKGROUND: Climate change profoundly shapes the population health at the global scale. However, there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease (CKD). METHODS: In the present study, we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018. Standard time-series regression models and random-effects meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span, respectively. RESULTS: A total of 768,129 hospitalizations for CKD was recorded during the study period. The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD, especially in sub-tropical cities. With a 1 °C increase in daily mean temperature, the cumulative relative risks (RR) over lag 0-7 d were 1.008 [95% confidence interval (CI) 1.003-1.012] for nationwide. The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%. Stronger associations were observed among younger patients and those with obstructive nephropathy. Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days (RR = 1.116, 95% CI 1.069-1.166) above the effect of daily mean temperature. CONCLUSIONS: Short-term heat exposure may increase the risk of hospitalization for CKD. Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.

Time-trend analysis of tuberculosis diagnosis in Shenzhen, China between 2011 and 2020.

Objective: To describe the trend of tuberculosis (TB) diagnosis in the migrant city Shenzhen, China, and analyze the risk factors of diagnosis delays. Methods: Demographic and clinical information of TB patients from 2011 to 2020 in Shenzhen were extracted. A bundle of measures to enhance TB diagnosis had been implemented since late 2017. We calculated the proportions of patients who underwent a patient delay (>30 days from syndrome onset to first care-seeking) or a hospital delay (>4 days from first care-seeking to TB diagnosis). Multivariable logistic regression was used to analyze the risk factors of diagnosis delays. Results: During the study period, 43,846 patients with active pulmonary TB were diagnosed and registered in Shenzhen. On average, the bacteriological positivity rate of the patients was 54.9%, and this increased from 38.6% in 2017 to 74.2% in 2020. Overall, 30.3 and 31.1% of patients had a patient delay or a hospital delay, respectively. Molecular testing significantly increased bacteriological positivity and decreased the risk of hospital delay. People >35 years old, the unemployed, and residents had a higher risk of delays in both patient care-seeking and hospital diagnosis than younger people, workers, or migrants. Compared with passive case-finding, active case-finding significantly decreased the risk of patient delay by 5.47 (4.85-6.19) times. Conclusion: The bacteriological positivity rate of TB patients in Shenzhen increased significantly but the diagnosis delays were still serious, which may need more attention when active case-finding in risk populations and optimization of molecular testing.

Microarray-based differential expression profiling of long noncoding RNAs and messenger RNAs in formalin-fixed paraffin-embedded human papillary thyroid carcinoma samples.

BACKGROUND: Long noncoding RNAs (lncRNAs) can regulate the expression of genes at almost every level. The altered expression of lncRNAs was observed in many kinds of cancers. Until recently, few studies have focused on the function of lncRNAs in the context of papillary thyroid carcinoma (PTC). METHODS: In the current study, we collected seven PTC and nodular goiter tissue samples and explored mRNA and lncRNA expression patterns in these samples by microarray. RESULTS: We observed aberrant expression of 94 lncRNAs and 99 mRNAs in the seven PTC samples as compared to the nodular goiter tissue [fold change (FC) ≥2.0; P<0.01]. To confirm these microarray results, quantitative polymerase chain reaction (q-PCR) was performed to assess the expression of three randomly selected differentially expressed mRNAs and lncRNAs, confirming our microarray findings significantly. We then performed gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analyses to systematically characterize the twelve significantly differential genes. A co-expression analysis revealed that the lncRNAs n382996, n342483, and n409114 were closely related to the regulation of MT1G, MT1H, and MT1F. CONCLUSIONS: In the present study a string of novel lncRNAs associated with PTC were identified. Further study of these lncRNAs should be performed to identify novel target molecules which may improve diagnosis and treatment of PTC.

[Expression of the NMDA receptor in the rat model of orchialgia].

OBJECTIVE: To explore the expression of the N-methyl-D-aspartate (NMDA) receptor in the rat model of orchialgia and its possible mechanisms. METHODS: According to Yoshioka's method, the male rats in the control group were injected with 0.2 ml saline, and those in the experimental group with 0.2 ml 2% acetic acid solution. Then we tested the behavioral responses of the rats and determined the expressions of the subunits NR1 and NR2B of the NMDA receptor in the dorsal root ganglion and spinal dorsal horn by Western blot, RT-qPCR and immunofluorescence staining. RESULTS: The withdrawal latency was decreased in the model rats, reaching the lowest value at 4 hours after modeling, significantly lower than in the controls (ï¼»4.15 ± 0.84ï¼½ vs ï¼»12.32 ± 1.05ï¼½, P < 0.05). Compared with the controls, the model rats showed remarkably increased mRNA and protein expressions of NR2B in the dorsal root ganglion (P < 0.05) but not in the spinal dorsal horn at 4 hours. However, no statistically significant difference was found in the expression of NR1 either in the dorsal root ganglion or in the spinal dorsal horn between the two groups (P > 0.05). CONCLUSIONS: The NMDA receptor plays an important role in pathogenesis of orchialgia in rats. In the early stage of pain, upregulating the expression of the subunit NR2B of the NMDA receptor can mediate peripheral hyperalgesia and consequently orchialgia.

Dynamic profile of differentiated thyroid cancer in male and female patients with thyroidectomy during 2000-2013 in China: a retrospective study.

The study aimed to investigate the gender-related differences of disease onset, age distribution, blood type, clinical characteristics, and malignant behaviors of differentiated thyroid carcinoma (DTC) in Chinese patients. A total of 7385 consecutive thyroid cancer patients who underwent thyroidectomy were retrospectively reviewed. 4087 (55.3%) were diagnosed as benign and the other (3298, 44.7%) were as malignant. DTC accounted for 97.6% in the malignant tumor. More single nodules turned out to be DTC in male compared to multiple nodules (46.9% vs. 40.4%, P = 0.004). The proportion increased along with the increase of year during 2000-2013, which was from 7.5% to 68.1% in males and from 16.2% to 66.7% in females. The level of preoperative TSH was significantly higher in patients with DTC compared to the patients with benign (1.97 vs. 1.57 mIU/L, P < 0.001). The proportion of thyroid cancer was dominated in blood type B and the lowest incidence in blood type A in male, the difference was not statistically significant. The results showed that age, nodule number, BMI and serum TSH were the related factors for DTC. More aggressive behaviors of DTC were observed in male patients, and more attention should be focused on the timely diagnosis and treatment of these patients.

Characterization of papillary thyroid microcarcinomas using sonographic features in malignant papillary thyroid cancer: a retrospective analysis.

The diagnosis of malignant thyroid nodules is still a clinical challenge. This study aimed to determine the ultrasonographic characteristics of papillary thyroid carcinoma. The ultrasonographic and pathological data of 2453 thyroid nodules in a cohort of 1895 Chinese patients who underwent thyroidectomy from January 2010 to December 2012 were retrospectively reviewed. Anteroposterior and transversal (AP/TR) diameters ≥1, solid structure, infiltrative margins, hypoechoic appearance, and microcalcifications were more common in malignant nodules than in benign nodules (P < 0.01). These ultrasonographic features were independent risk factors of malignancy (P < 0.01) as determined by logistic regression analysis. Based on multivariate analysis, these characteristics were also present in large nodules (diameter >10 mm). However, in small nodules (diameter ≤10 mm), only AP/TR ≥1 and infiltrative margins were independent risk factors of malignancy (P < 0.01). Ultrasonography is of high diagnostic value for malignant thyroid nodules and may help to improve the differential diagnosis. Small and large nodules have distinct ultrasonographic features.

MR findings of Rosai-Dorfman disease in sellar and suprasellar region.

BACKGROUND: Rosai-Dorfman disease (RDD) in sellar/suprasellar region is a rare intracranial disorder. The diagnostic evaluation of this condition using magnetic resonance imaging (MRI) has seldom been described previously. The purpose of our study was to describe MRI characteristics of sellar/suprasellar region RDD. METHODS: Five patients with proved sellar/suprasellar region RDD from May 2005 to March 2010 were retrospectively reviewed. All the patients had undergone magnetic resonance scanning. The number, location, signal intensity (SI), and enhancement pattern of the lesions on MRI were retrospectively evaluated. RESULTS: Pathological diagnosis of RDD was achieved in all 5 cases including 4 by surgery and 1 by biopsy. The most common presenting symptoms were headache (n = 4) and blurred vision (n = 3). On MRI, isolated suprasellar lesion was found in 2 cases. Suprasellar lesion combined with intrasellar, dural, intra-axial and orbital lesions was found in 3 cases. All lesions showed homogeneous isointense SI on T1-weighted images and hypointense to isointense SI on T2-weighted images except one lesion in the midbrain with slight hyperintense SI on T2-weighted images. All lesions showed homogeneous enhancement. CONCLUSION: Homogenously enhancing sellar/suprasellar masses of hypointense to isointense SI on T2-weighted images are suggestive of RDD, and central hypointensity on T2-weighted images may be a specific finding. Intra-axial and extra-axial involvements may coexist with sellar/suprasellar region RDD. Although radiological findings can provide some evidence for this rare entity, differential diagnosis is still needed.

[Clinicopathologic analysis of myocardial infarction with or without left ventricular aneurysm formation in the elderly patients].

OBJECTIVE: To analyze the clinic-pathologic features of elderly myocardial infarction patients (> 60 years) with and without left ventricular aneurysm formation. METHODS: Between January 1980 and October 2009, 107 myocardial infarction patients were divided into aneurysm group (n = 31) and non-aneurysm group (n = 76) according to autopsy results and the clinic-pathologic features of the two groups were compared. RESULTS: Previous angina pectoris history was significantly less in aneurysm group than in non-aneurysm group [45.2% (14/31) vs. 92.1% (70/76), P = 0.047]. Incidence of hypertension was significantly higher in aneurysm group than in non-aneurysm group [77.4% (24/31) vs. 36.8% (28/76), P = 0.033]. The percentage of single-vessel disease [54.8% (17/31) vs. 23.7% (18/76), P = 0.033] and the LAD disease [96.8% (30/31) vs. 51.3% (39/76), P = 0.048] were both significantly higher in aneurysm group than in non-aneurysm group. Heart failure and ventricular arrhythmias were more likely the cause of death in patients with aneurysm than patients without aneurysm [56.3% (18/31) vs. 19.7% (15/76), P = 0.007]. Aneurysm mostly located in left ventricular anterior wall and apex. CONCLUSIONS: Our results suggest that patients with left ventricular aneurysm formation are more likely to have hypertension, single-vessel disease and LAD disease, heart failure and ventricular arrhythmias but less previous angina pectoris than patients without left ventricular aneurysm formation. The common locations of ventricular aneurysm formation were left ventricular anterior wall and apex.

The Use of CT Perfusion to Determine Microvessel Density in Lung Cancer: Comparison with FDG-PET and Pathology.

OBJECTIVE: To investigate the validity of CT perfusion in assessing angiogenic activity of lung cancer. METHODS: Fifty-six patients with lung cancer scheduled for elective surgical resection received 16-slice helical CT perfusion imaging. Time-density curve (TDC), blood flow (BF), blood volume (BV), mean transmit time (MTT) and permeability surface area product (PS) were calculated. 18F-deoxyglucose-positron emission tomography (FGD-PET) was carried out in 14 out of the 56 patients to calculate standardized uptake values (SUVs). Tumor microvessel density (MVD) was examined using CD34 immunohistochemical staining of the resected tumor tissue. Pearson's correlation analysis was used to evaluate potential correlation between CT perfusion parameters and MVD or SUV. RESULTS: Average time to peak height (TPH) of the TDCs (including two types of TDC) was 24.38±5.69 seconds. Average BF, BV, MTT and PS were 93.42±53.45 ml/100g/min,93.42±53.45 ml/100g,6.83±4.51 s and 31.92±18.73 ml/100g/min, respectively. Average MVD was 62.04±29.06/HPF. The mean SUV was 6.33±3.26. BF was positively correlated with MVD (r=0.620,P<0.01) and SUV (r=0.891, P<0.01). PS was also positively correlated with SUV (r=0.720, P<0.05). A positive correlation was also observed between tumor MVD and SUV (r=0.915, P<0.01). CONCLUSIONS: CT perfusion imaging is a reliable tool to evaluate the tumor neovascularity of lung cancer.

Mortality, cause of death and life expectancy of Chinese Canadians in Alberta.

OBJECTIVE: To describe mortality, cause of death and life expectancy among Chinese (both immigrant and Canadian-born) and other Canadians in the Province of Alberta. METHODS: A Chinese surname list was applied to the Alberta Health Insurance Plan and Vital Statistics Birth registry databases to define the Chinese population, and to the Vital Statistics Death registry to determine deaths among Chinese in Alberta from 1995 to 2003. Age- and sex-specific mortality, cause of death and life expectancy were calculated. RESULTS: Of nearly 3 million Alberta residents, about 4% were Chinese in 2003. The age-adjusted mortality for Chinese was 4.2 per 1000 and for non-Chinese 6.2 per 1000 population. Infant mortality was lower for Chinese (4.9/1000 live births) than non-Chinese (6.2/1000 live births). Life expectancy at birth was 6.3 years longer for Chinese males compared to non-Chinese males (83.3 versus 77.0), and 5.4 years longer for Chinese females compared to non-Chinese females (87.9 versus 82.5). Cancer, heart disease and stroke were the leading causes of death for both Chinese and non-Chinese Albertans. CONCLUSIONS: The Chinese ethnic population of Alberta had lower mortality and longer life expectancy than remaining Albertans, suggesting that the Chinese population has better health status than other Albertans. Reasons for the health gap between Chinese and non-Chinese populations should be further explored.

[Raising fat content in transgenic rice by anti-PEP gene transformation].

Gene for phosphoenolpyruvate carboxylase (PEPCase) was incorporated in antisense orientation into genome of japonica rice variety Xiushui 11 through Agrobacterium tumefaciens-mediated transformation of mature seeds-derived embryogenic calli, and a total of 95 transgenic plants were regenerated, which were confirmed by histochemical detection of GUS activity (Fig.2), PCR assay (Fig.3) and Southern hybridization analysis (Fig.4). The transgene was inherited by the T1 progeny and Mendelian 3:1 segregation ratio was observed in most transgenic lines. It was found that the fat content of hulled grains of T2 transgenic lines was 0.37 +/- 0.12 per cent higher than that of the control, most of which were statistically very significant (Table 2).

Highly efficient transformation and plant regeneration of tall fescue mediated by Agrobacterium tumefaciens.

An efficient and reproducible system has been developed for the production of transgenic plants in tall fescue (Festuca arundinacea Schreb.) using A. tumefaciens-mediated transformation. Two-months-old suspension cultures served as excellent explants for transformation. The explants were inoculated with an A. tumefaciens strain EHA105 carrying a plasmid pDBA121 containing genes for hygromycin phosphotransferase (hpt) and phosphinotricin acetyltransferase (bar). The commercial herbicide Basta was used as a selective agent. Inclusion of acetosyringone (ACS) 20 mg/L in the co-culture medium led to an increase in transformation efficiency. The efficiency of transformation was highly dependent on the genotype, the explant, the culture medium and selective agent used. Tall fescue transformation efficiency is 2.85-10.9 plants per gram fresh weight (FW) of suspension cultures. This is much higher than the corresponding values reported before (2-5 plants). So far more than 300 transgenic plants have been obtained, the fertility of some transgenic plants had decreased. Stable integration and high expression of the transgenes were confirmed by PCR analysis and Southern blot hybridization or herbicide Basta spraying test.

Potential factors that may affect acceptance of routine prenatal HIV testing.

BACKGROUND: Despite increasing advocacy for an "opt-out" strategy in routine prenatal HIV screening programs in Canada, no published studies have examined factors that may affect acceptance of prenatal HIV testing. METHODS: We included all pregnant women in Alberta who received prenatal care (N = 38,712) and their caregivers (N = 2,007) between January 1 and November 30, 2000. Factors associated with non-acceptance of HIV testing in both pregnant women and their caregivers were assessed using multivariate logistic regression. RESULTS: Overall, 1.5% of women declined HIV testing. First Nations women were about twice as likely to decline the test (adjusted odds ratio [OR(adj)] 1.91, 95% CI [1.42-2.58]) compared to non-First Nations women (p < 0.001). The proportion also increased with age (chi2 trend p < 0.001) in the general population. In First Nations women, however, most (3.2%) declined in the 20-24 year age group. No significant effect was seen for a socio-economic status marker or for the place of residence. The caregivers of women who declined HIV testing were more likely to be female (OR(adj) 1.56 [1.28-1.89]), midwives (OR(adj) 140.65 [58.61-337.49]), other non-obstetrical medical specialties (OR(adj) 4.92 [1.94-12.47]), and general practitioners (OR(adj) 3.44 [1.87-6.33]). CONCLUSION: In an "opt-out" routine prenatal HIV screening program, the characteristics of both the pregnant women and their caregivers may contribute to the non-acceptance of HIV testing. A higher likelihood of declining HIV testing among First Nations pregnant women and other pregnant women under the care of midwives and female physicians warrants further study.

[Clinicopathologic and radiologic features of dysembryoplastic neuroepithelial tumors].

OBJECTIVE: To study the clinicopathologic features and radiologic findings of dysembryoplastic neuroepithelial tumor (DNT). METHODS: The clinical presentations, radiologic findings, histologic features and immunophenotype of 9 cases of DNT were analyzed. RESULTS: The age of patients ranged from 12 to 51 years (mean age = 32 years). Most presented with partial seizures, sometimes accompanied by transient aphasia, agraphia and decreased visual acuity. One case was asymptomatic and discovered incidentally during a routine check-up. All patients had no neurological deficit found on physical examination. All tumors were located in the supratentorial cerebral cortex. There was no peritumoral edema or space-occupying effect on radiologic examination. The tumors involved either frontal lobe (number = 4), temporal lobe (number = 4), frontoparietal lobe (number = 1) . Two cases showed cystic changes. Two histologic variants of DNT were recognized: simple (number = 3) and complex (number = 6). Simple variant was composed mainly of the glioneuronal element, accompanied by surrounding oligodendrocyte-like cells, and the complex variant contained a low-grade glioma component, in addition to the glioneuronal element and sometimes foci of cortical dysplasia. CONCLUSIONS: DNT is a benign tumor with excellent prognosis after surgical excision. Local recurrence is rare. Complex variant of DNT needs to be distinguished from other types of low-grade glioma.

Impact of preeclampsia and gestational hypertension on birth weight by gestational age.

The predominant etiologic theory of preeclampsia is that reduced uteroplacental perfusion is the unique pathogenic process in the development of preeclampsia. Decreased uteroplacental blood flow would result in lower birth weights. To date, no study has assessed the effect of preeclampsia on birth weight by gestational age. Thus, the authors conducted a retrospective cohort study based on 97,270 pregnancies that resulted in delivery between 1991 and 1996 at 35 hospitals in northern and central Alberta, Canada. Differences in mean birth weight between women with preeclampsia and normotensive women ranged from -547.5 g to 239.5 g for gestational age categories ranging from < or = 32 weeks to > or = 2 weeks. The birth weights were statistically significantly lower among mothers with preeclampsia who delivered at < or = 37 weeks, with an average difference of -352.5 g. However, the birth weights were not lower among preeclamptic mothers who delivered after 37 weeks (average difference of 49.0 g). In Alberta, 61.2% of preeclamptic patients gave birth after 37 weeks of gestation. The authors conclude that babies born to mothers with preeclampsia at term have fetal growth similar to that of babies born to normotensive mothers. This finding does not endorse the currently held theory that reduced uteroplacental perfusion is the unique pathophysiologic process in preeclampsia.