[Periconceptional maternal homocysteine and birth weight outcomes in offspring: a prospective cohort study].

Objective: To quantify the associations between periconceptional maternal homocysteine (HCY) and offspring's birth weight and risk of small for gestational age (SGA) infant. Methods: The 19 984 mother-child pairs in this prospective cohort study were recruited from the Shanghai preconception cohort; the infants were delivered from 1st September 2016 to 11th November 2022. A standardized questionnaire was used to collect the mothers' demographic information, medical history, dietary supplement use, and maternal complications during pregnancy, and their serum samples were collected. Serum HCY, folate, and vitamin B12 were measured using chemiluminescent microparticle immunoassay based on serum sample drawn at enrollment. Birth weight data were obtained from medical records. Multiple imputation methods were applied to handle missing data in key variables. Multivariable linear regression and Poisson regression models were used to analyze the relationship between maternal HCY concentration during the periconceptional period and the birth weight and SGA risk of the offspring. Results: A total of 9 452 pairs were enrolled preconceptionally and the remaining 10 532 pairs were enrolled in early pregnancy. The proportion of mothers whose pregnancy age was greater than 35 years was 9.2% (1 832/19 984), the proportion of primiparous women was 76.5% (15 283/19 984), the proportion of pre-pregnancy overweight and obesity was 14.0% (2 804/19 984), the proportion of using folic acid supplements before pregnancy was 21.4% (4 272/19 984), and the proportion of those who supplemented with folic acid during early pregnancy was 85.2% (8 976/10 532); gestational diabetes mellitus was in 6.2% (1 245/19 984), gestational hypertensive syndrome in 3.6% (711/19 984). The birth weight of the offspring was (3 297±468) g, and there were 1 962 SGA children (9.8%). The HCY concentration in the overall population in appropriate for gestational age during the periconceptional period was (7.9±3.2) µmol/L, with (8.3±3.7) µmol/L in the preconception subgroup and (7.3±2.4) µmol/L in the early pregnancy subgroup. After adjustment for the covariates of perinatal demographic information, adverse pregnancy outcomes, serum folate and vitamin B12, increased maternal periconceptional HCY was significantly associated with lower offspring birth weight (ß=-2.30, 95%CI -4.43--0.16, P=0.035). Only the early pregnancy subgroup was significantly associated with lower offspring birth weight (ß=-7.39, 95%CI-11.50--3.21, P<0.001). No association was found between peripregnancy HCY and offspring SGA risk. However, elevated HCY in early pregnancy was associated with an increased risk of SGA in the offspring (RR=1.05, 95%CI 1.01-1.08, P=0.002). Periconceptional vitamin B12 was a mediator of the association between HCY and offspring birth weight, accounting for 16.5%, 41.2% and 5.4% of its total effect in the overall periconceptional population, the pre-pregnancy subgroup and the early pregnancy subgroup, respectively. Conclusions: Maternal periconceptional HCY level is associated with lower birth weight in offspring, but not with the risk of SGA. Elevated maternal HCY in early pregnancy subgroup may be associated with increased risk of SGA in offspring.

[Association of lipoprotein a in early pregnancy with gestational diabetes mellitus: a prospective cohort study].

Objective: To investigate the association of lipoprotein a (Lpa) in early pregnancy with gestational diabetes mellitus (GDM) risk. Methods: A total of 445 pregnant women in 12-14 gestational weeks from "Maternal Key Nutritional Factors and Offspring's Atopic Dermatitis" cohort were included in this study. The demographic characteristics of participants were collected by using questionnaires, and the fasting glucose and lipids levels in early pregnancy were measured. The results of oral glucose tolerance test (OGTT) between 24-28 gestational weeks were recorded. Multivariate logistic regression model was applied to analyze the association of Lpa with GDM by calculating the OR and 95%CI after adjustment for covariates. Results: The incidence number of GDM was 78 (17.5%). The Lpa level in pregnant women with GDM was significantly higher than that in pregnant women without GDM [105.5 (92.0, 122.0) vs. 97.0 (87.0, 109.0) mg/L], P<0.05. Lpa was significantly associated with GDM risk [OR (95%CI) =1.21(1.08-1.36) per 10 mg/L], P<0.05. The association was still significant after adjustment for covariates including age, gestational weeks et al, the adjusted OR was 1.14 (95%CI: 1.01-1.30), P=0.03. Conclusions: The elevation of Lpa in early pregnancy is one of risk factor for GDM. Maintaining normal Lpa level during early pregnancy can benefit early prevention of GDM and offspring health.

The role of bacterial colonization of ventilator circuit in development of ventilator-associated pneumonia: a prospective observational cohort study.

OBJECTIVES: Ventilator-associated pneumonia (VAP) is a significant cause of prolonged hospital stay and increased mortality in mechanically ventilated children. Studies of the relationship between bacterial colonization of ventilator circuits (VCs) and VAP are lacking. This study aimed to investigate the role of bacterial colonization of VCs in the development of VAP, and to provide evidence for preventing VAP. METHODS: Mechanically ventilated patients admitted to the paediatric intensive care unit of a teaching hospital in China from October 2018 to November 2019 were enrolled. Specimens were collected from the VC and the patient's lower respiratory tract (LRT) for bacterial culture. Paired bacteria isolated from the VC and the patient's LRT, where colonization of the VC preceded that of the LRT, were evaluated for relatedness using pulsed field gel electrophoresis (PFGE). RESULTS: A total of 114 patients were included; the incidence rate of VAP was 28.1% (32/114). A total of 1368 samples were collected from VCs; 16% had positive bacterial culture. There was no significant difference in bacterial colonization of VCs between VAP and non-VAP. In 13 patients, the LRT and VC were concurrently colonized with the same bacteria, where colonization of the VC occurred before colonization of the patient's LRT. PFGE results demonstrated high correlation between bacteria from the LRT and VC in 11 patients. Among 114 mechanically ventilated children, VAP caused by bacteria from the VC occurred in six patients, accounting for 18.8% (6/32) of the overall VAP rate in this study. DISCUSSION: Bacterial colonization of the VC is a significant cause of VAP development in mechanically ventilated children. Preventive strategies for early identification and decontamination measures for contaminated VC may play a key role in preventing VAP.

[Application of three semi-quantitative risk assessment methods in electroplating enterprises].

Objective: To apply the semi-quantitative risk assessment model in the Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazardous Factors in the Workplace to assess the occupational health risk of electroplating enterprises and explore its applicable conditions and characteristics. Methods: Three electroplating enterprises were selected as the research objects. Occupational hygiene survey and hazard factor detection were conducted on the spot. Three semi-quantitative risk assessment methods were used to assess the risk, and the evaluation results were compared. Results: The consistency between the contact index method and the comprehensive index method was strong. The weighted Kappa value was 0.946 and the P value was less than 0.001, but the consistency between the contact ratio method, the contact index method and the comprehensive index method was poor. The weighted Kappa value was 0.345 and 0.391, and the P value was 0.009 and 0.004, respectively. When the contact concentration is less than 50% OELs, the evaluation results of the contact ratio method are lower than those of the exponential method and the comprehensive exponential method. The consistency of the three methods was the highest when the contact concentration (>50%) and (OELs, the results of the contact ratio method are higher than those of the index method and the comprehensive index method. Conclusion: Contact ratio method is suitable for occupational health risk assessment under the condition of incomplete occupational health information and for enterprise managers to identify key control points of health risk through self-assessment; Contact index method is suitable for hazard risk assessment of occupational hazards without sampling test conditions or OELs, and pre-assessment of occupational hazards of construction projects without access to analogical test data. The index method is suitable for occupational health risk assessment with available testing data and complete occupational health information.

[Prevalence of Helicobacter pylori infection among children aged 7 to 18 years old: a school-based cross-sectional study in Minhang district of Shanghai in 2014].

OBJECTIVE: To study the infection rate and current infection rate of Helicobacter pylori (Hp) among children aged 7 to 18 years old in Minhang district of Shanghai. METHOD: A school-based cross-sectional study in three elementary and middle schools (with students aged 7 to 18 years old) in Minhang district of Shanghai was conducted. A total of 1 988 students were investigated by questionnaire and non-invasive tests. The positive rate of serum Hp-IgG or (13)C urea breath test was the basis for calculation for Hp infection rate. The positive rate of (13)C urea breath test was the basis for current infection rate. The relationship between infection rate and age was studied through Spearman rank correlation analysis. The consistency of the two diagnostic methods was determined using kappa value analysis. RESULT: A total of 1 988 subjects were included in the analysis: 944 males and 944 females. The Hp infection rate was 36.3%(721/1 988). Current infection rate was 32.1%(625/1 949). Hp infection rates of primary (7-12 years old), junior (13-15 years old), high school group (16-18 years old) were 27.4% (223/813), 33.6% (93/277), 45.1% (405/898) respectively. Hp infection was associated with age, with a correlation coefficient of 0.167 (P<0.001). The kappa value of the serum Hp-IgG and (13)C Urea breath test was 0.67. CONCLUSION: Hp infection rate among children aged 7 to 18 years old in Minhang district of Shanghai is 36.3%, with the infection rate increasing with age. Serum Hp-IgG and the (13)C urea breath test are two detection methods each of which has advantages and disadvantages.

[Distribution of peripheral arterial stiffness and endothelial function as well as their correlations with cardiovascular risk factors in children and adolescents].

OBJECTIVE: To investigate the distribution of peripheral arterial stiffness, endothelial function and their correlations with cardiovascular risk factors in the 7-17 year-olds. METHODS: Normal weight and obese subjects aged 7-17 years with completed data on questionnaires, anthropometric and blood biochemical tests, were recruited from a cross-sectional population-based study on childhood hypertension in Minhang district of Shanghai. Automatic waveform analyzer (BP-203RPE-I) and Endopat 2000 were used to measure the arterial stiffness. Endothelial function with brachial-ankle pulse wave velocity (baPWV) and reactive hyperemia index (RHI) were recorded. BaPWV and RHI were standardized by age. Skewed biochemical variables were log transformed. Linear correlation analysis was performed to observe association between baPWV, RHI and other measured variables. RESULTS: A total of 452 normal-weight and 94 obese subjects were recruited, including 299 males. Data showed that baPWV and RHI increased with age in normal weight subjects(r=0.33, P<0.01; r=0.36, P<0.01). RESULTS from Linear correlation analysis revealed that baPWV was positively correlated with BMI (r=0.13, P=0.002), systolic blood pressure (SBP) (r=0.20, P<0.01), diastolic blood pressure (DBP) (r=0.27, P<0.01), triglycerides (TG) (r=0.11, P=0.010), insulin (r=0.21, P=0.004) and the HOMA insulin resistance index (r=0.21, P=0.005), but negatively correlated with high-density lipoprotein cholesterol (r=-0.09, P=0.039). RHI was positively correlated with BMI (r=0.10, P=0.018) but negatively correlated with DBP (r=-0.10, P=0.016). Males had higher baPWVs than females (P=0.04). However, RHI did not differ between genders. CONCLUSIONS: The fact that baPWV and RHI increased along with age, indicated that the arterial stiffness and endothelial function continued to develop in normal weight childhood and adolescence. Arterial stiffness was correlated with cardiovascular risk-related parameters whereas endothelial function was not. BaPWV might be more sensitive in evaluating the cardiovascular risk in children and adolescents than RHI did.

Overweight, high blood pressure and impaired fasting glucose in Uyghur, Han, and Kazakh Chinese children and adolescents.

OBJECTIVES: To investigate whether the levels of blood pressure and fasting glucose differ among Chinese children of three different ethnicities (i.e., Uyghurs, Kazakhs, and Hans) and whether the differences are explained by childhood obesity. METHODS: A school-based cross-sectional study was conducted in a large three ethnic pediatric population (n = 6633), whose ages ranged from 7 to 18 years. Anthropometrics and blood pressure were measured using standard protocols. Fasting glucose was measured in a subset of children (n = 2295) who were randomly selected based on ethnicity and age. The age-sex stratified Chinese national cut-offs were used to define obesity and high blood pressure (HBP). The prevalence of HBP, impaired fasting glucose (IFG), mean levels of blood pressure, and glucose were compared among three ethnic groups. RESULTS: 2142 Uyghurs, 2078 Han, and 1997 Kazakhs were analyzed. After adjusting for age and body mass index (BMI), the mean blood pressure for Uyghurs was on average, 2-4 mm Hg lower than those for Hans and Kazakhs. Kazakhs had the lowest mean fasting glucose compared with Hans and Uyghurs (4.5 vs. 5.0 vs. 4.8 mmol/L, respectively). The differences in blood pressure and fasting glucose persisted even after adjusting for age and BMI, and the differences among ethnic groups in blood pressure levels and fasting glucose levels were observed as early as 7-9 years of age. CONCLUSIONS: The prevalence of HBP and IFG differed significantly among Uyghurs, Hans, and Kazakhs, and the ethnic differences observed in childhood were consistent with those observed in adults from the same region. While childhood obesity is a significant risk factor for hypertension and elevated glucose, the differences among ethnic groups were not explained by obesity alone.

Effect of conditioning by PAM polymers with different charges on the structural and characteristic evolutions of water treatment residuals.

Three types of polyacrylamide (PAM) flocculants with different charges (cationic PAM WD4960, nonionic PAM M351, and anionic PAM WDA110) were used for water treatment residuals (WTRs) conditioning, and the physicochemical, morphological and structural characteristics of raw and conditioned WTRs were investigated. Rheological methods were employed to analyze the internal structural transition between the raw and conditioned WTRs under a typical dosage of WD4960. Results showed that when the raw WTRs were conditioned with the polymers, the optimum dosage of WD4960 was 4.82 g/kg total suspended solid (TSS) while that of both M351 and WDA110 was 7.24 g/kg TSS. The residual PAM content in the supernatant of the WTR matrix conditioned at the optimum WD4960 dosage was 5.59 mg/L, which is the least among the supernatants obtained with the three types of PAM. Furthermore, the visible fulvic acid (FA) in the supernatant disappeared and the intensity of the ultraviolet FA decreased. The average diameter of irregularly shaped aggregates in the WTR suspensions increased from 35.73 µm to several hundred micrometers with increasing PAM dosage. The size of WTR aggregates conditioned at the optimum WD4960 dosage was much larger than that of aggregates obtained at the optimum M351 or WDA110 dosages. Two-dimensional fractal dimension (D2) values presented an increasing trend with increasing PAM dosage. D2 values of the conditioned WTR aggregates were 1.87, 1.76, and 1.83 at optimum WD4960, M351, and WDA110 dosages, respectively. The cationic PAM (CPAM) WD4960 thus appears to be a more ideal conditioner for WTRs. Consistent relationships were observed among the capillary suction time (CST), average particle size, and D2 values of the conditioned WTR aggregates at the optimum WD4960 dosage. Mass fractal dimensions (D(f)) indicated that both the raw and WD4960-conditioned WTRs behave like weak-link flocs/aggregates. D(f) values (log G'-log TSS) of the WTR aggregates before and after conditioning with the optimum WD4960 dosage were 2.79 and 2.81, respectively. Although the transition from an alum/ferric hydrogel to a cross-linked gel occurred during the WD4960-conditioning process, only a small amount of the alum/ferric hydrogel was destroyed, and the conditioned WTR aggregates showed a gel-like matrix in which residual alum-ferric hydrogels were embedded in cross-linked WD4960 molecules.

Adsorption of lead and humic acid on chitosan hydrogel beads.

Chitosan hydrogel beads were studied for the adsorption of lead ions and humic acid from aqueous solutions to examine the adsorption behaviors and mechanisms. The experiments were carried out at room temperature with solution pH ranging from 5 to 7.5 (in near neutral pH range). Three types of batch adsorption experiments, including single species adsorption, sequential adsorption of one species after another and co-adsorption of both species, were investigated. The results show that: (1) adsorption of either species mainly results from the complexations between adsorbate and functional groups at the surface of the hydrogel beads; (2) previously adsorbed species can either act as additional binding sites for, or occupy the same binding sites as the subsequent species to be adsorbed, resulting in enhanced or retarded adsorption of the subsequent species; and (3) for co-adsorption, metal-organic interactions play a very important role in determining the extent of adsorption. It is concluded that multi-species adsorption can be significantly affected by adsorbate interactions and the understanding of these interactions needs great attention in adsorption study in the future.

Childhood-onset schizophrenia/autistic disorder and t(1;7) reciprocal translocation: identification of a BAC contig spanning the translocation breakpoint at 7q21.

Childhood-onset schizophrenia (COS) is defined by the development of first psychotic symptoms by age 12. While recruiting patients with COS refractory to conventional treatments for a trial of atypical antipsychotic drugs, we discovered a unique case who has a familial t(1;7)(p22;q21) reciprocal translocation and onset of psychosis at age 9. The patient also has symptoms of autistic disorder, which are usually transient before the first psychotic episode among 40-50% of the childhood schizophrenics but has persisted in him even after the remission of psychosis. Cosegregating with the translocation, among the carriers in the family available for the study, are other significant psychopathologies, including alcohol/drug abuse, severe impulsivity, and paranoid personality and language delay. This case may provide a model for understanding the genetic basis of schizophrenia or autism. Here we report the progress toward characterization of genomic organization across the translocation breakpoint at 7q21. The polymorphic markers, D7S630/D7S492 and D7S2410/D7S646, immediately flanking the breakpoint, may be useful for further confirming the genetic linkage for schizophrenia or autism in this region. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:749-753, 2000. Published 2000 Wiley-Liss, Inc.

Sequence analysis and mapping of a novel human mitochondrial ATP synthase subunit 9 cDNA (ATP5G3).

We describe the cloning, sequence analysis, and chromosomal mapping of a novel mitochondrial ATP synthase subunit 9cDNA, P3. Subunit 9 transports protons across the inner mitochondrial membrane to the F1-ATPase protruding on the matrix side, resulting in the generation of ATP. Sequence analysis of the P3 cDNA reveals only 80% identity with the human subunit 9 genes P1 and P2 in the DNA sequence encoding the mature peptide. However, this sequence predicts a mature protein identical to P1 and P2. The predicted sequence of the P3 leader peptide differs from the P1 and P2 leaders, but retains the "RFS" motif critical for mitochondrial import and maturation. The P3 gene (ATP5G3) maps to chromosome 2.

Linkage analysis in juvenile neuronal ceroid lipofuscinosis.

Neuronal ceroid lipofuscinosis (NCL, Batten disease) is an autosomal recessive disease characterized by progressive mental retardation, cortical atrophy, seizures, and retinal degeneration. Several subtypes have been delineated on the basis of age-at-onset and histological characteristics; the most common is the juvenile (JNCL) form. Recently, the gene for JNCL was shown to reside on chromosome 16 through linkage studies to the haptoglobin locus and anonymous DNA markers using numerous European families. We have now examined 8 families from North America with JNCL for linkage to markers in 16q21-23. Results in 3 families tend to support linkage to chromosome 16;3 families remained uninformative, and 2 families produced negative lod scores in this region. A test of homogeneity was suggestive, but could not significantly reject the null hypothesis of homogeneity. We are continuing to collect families, particularly those with multiple living affecteds, and are identifying other probes in this region. Given close localization on chromosome 16 for JNCL, molecular strategies, including candidate gene strategies, are being explored.