Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study.

BACKGROUND: The World Health Organization emphasizes the importance of completely voluntary blood donation to maintain safe and sustainable blood supplies. However, the benefits of blood donation for donors, such as reducing the risk of disease, remain a topic of debate due to the existence of the healthy donor effect (HDE). This effect arises because of inherent health differences between blood donors and the general population, and it is also considered a methodological issue. OBJECTIVE: This study aims to generate a more detailed health profile of blood donors from a donor cohort study to mitigate and quantify the HDE and properly interpret the association between blood donation and disease outcomes among blood donors. METHODS: A retrospective cohort study was conducted between January 2012 and December 2018 among donors before their first donation. One-to-one propensity score matching was conducted through a random selection of individuals without any history of blood donation, as reported from their electronic health records. We conducted a Poisson regression between blood donors and non-blood donors before the first donation to estimate the adjusted incidence rate ratio (AIRR) of selected blood donation-related diseases, as defined by 13 categories of International Classification of Diseases, Tenth Revision (ICD-10) codes. RESULTS: Of the 0.6 million blood donors, 15,115 had an inpatient record before their first donation, whereas 17,356 non-blood donors had an inpatient record. For the comparison between blood donors and the matched non-blood donors, the HDE (the disease incidence rate ratio between non-blood donors and blood donors) was an AIRR of 1.152 (95% CI 1.127-1.178; P<.001). Among disease categories not recommended for blood donation in China, the strongest HDE was observed in the ICD-10 D50-D89 codes, which pertain to diseases of the blood and blood-forming organs as well as certain disorders involving the immune mechanism (AIRR 3.225, 95% CI 2.402-4.330; P<.001). After age stratification, we found that people who had their first blood donation between 46-55 years old had the strongest HDE (AIRR 1.816, 95% CI 1.707-1.932; P<.001). Both male and female donors had significant HDE (AIRR 1.082, 95% CI 1.05-1.116; P=.003; and AIRR 1.236, 95% CI 1.196-1.277; P<.001, respectively) compared with matched non-blood donors. CONCLUSIONS: : Our research findings suggest that the HDE is present among blood donors, particularly among female donors and those who first donated blood between the ages of 46 and 55 years. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200055983; https://www.chictr.org.cn/showproj.html?proj=51760.

Exploring multimorbidity profiles in middle-aged inpatients: a network-based comparative study of China and the United Kingdom.

BACKGROUND: Multimorbidity is better prevented in younger ages than in older ages. This study aims to identify the differences in comorbidity patterns in middle-aged inpatients from China and the United Kingdom (UK). METHODS: We utilized 184,133 and 180,497 baseline hospitalization records in middle-aged populations (40-59 years) from Shaanxi, China, and UK Biobank. Logistic regression was used to calculate odds ratios and P values for 43,110 unique comorbidity patterns in Chinese inpatients and 21,026 unique comorbidity patterns in UK inpatients. We included the statistically significant (P values adjusted by Bonferroni correction) and common comorbidity patterns (the pattern with prevalence > 1/10,000 in each dataset) and employed network analysis to construct multimorbidity networks and compare feature differences in multimorbidity networks for Chinese and UK inpatients, respectively. We defined hub diseases as diseases having the top 10 highest number of unique comorbidity patterns in the multimorbidity network. RESULTS: We reported that 57.12% of Chinese inpatients had multimorbidity, substantially higher than 30.39% of UK inpatients. The complete multimorbidity network for Chinese inpatients consisted of 1367 comorbidities of 341 diseases and was 2.93 × more complex than that of 467 comorbidities of 215 diseases in the UK. In males, the complexity of the multimorbidity network in China was 2.69 × more than their UK counterparts, while the ratio was 2.63 × in females. Comorbidities associated with hub diseases represented 68.26% of comorbidity frequencies in the complete multimorbidity network in Chinese inpatients and 55.61% in UK inpatients. Essential hypertension, dyslipidemia, type 2 diabetes mellitus, and gastritis and duodenitis were the hub diseases in both populations. The Chinese inpatients consistently demonstrated a higher frequency of comorbidities related to circulatory and endocrine/nutritional/metabolic diseases. In the UK, aside from these comorbidities, comorbidities related to digestive and genitourinary diseases were also prevalent, particularly the latter among female inpatients. CONCLUSIONS: Chinese inpatients exhibit higher multimorbidity prevalence and more complex networks compared to their UK counterparts. Multimorbidity with circulatory and endocrine/nutritional/metabolic diseases among both Chinese and UK inpatients necessitates tailored surveillance, prevention, and intervention approaches. Targeted interventions for digestive and genitourinary diseases are warranted for the UK.

Cohort Profile: The Shaanxi Blood Donor Cohort in China.

Purpose: The Shaanxi Blood Donor Cohort was set up to investigate the impact of blood donation on the health of donors compared with non-blood donors. The specific aims of the study include (1) identifying the geographical and temporal trends of incidence for diseases in both blood donors and non-blood donors; (2) assessing the impact of environmental exposures, lifestyle, body mass index (BMI) and blood type on disease burdens, stratified between blood donors and non-blood donors; and (3) among blood donors, investigating if regular blood donation has a positive impact on donors' health profiles, based on a cohort with a mixed retrospective and prospective study design. Participants: A total of 3.4 million adults, with an equal number and identical demographic characteristics (year of birth, sex and location of residence) of blood donors and non-blood donors, were enrolled on 2012. The one-to-one matching was conducted through a repeated random selection of individuals without any history of blood donation from the Shaanxi Electronic Health Records. The cohort has been so far followed up to the end of 2018, summing to nearly 24 million years of follow-up. The cohort will be followed up prospectively every 3 years until 2030. Findings to Date: Of the 1.7 million blood donors, 418,312 (24.5%) and 332,569 (19.5%) individuals were outpatients and inpatients, accounting for 1,640,483(96.2%) outpatient and 496,061 (29.1%) inpatient visits. Of the same number of non-blood donors, 407,798 (23.9%) and 346,097 (20.3%) individuals were hospital outpatients and inpatients, accounting for 1,655,725 (97.1%) outpatient and 562,337 (33.0%) inpatient visits. The number of outpatient and inpatient visits by non-blood donors was 0.9 and 3.9% higher than those of the blood donors (p < 0.01). Blood donors demonstrate significantly fewer inpatients visits than non-blood donors for major chronic disease categories (p < 0.01). Future Plans: We are currently exploring the long term benefits of blood donation on major chronic disease categories and multimorbidities in this large population cohort. The study results are adjusted by the "healthy donor effect." This cohort study will continue until 2030.

Association of ABO blood group with respiratory disease hospitalization and severe outcomes: a retrospective cohort study in blood donors.

OBJECTIVES: Environmental, socioeconomic, and genetic factors all are associated with respiratory diseases. We aimed to investigate the association between the ABO blood group and the susceptibility to respiratory diseases. METHODS: We constructed a retrospective cohort study of blood donors in Shaanxi, China between January 1, 2012, and December 31, 2018, to investigate the impacts of the ABO blood group on the risk of hospitalization due to respiratory diseases. RESULTS: Of 1,686,263 enrolled participants (680,788 females), 26,597 were admitted to the hospital for respiratory diseases. Compared with blood group O, blood groups A, B, and AB all demonstrated a higher risk for diseases of the upper respiratory tract (International Classification of Diseases, Tenth Revision: J30-J39) (ARR (Adjusted relative risk) 1.139, 95% confidence interval [1.106-1.225]; 1.095 [1.019-1.177]; 1.178 [1.067-1.30], respectively). Conversely, blood group A was found to have a lower risk (0.86 [0.747-0.991]) for influenza (J09-J11) and blood group B had a lower risk for pneumonia (J12-J18) (0.911 [0.851-0.976]) than blood group O. The duration of hospitalization was significantly different across the blood groups in J09-J11 and J30-J39 (P <0.05). CONCLUSION: The blood group appears to be a prognostic factor in differentiating the occurrence of specific respiratory diseases and duration.

CCL5-dependent mast cell infiltration into the tumor microenvironment in clear cell renal cell carcinoma patients.

We investigated the mechanisms affecting tumor progression and survival outcomes in Polybromo-1-mutated (PBRM1MUT) clear cell renal cell carcinoma (ccRCC) patients. PBRM1MUT ccRCC tissues contained higher numbers of mast cells and lower numbers of CD8+ and CD4+ T cells than tissues from PBRM1WT ccRCC patients. Hierarchical clustering, pathway enrichment and GSEA analyses demonstrated that PBRM1 mutations promote tumor progression by activating hypoxia inducible factor (HIF)-related signaling pathways and increasing expression of vascular endothelial growth factor family genes. PBRM1MUT ccRCC tissues also show increased expression of C-C motif chemokine ligand 5 (CCL5). PBRM1-silenced ccRCC cells exhibited greater Matrigel tube formation and cell proliferation than controls. In addition, HMC-1 human mast cells exhibited CCL5-dependent in vitro migration on Transwell plates. High CCL5 expression in PBRM1MUT ccRCC patients correlated with increased expression of genes encoding IFN-γ, IFN-α, IL-6, JAK-STAT3, TNF-α, and NF-ΚB. Moreover, high CCL5 expression was associated with poorer survival outcomes in ccRCC patients. These findings demonstrate that CCL5-dependent mast cell infiltration promotes immunosuppression within the tumor microenvironment, resulting in tumor progression and adverse survival outcomes in PBRM1MUT ccRCC patients.

[Health Assessment of the Stream Ecosystem in the North Canal River Basin, Beijing, China].

With increasing urbanization, the stream ecosystem in Beijing has faced great challenges. Phytoplankton, benthic macroinvertebrates, and water quality were investigated based on 25 sampling sites in the North Canal River basin in July 2015, and the quality of the habitat was assessed in situ. A total of 22 metrics, including aquatic organism, hydrology, water quality, and habitat, were calculated to be the candidate indicators. A principal component analysis (PCA) and correlation analysis were used to select the core metrics from the candidate indicators, and the weight of each core metric was estimated by using the entropy method. The integrated index of stream ecological health was constructed to assess the health condition of the North Canal River basin. The results of the PCA and correlation analysis showed that nine metrics were selected as the core metrics to construct the integrated index of stream ecological health, i. e., the Shannon-Wiener diversity index of phytoplankton and benthic macroinvertebrates, water temperature, BOD5, NH4+-N, F-, Zn, petroleum, and the qualitative habitat evaluation index (QHEI). According to the results of the health assessment, 12% of the sampling sites in the North Canal River basin were considered to be healthy (Ⅰ) or sub-healthy (Ⅱ), and more than half were poor (Ⅳ) or bad (Ⅴ). Therefore, the aquatic ecosystem in the North Canal River basin was generally unhealthy. The upstream was better than the midstream and downstream, where the spatial heterogeneity of the health condition was strong. The health condition in the Nansha River, the midstream of the Qinghe River, and the main stream of the Tonghui River were poor, while the upstream of the Liangshui River and the tributaries of the Wenyu River were good. In general, the condition of the stream ecosystem in the North Canal River basin was relatively complicated.

Isolation, characterization and antioxidant activity of polysaccharide from Schisandra sphenanthera.

A water-soluble polysaccharide (SSPP11) from Schisandra sphenanthera was purified by DEAE-cellulose and Sephadex G-100 columns. Structure of SSPP11 and its antioxidant activity was evaluated. Results showed that SSPP11 has a molecular weight of 5.3×10(3)Da and is composed of Man, Glu and Gal. A linkage analysis and NMR study revealed that SSPP11 has a backbone of →1)-d-Man-(6→, →1)-d-Manp-(2→, →1)-d-Glup(4→, →1)-d-Glup-(6→, →1)-d-Galp-(4→, →1)-d-Galp-(4,6→ and →1)-d-Manp-(3,6→, with Man, Glu and Gal, which are distributed in branched chains. The Congo red absorption test revealed that SSPP11 has a triple helix stereo-configuration. Moreover, antioxidant activity of SSPP11 was stronger than the polysaccharide from Schisandra chinensis (Turcz.) Baill. In sum, this study demonstrates that a moderate molecular weight, triple helix stereo-configuration and higher degree of branching are beneficial for exerting antioxidant activity.

Structure analysis of a bioactive heteropolysaccharide from Schisandra chinensis (Turcz.) Baill.

Our previous study revealed that Schisandra polysaccharide (SCPP11) exerted excellent antitumor and immunomodulatory activities. In this investigation, the structure of SCPP11 was elucidated. The results indicated that SCPP11 has a backbone that is composed of 1,4-disubstituted-ß-gal, 1,4-disubstituted-α-glu,1,6-disubstituted-ß-man and 1,4,6-disubstituted-α-gal. The branches was composed of 1,4-disubstituted-α-glu and 1-substituted-ß-glu. The Mw and (r(g)(2))(z)(1/2) of the polymer molecules in 0.1 M NaCl were 1.793 × 10(4) Da and 11 nm, respectively. The exponent of (r(g)(2))(z)(1/2) versus Mw(0.39) suggested SCPP11 adopted a globular conformation with seldom random coil. Circular dichroism analysis revealed the presence of ordered structures in SCPP11. AFM and TEM further confirmed the agglomerated morphologies of SCPP11. In addition, it inferred the agglomerated conformation, branching structure and flexibility of chain are beneficial for exerting excellent activities. This information will be helpful in the recognition of biological systems for polysaccharides and the selection of active polysaccharide.

Enhanced antitumor and reduced toxicity effect of Schisanreae polysaccharide in 5-Fu treated Heps-bearing mice.

Previous study indicated that the refined polysaccharide from Schisandra could improve the CTX-induced inhibition of T and B lymphocytes proliferation. Accordingly, the enhanced antitumor and reduced toxicity effects of a low molecular weight purified polysaccharide from Schisandra (SCPP11) were investigated in 5-fluorouracil (5-Fu) treated Heps-bearing mice. The results revealed that the SCPP11 (oral administration) exhibited a significant enhanced effect of antitumor activity when combined with 5-Fu. Moreover, a increased effect was also observed in boosting immunity functions when the Heps-bearing mice receiving SCPP11 combination with 5-Fu administration, including increased in thymus indexes and enhancing serum IL-2 and TNF-α secretion. In addition, SCPP11 could ameliorate the hematological and biochemical parameters changes induced by 5-Fu to normal level, and reduce the formation of MDA and enhance the activities of SOD in liver to against 5-Fu induced free radical damage. The above results suggested that the SCPP11 combined with 5-Fu presented enhanced effects on antitumor activity and the SCPP11 could attenuate the 5-Fu-induced toxicity effect. It could serve as a new and promising adjuvant for chemotherapy drugs.

Microemulsion-based synthesis of porous zinc ferrite nanorods and its application in a room-temperature ethanol sensor.

Porous zinc ferrite (ZnFe(2)O(4)) nanorods with a diameter of around 50 nm and a length of several micrometers have been synthesized by a microemulsion-based method in combination with calcination at 500 °C. The morphology and structure of the ZnFe(2)O(4) nanorods and its precursor (ZnFe(2)(C(2)O(4))(3) nanorods) were systematically characterized by x-ray powder diffraction, transmission electron microscopy, field emission scanning electron microscopy and high-resolution transmission electron microscopy. The formation mechanism for the porous ZnFe(2)O(4) nanorods is also discussed. Moreover, the porous ZnFe(2)O(4) nanorods were applied in a room-temperature ethanol sensor and exhibited much better sensing performance than ZnFe(2)O(4) nanoparticles.