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1.
JAMA Pediatr ; : e214375, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34747972

RESUMO

Importance: A rapid nutritional transition has caused greater childhood obesity prevalence in many countries, but the repertoire of effective preventive interventions remains limited. Objective: To determine the effectiveness of a novel multifaceted intervention for obesity prevention in primary school children. Design, Setting, and Participants: A cluster randomized clinical trial was conducted during a single school year (from September 11, 2018, to June 30, 2019) across 3 socioeconomically distinct regions in China according to a prespecified trial protocol. Twenty-four schools were randomly allocated (1:1) to the intervention or the control group, with 1392 eligible children aged 8 to 10 years participating. Data from the intent-to-treat population were analyzed from October 1 to December 31, 2019. Interventions: A multifaceted intervention targeted both children (promoting healthy diet and physical activity) and their environment (engaging schools and families to support children's behavioral changes). The intervention was novel in its strengthening of family involvement with the assistance of a smartphone app. The control schools engaged in their usual practices. Main Outcomes and Measures: The primary outcome was the change in body mass index (BMI; calculated as weight in kilograms divided by height in square meters) from baseline to the end of the trial. Secondary outcomes included changes in adiposity outcomes (eg, BMI z score, prevalence of obesity), blood pressure, physical activity and dietary behaviors, obesity-related knowledge, and physical fitness. Generalized linear mixed models were used in the analyses. Results: Among the 1392 participants (mean [SD] age, 9.6 [0.4] years; 717 boys [51.5%]; mean [SD] BMI, 18.6 [3.7]), 1362 (97.8%) with follow-up data were included in the analyses. From baseline to the end of the trial, the mean BMI decreased in the intervention group, whereas it increased in the control group; the mean between-group difference in BMI change was -0.46 (95% CI, -0.67 to -0.25; P < .001), which showed no evidence of difference across different regions, sexes, maternal education levels, and primary caregivers (parents vs nonparents). The prevalence of obesity decreased by 27.0% of the baseline figure (a relative decrease) in the intervention group, compared with 5.6% in the control group. The intervention also improved other adiposity outcomes, dietary, sedentary, and physical activity behaviors, and obesity-related knowledge, but it did not change moderate- to vigorous-intensity physical activity, physical fitness, or blood pressure. No adverse events were observed during the intervention. Conclusions and Relevance: The multifaceted intervention effectively reduced the mean BMI and obesity prevalence in primary school children across socioeconomically distinct regions in China, suggesting its potential for national scaling. Trial Registration: ClinicalTrials.gov Identifier: NCT03665857.

2.
Clin Neurol Neurosurg ; 211: 107023, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34800814

RESUMO

Alexander disease (AxD) is a rare, autosomal dominant genetic disorder with an incidence of approximately 1 in 27,00.000. It is caused by a missense mutation in the GFAP gene encoding the glial fibrillary acidic protein. Fragile X-associated tremor/ataxia syndrome (FXTAS) is an X-linked dominant genetic disease, usually caused by a pre-mutation: an unmethylated expansion in the range of 50-200 CGG repeats in the fragile X mental retardation 1 (FMR1) gene. The clinical manifestations of these two diseases are complex and have some similarities. Both type II AxD and FXTAS may have ataxia as the first symptom. Here, we describe a case of type II AxD with ataxia as the first symptom accompanying a hemizygous mutation in the FMR1 gene (NM_001185081, exon13, c 0.1256C>T, p.T419M, g 0.147026507C>T). A sporadic genetic mutation led us to misdiagnose the patient with FXTAS initially. Whole-genome sequencing confirmed a heterozygous mutation in the GFAP gene (NM_002055.5, exon4, c 0.1158C>A, p.N386K, g 0.6310C>A). This report indicates that when the patient's clinical manifestation is ataxia, and imaging results suggest that the midbrain, medulla oblongata, and other subcerebellar structures are atrophied, AxD should be considered. Whole-genome sequencing is thus feasible to avoid missed diagnoses and misdiagnoses.

3.
J Asian Nat Prod Res ; : 1-7, 2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34605341

RESUMO

One new ionone glycoside, named centrantheroside F (1), together with 9 known compounds (2-10), were isolated from the roots of Centranthera grandiflora. Their structures were determined by spectroscopic data analyses and comparing with the literature data. The absolute configuration of 1 was confirmed via 2 D NMR and electronic circular dichroism (ECD). All isolated compounds were evaluated for their inhibitory activity on lipopolysaccharide (LPS)-induced nitric oxide (NO) production.

4.
Anesthesiology ; 135(2): 218-232, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34195765

RESUMO

BACKGROUND: Delirium is a common and serious postoperative complication, especially in the elderly. Epidural anesthesia may reduce delirium by improving analgesia, reducing opioid consumption, and blunting stress response to surgery. This trial therefore tested the hypothesis that combined epidural-general anesthesia reduces the incidence of postoperative delirium in elderly patients recovering from major noncardiac surgery. METHODS: Patients aged 60 to 90 yr scheduled for major noncardiac thoracic or abdominal surgeries expected to last 2 h or more were enrolled. Participants were randomized 1:1 to either combined epidural-general anesthesia with postoperative epidural analgesia or general anesthesia with postoperative intravenous analgesia. The primary outcome was the incidence of delirium, which was assessed with the Confusion Assessment Method for the Intensive Care Unit twice daily during the initial 7 postoperative days. RESULTS: Between November 2011 and May 2015, 1,802 patients were randomized to combined epidural-general anesthesia (n = 901) or general anesthesia alone (n = 901). Among these, 1,720 patients (mean age, 70 yr; 35% women) completed the study and were included in the intention-to-treat analysis. Delirium was significantly less common in the combined epidural-general anesthesia group (15 [1.8%] of 857 patients) than in the general anesthesia group (43 [5.0%] of 863 patients; relative risk, 0.351; 95% CI, 0.197 to 0.627; P < 0.001; number needed to treat 31). Intraoperative hypotension (systolic blood pressure less than 80 mmHg) was more common in patients assigned to epidural anesthesia (421 [49%] vs. 288 [33%]; relative risk, 1.47, 95% CI, 1.31 to 1.65; P < 0.001), and more epidural patients were given vasopressors (495 [58%] vs. 387 [45%]; relative risk, 1.29; 95% CI, 1.17 to 1.41; P < 0.001). CONCLUSIONS: Older patients randomized to combined epidural-general anesthesia for major thoracic and abdominal surgeries had one third as much delirium but 50% more hypotension. Clinicians should consider combining epidural and general anesthesia in patients at risk of postoperative delirium, and avoiding the combination in patients at risk of hypotension.


Assuntos
Analgesia Epidural/métodos , Anestesia Geral/métodos , Delírio do Despertar/epidemiologia , Avaliação Geriátrica/métodos , Procedimentos Cirúrgicos Operatórios , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Quimioterapia Combinada , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade
5.
Anesthesiology ; 135(2): 233-245, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34195784

RESUMO

BACKGROUND: Experimental and observational research suggests that combined epidural-general anesthesia may improve long-term survival after cancer surgery by reducing anesthetic and opioid consumption and by blunting surgery-related inflammation. This study therefore tested the primary hypothesis that combined epidural-general anesthesia improves long-term survival in elderly patients. METHODS: This article presents a long-term follow-up of patients enrolled in a previous trial conducted at five hospitals. Patients aged 60 to 90 yr and scheduled for major noncardiac thoracic and abdominal surgeries were randomly assigned to either combined epidural-general anesthesia with postoperative epidural analgesia or general anesthesia alone with postoperative intravenous analgesia. The primary outcome was overall postoperative survival. Secondary outcomes included cancer-specific, recurrence-free, and event-free survival. RESULTS: Among 1,802 patients who were enrolled and randomized in the underlying trial, 1,712 were included in the long-term analysis; 92% had surgery for cancer. The median follow-up duration was 66 months (interquartile range, 61 to 80). Among patients assigned to combined epidural-general anesthesia, 355 of 853 (42%) died compared with 326 of 859 (38%) deaths in patients assigned to general anesthesia alone: adjusted hazard ratio, 1.07; 95% CI, 0.92 to 1.24; P = 0.408. Cancer-specific survival was similar with combined epidural-general anesthesia (327 of 853 [38%]) and general anesthesia alone (292 of 859 [34%]): adjusted hazard ratio, 1.09; 95% CI, 0.93 to 1.28; P = 0.290. Recurrence-free survival was 401 of 853 [47%] for patients who had combined epidural-general anesthesia versus 389 of 859 [45%] with general anesthesia alone: adjusted hazard ratio, 0.97; 95% CI, 0.84 to 1.12; P = 0.692. Event-free survival was 466 of 853 [55%] in patients who had combined epidural-general anesthesia versus 450 of 859 [52%] for general anesthesia alone: adjusted hazard ratio, 0.99; 95% CI, 0.86 to 1.12; P = 0.815. CONCLUSIONS: In elderly patients having major thoracic and abdominal surgery, combined epidural-general anesthesia with epidural analgesia did not improve overall or cancer-specific long-term mortality. Nor did epidural analgesia improve recurrence-free survival. Either approach can therefore reasonably be selected based on patient and clinician preference.


Assuntos
Analgesia Epidural/mortalidade , Anestesia Geral/mortalidade , Avaliação Geriátrica/métodos , Procedimentos Cirúrgicos Operatórios/mortalidade , Idoso , Idoso de 80 Anos ou mais , Analgesia Epidural/métodos , Anestesia Geral/métodos , China/epidemiologia , Quimioterapia Combinada , Feminino , Seguimentos , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sobrevida
6.
Huan Jing Ke Xue ; 42(6): 3063-3073, 2021 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-34032107

RESUMO

The characteristics of particles and microorganisms on leaf surfaces have great significance for the near-surface environment and ecology. Here, fresh leaves of holly and Ligustrum were examined from different functional areas in Qingdao. Environmental scanning electron microscopy was used to observe particles and microorganisms on the leaf surfaces during different seasonal, and Illumina high-throughput sequencing was performed to analyze the phyllosphere bacterial community structure. The results showed that the retention of TSP on leaves in autumn and winter was higher than in spring and summer. The leaves of the two plants were more likely to retain PM10 and PM2.5; however, the dust retention capacity of holly leaves was higher than that of Ligustrum, especially for particle sizes greater than 10 µm. The numbers of particles on the leaf surfaces along an urban main road were higher than in two other locations, and were greatly affected by ground dust and automobile exhaust emissions. The community structure of phyllospheric microorganisms showed distinct seasonal variation, with different types of fungi, fungal spores, and mycelium observed on the leaf surfaces. Mycelium was more frequently detected on leathery leaves, and fungal spores with even folds were detected on the leaf epidermis of Ligustrum. The relative abundances of phyllospheric microorganisms were highest on leaves from an urban park, explained by a positive effect of humidity on growth. Significant differences in bacterial community abundance were observed between seasons. Specifically, bacterial abundance was highest in spring and lowest in summer. γ-Proteobacteria were the dominant bacteria, and the two plants shared a similar core microbial community. In addition, the phyllospheric bacterial community structure of leaves from urban arterial roads with ground dust pollution was significantly different from the leaves collected from other city areas. Our research results suggest a significant correlation between the leaf-surface particles and microbial community structure on representative plants in different areas of the city, which provides reference information for urban greening activities.


Assuntos
Poluentes Atmosféricos , Ilex , Ligustrum , Poluentes Atmosféricos/análise , Bactérias , Monitoramento Ambiental , Material Particulado/análise , Folhas de Planta/química , Estações do Ano
7.
J Pain Res ; 14: 1119-1127, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33907459

RESUMO

Migraine with brainstem aura (MBA) accompanied by disorders of consciousness (DOC) is a rare subtype of migraine. The pathophysiology of MBA with DOC has not been elucidated yet. Some patients have a family history of migraine, and women are more affected than men. The aura symptoms are diverse; however, when MBA is combined with DOC, the clinical manifestations are more complicated. Coma is the most common clinical manifestation. The overall duration of the patient's DOC is short and can often return to normal within half an hour. Headache often occurs after regaining consciousness and can also occur at the same time as DOC. The most common headache is located at the occipital region. Although DOC is reversible, considering the current small number of cases, we still need to improve our understanding of the disease to avoid misdiagnosis. The MBA patient's electroencephalogram and cerebral blood flow perfusion may have transient changes and may return to normal in the interictal period or after the DOC. Although triptans have traditionally been contraindicated in MBA under drug instructions, the evidence of basilar artery constriction, as postulated in MBA, is lacking. Lasmiditan is currently the first and only 5-HT 1F receptor agonist approved by the Food and Drug Administration. The calcitonin gene-related peptide receptor antagonists and monoclonal antibody therapies may be the most promising for future consideration. Here, the pathophysiology, clinical manifestations, diagnostic tools, and treatment progress for MBA with DOC are reviewed.

8.
Schizophr Bull ; 47(5): 1364-1374, 2021 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-33768244

RESUMO

Recent large-scale integrative analyses (including Transcriptome-Wide Association Study [TWAS] and Summary-data-based Mendelian Randomization [SMR]) have identified multiple genes whose cis-regulated expression changes may confer risk of schizophrenia. Nevertheless, expression quantitative trait loci (eQTL) data and genome-wide associations used for integrative analyses were mainly from populations of European ancestry, resulting in potential missing of pivotal biological insights in other continental populations due to population heterogeneity. Here we conducted TWAS and SMR integrative analyses using blood eQTL (from 162 subjects) and GWAS data (22 778 cases and 35 362 controls) of schizophrenia in East Asian (EAS) populations. Both TWAS (P = 2.89 × 10-14) and SMR (P = 6.04 × 10-5) analyses showed that decreased TMEM180 mRNA expression was significantly associated with risk of schizophrenia. We further found that TMEM180 was significantly down-regulated in the peripheral blood of schizophrenia cases compared with controls (P = 8.63 × 10-4 in EAS sample), and its expression was also significantly lower in the brain tissues of schizophrenia cases compared with controls (P = 1.87 × 10-5 in European sample from PsychENCODE). Functional explorations suggested that Tmem180 knockdown affected neurodevelopment, ie, proliferation and differentiation of neural stem cells. RNA sequencing showed that pathways regulated by Tmem180 were significantly enriched in brain development and synaptic transmission. In conclusion, our study provides convergent lines of evidence for the involvement of TMEM180 in schizophrenia, and highlights the potential and importance of resource integration and sharing at this big data era in bio-medical research.

9.
JAMA Psychiatry ; 78(3): 320-330, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33263727

RESUMO

Importance: The genetic basis of bipolar disorder (BD) in Han Chinese individuals is not fully understood. Objective: To explore the genetic basis of BD in the Han Chinese population. Design, Setting, and Participants: A genome-wide association study (GWAS), followed by independent replication, was conducted to identify BD risk loci in Han Chinese individuals. Individuals with BD were diagnosed based on DSM-IV criteria and had no history of schizophrenia, mental retardation, or substance dependence; individuals without any personal or family history of mental illnesses, including BD, were included as control participants. In total, discovery samples from 1822 patients and 4650 control participants passed quality control for the GWAS analysis. Replication analyses of samples from 958 patients and 2050 control participants were conducted. Summary statistics from the European Psychiatric Genomics Consortium 2 (PGC2) BD GWAS (20 352 cases and 31 358 controls) were used for the trans-ancestry genetic correlation analysis, polygenetic risk score analysis, and meta-analysis to compare BD genetic risk between Han Chinese and European individuals. The study was performed in February 2020. Main Outcomes and Measures: Single-nucleotide variations with P < 5.00 × 10-8 were considered to show genome-wide significance of statistical association. Results: The Han Chinese discovery GWAS sample included 1822 cases (mean [SD] age, 35.43 [14.12] years; 838 [46%] male) and 4650 controls (mean [SD] age, 27.48 [5.97] years; 2465 [53%] male), and the replication sample included 958 cases (mean [SD] age, 37.82 [15.54] years; 412 [43%] male) and 2050 controls (mean [SD] age, 27.50 [6.00] years; 1189 [58%] male). A novel BD risk locus in Han Chinese individuals was found near the gene encoding transmembrane protein 108 (TMEM108, rs9863544; P = 2.49 × 10-8; odds ratio [OR], 0.650; 95% CI, 0.559-0.756), which is required for dendritic spine development and glutamatergic transmission in the dentate gyrus. Trans-ancestry genetic correlation estimation (ρge = 0.652, SE = 0.106; P = 7.30 × 10-10) and polygenetic risk score analyses (maximum liability-scaled Nagelkerke pseudo R2 = 1.27%; P = 1.30 × 10-19) showed evidence of shared BD genetic risk between Han Chinese and European populations, and meta-analysis identified 2 new GWAS risk loci near VRK2 (rs41335055; P = 4.98 × 10-9; OR, 0.849; 95% CI, 0.804-0.897) and RHEBL1 (rs7969091; P = 3.12 × 10-8; OR, 0.932; 95% CI, 0.909-0.956). Conclusions and Relevance: This GWAS study identified several loci and genes involved in the heritable risk of BD, providing insights into its genetic architecture and biological basis.

10.
Biol Psychiatry ; 89(3): 246-255, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33246552

RESUMO

BACKGROUND: Genome-wide association studies (GWASs) have reported hundreds of genomic loci associated with schizophrenia, yet identifying the functional risk variations is a key step in elucidating the underlying mechanisms. METHODS: We applied multiple bioinformatics and molecular approaches, including expression quantitative trait loci analyses, epigenome signature identification, luciferase reporter assay, chromatin conformation capture, homology-directed genome editing by CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/Cas9), RNA sequencing, and ATAC-Seq (assay for transposase-accessible chromatin using sequencing). RESULTS: We found that the schizophrenia GWAS risk variations at 16p11.2 were significantly associated with messenger RNA levels of multiple genes in human brain, and one of the leading expression quantitative trait loci genes, MAPK3, is located ∼200 kb away from these risk variations in the genome. Further analyses based on the epigenome marks in human brain and cell lines suggested that a noncoding single nucleotide polymorphism, rs4420550 (p = 2.36 × 10-9 in schizophrenia GWAS), was within a DNA enhancer region, which was validated via in vitro luciferase reporter assays. The chromatin conformation capture experiment showed that the rs4420550 region physically interacted with the MAPK3 promoter and TAOK2 promoter. Precise CRISPR/Cas9 editing of a single base pair in cells followed by RNA sequencing further confirmed the regulatory effects of rs4420550 on the transcription of 16p11.2 genes, and ATAC-Seq demonstrated that rs4420550 affected chromatin accessibility at the 16p11.2 region. The rs4420550-[A/A] cells showed significantly higher proliferation rates compared with rs4420550-[G/G] cells. CONCLUSIONS: These results together suggest that rs4420550 is a functional risk variation, and this study illustrates an example of comprehensive functional characterization of schizophrenia GWAS risk loci.


Assuntos
Estudo de Associação Genômica Ampla , Esquizofrenia , Cromatina/genética , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , Genômica , Humanos , Esquizofrenia/genética
11.
Schizophr Bull ; 47(1): 219-227, 2021 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-32662510

RESUMO

Recent advances in functional genomics have facilitated the identification of multiple genes and isoforms associated with the genetic risk of schizophrenia, yet the causal variations remain largely unclear. A previous study reported that the schizophrenia risk single-nucleotide polymorphism (SNP) rs7085104 at 10q24.32 was in high linkage disequilibrium (LD) with a human-specific variable number of tandem repeat (VNTR), and both were significantly associated with the brain mRNA expression of a human-unique AS3MTd2d3 isoform in Europeans and African Americans. In this study, we have shown the direct regulation of the AS3MTd2d3 mRNA expression by this VNTR through an in vitro minigene splicing assay, suggesting that it is likely a causative functional variation. Intriguingly, we have further confirmed that the VNTR and rs7085104 are significantly associated with AS3MTd2d3 mRNA expression in brains of Han Chinese donors, and rs7085104 is also associated with risk of schizophrenia in East Asians. Finally, the overexpression of AS3MTd2d3 in cultured primary hippocampal neurons results in significantly reduced densities of mushroom dendritic spines, implicating its potential functional impact. Considering the crucial roles of dendritic spines in neuroplasticity, these results reveal the potential regulatory impact of the schizophrenia risk VNTR on AS3MTd2d3 and provide insights into the underlying biological mechanisms.


Assuntos
Espinhas Dendríticas , Regulação da Expressão Gênica/genética , Hipocampo/metabolismo , Metiltransferases/genética , Esquizofrenia/genética , Sequências de Repetição em Tandem/genética , Processamento Alternativo , Animais , Células Cultivadas , China , Técnicas Genéticas , Humanos , Polimorfismo de Nucleotídeo Único , Isoformas de Proteínas , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , Esquizofrenia/etnologia
12.
Neuropsychopharmacology ; 46(6): 1103-1112, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32791513

RESUMO

Genetic analyses for bipolar disorder (BD) have achieved prominent success in Europeans in recent years, whereas its genetic basis in other populations remains relatively less understood. We herein report that the leading risk locus for BD in European genome-wide association studies (GWAS), the single-nucleotide polymorphism (SNP) rs9834970 near TRANK1 at 3p22 region, is also genome-wide significantly associated with BD in a meta-analysis of four independent East Asian samples including 5748 cases and 65,361 controls (p = 2.27 × 10-8, odds ratio = 1.136). Expression quantitative trait loci (eQTL) analyses and summary data-based Mendelian randomization (SMR) analyses in multiple human brain samples suggest that lower TRANK1 mRNA expression is a principal BD risk factor explaining its genetic risk signals at 3p22. We also identified another SNP rs4789 in the 3' untranslated region (3'UTR) of TRANK1 showing stronger eQTL associations as well as genome-wide significant association with BD. Despite the relatively unclear neuronal function of TRANK1, our mRNA expression analyses in the human brains and in rat primary cortical neurons reveal that genes highly correlated with TRANK1 are significantly enriched in the biological processes related to dendritic spine, synaptic plasticity, axon guidance and circadian entrainment, and are also more likely to exhibit strong associations in psychiatric GWAS (e.g., the CACNA1C gene). Overall, our results support that TRANK1 is a potential BD risk gene. Further studies elucidating its roles in this illness are needed.


Assuntos
Transtorno Bipolar , Animais , Transtorno Bipolar/genética , Canais de Cálcio Tipo L , Citocinas , Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla , Humanos , Polimorfismo de Nucleotídeo Único/genética , Locos de Características Quantitativas/genética , Ratos
13.
Huan Jing Ke Xue ; 41(12): 5225-5235, 2020 Dec 08.
Artigo em Chinês | MEDLINE | ID: mdl-33374038

RESUMO

With the development of industrialization and urbanization in China, there are many environmental problems especially air pollution, which has serious impacts on the sustainable development of economy, ecological environment and public health. Since 2013, a series of environmental protection laws and regulations, and industrial and energy policies have been successively implemented, including Action Plan for Air Pollution Control, and Three-Year Action Plan to Win the Blue Sky Defense War etc. The air quality of the whole country has been improved. In order to evaluate the dynamic changes of environmental health benefits from air pollution control in China, this paper estimates the health effects and health economic losses caused by PM2.5 pollution, and makes a comparative analysis among different regions and cities based on the data of 297 cities at prefecture level and above in China from 2015 to 2018. The results show that, due to sharp decline of ρ(PM2.5), the population exposed to ρ(PM2.5)>35 µg·m-3 decreased year by year, and the proportion of the total population decreased from 80.88% to 62.32%. The total number of all kinds of health endpoints decreased from 33.23 million to 15.91 million, health economic loss decreased from 1579.04 billion yuan to 838.42 billion yuan, the proportion of healthy economic loss in GDP dropped from 2.31% to 0.99%. Among the six regions, the index values of Beijing, Tianjin, Hebei, and surrounding areas, and Chengyu areas have declined year by year. However, Fenwei Plain areas, Yangtze River Delta areas, Pearl River Delta areas, and the middle reaches of the Yangtze River show a complex trend of increasing in some years and decreasing later. However, the situation of Fenwei Plain is still more serious than other areas, and the ρ(PM2.5) is next to Beijing, Tianjin, Hebei and surrounding areas. ρ(PM2.5) of all 11 cities still exceed 35 µg·m-3 in 2018. Compared with 2015, the number of early deaths decreased by 1500, but the total number of all kinds of health endpoints increased by 18900. The health economic loss is 80.711 billion yuan, an increase of 10.714 billion yuan than that in 2015. The proportion of health economic loss in GDP is 3.16%, which is 0.25% lower than that in 2015. The per capita health economic loss is 182.67 yuan higher than that in 2015. In terms of cities, from 2015 to 2018, ρ(PM2.5) in 228 cities decreased with varying degrees. Among which, Dezhou and Baoding dropped the most, only 10 cities saw ρ(PM2.5) rise. 14 cities saw an increase in the number of healthy endpoints, and 11 cities saw an increase in the proportion of healthy economic loss to GDP. Although the index values of Baoding, Xingtai, Handan, and other cities have declined year by year, they still rank top 10 every year. The index value of Xi'an, Xianyang, Linfen, and other cities in 2018 is more than that in 2015. The research shows that the environmental health benefits of air pollution control are significant in China, but it is still necessary to further strengthen regional joint prevention and control, as well as one city one policy.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Pequim , China , Cidades , Monitoramento Ambiental , Material Particulado/análise
14.
BMJ Open ; 10(10): e039472, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33127634

RESUMO

OBJECTIVE: To investigate the normal range of serum potassium, the prevalence of dyskalaemia and the associated factors in Chinese older adults. DESIGN: A cross-sectional study conducted from September 2017 to March 2018. SETTING: Forty-eight community elderly care facilities in four regions in northern China. PARTICIPANTS: A total of 1266 (308 apparently healthy and 958 unhealthy) participants 55 years or older and with fasting serum potassium measured. MAIN OUTCOME MEASURES AND METHODS: Serum potassium <3.5 mEq/L and >5.5 mEq/L (guidelines definition) and <2.5th and >97.5th percentiles of the distribution among healthy participants (our study definition) were both used to define hypokalaemia and hyperkalaemia, respectively. Multivariable generalised estimating equation models were used to adjust for clustering effect in the analyses of factors associated with risk of dyskalaemia and with variations in serum potassium. RESULTS: The study participants had a mean age of 70 (8.8) years. Among apparently healthy participants, the 2.5th and 97.5th percentiles of serum potassium distribution were 3.7 mEq/L and 5.3 mEq/L, respectively. Using the study definition, the prevalence of hyperkalaemia was 4.3% (95% CI 3.2% to 5.4%) and of hypokalaemia was 4.0% (95% CI 2.9% to 5.1%). Multivariable analyses showed that risk of hyperkalaemia was associated with unhealthy conditions (OR=2.21; 95% CI 1.17 to 4.18); risk of hypokalaemia was associated with unhealthy conditions (OR=2.56; 95% CI 1.05 to 6.23), older age (OR=1.70 per 10-year increase; 95% CI 1.04 to 2.79) and region (OR=16.87; 95% CI 6.41 to 44.38); and higher serum potassium was associated with male gender (mean difference (MD)=0.12; 95% CI 0.05 to 0.19) and estimated glomerular filtration rate <60 mL/min/1.73 m2 (MD=0.29; 95% CI 0.12 to 0.46). Using the guidelines definition, hyperkalaemia accounted for 2.7% (1.8%, 3.6%) and hypokalaemia 1.8% (1.1%, 2.5%). Analyses of the associated factors showed similar trends. CONCLUSIONS: The study suggested a narrower normal range of serum potassium for defining dyskalaemia, which was common in older Chinese and more prevalent in unhealthy ones. TRIAL REGISTRATION NUMBER: NCT03290716; Pre-results.


Assuntos
Potássio , Idoso , China/epidemiologia , Estudos Transversais , Humanos , Masculino , Prevalência , Valores de Referência
15.
Zool Res ; 41(6): 632-643, 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-32987454

RESUMO

Accumulating studies have been conducted to identify risk genes and relevant biological mechanisms underlying major depressive disorder (MDD). In particular, transcriptomic analyses in brain regions engaged in cognitive and emotional processes, e.g., the dorsolateral prefrontal cortex (DLPFC), have provided essential insights. Based on three independent DLPFC RNA-seq datasets of 79 MDD patients and 75 healthy controls, we performed differential expression analyses using two alternative approaches for cross-validation. We also conducted transcriptomic analyses in mice undergoing chronic variable stress (CVS) and chronic social defeat stress (CSDS). We identified 12 differentially expressed genes (DEGs) through both analytical methods in MDD patients, the majority of which were also dysregulated in stressed mice. Notably, the mRNA level of the immediate early gene FOS ( Fos proto-oncogene) was significantly decreased in both MDD patients and CVS-exposed mice, and CSDS-susceptible mice exhibited a greater reduction in Fos expression compared to resilient mice. These findings suggest the potential key roles of this gene in the pathogenesis of MDD related to stress exposure. Altered transcriptomes in the DLPFC of MDD patients might be, at least partially, the result of stress exposure, supporting that stress is a primary risk factor for MDD.


Assuntos
Depressão/metabolismo , Transtorno Depressivo Maior/metabolismo , Transcriptoma , Animais , Sequência de Bases , Bases de Dados de Ácidos Nucleicos , Depressão/genética , Transtorno Depressivo Maior/genética , Regulação da Expressão Gênica , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Camundongos , Córtex Pré-Frontal/metabolismo , Locos de Características Quantitativas , Estresse Fisiológico
16.
Int J Infect Dis ; 100: 133-138, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32916250

RESUMO

OBJECTIVE: The aim was to develop and evaluate the impact of a new model in which the infectious disease (ID) physician and pharmacist work together to treat diabetic foot infections (DFIs). METHODS: A quasi-experimental before-after study was conducted. The medical charts of inpatients with DFI admitted between April 1, 2017 and March 31, 2018 were reviewed retrospectively (control group, n = 30). Inpatients diagnosed with DFI between April 1, 2018 and March 31, 2019 were enrolled prospectively as the intervention group and received treatment through dedicated ID teamwork (intervention group, n = 35). RESULTS: The distribution of infection severity and levels of metabolic criteria were similar in the two groups. Compared with the control group, the intervention group received adequate initial empirical treatment more frequently (96.8% vs 43.5%, p < 0.001) and had a shorter median duration of fever (1 day vs 7.5 days, p < 0.001). Rates of healing and relapse within 6 months were similar in the two groups, although the intervention group showed more sites of osteomyelitis (p = 0.036) and a higher percentage of polymicrobial infections (48.6% vs 10.0%, p = 0.001). CONCLUSION: The early and full participation of ID physicians and pharmacists in the treatment of DFI facilitated targeted antimicrobial treatment and improved patient outcomes.


Assuntos
Antibacterianos/uso terapêutico , Pé Diabético/complicações , Pé Diabético/tratamento farmacológico , Doenças do Pé/etiologia , Infecções/tratamento farmacológico , Osteomielite/tratamento farmacológico , Equipe de Assistência ao Paciente , Pé Diabético/diagnóstico , Feminino , Doenças do Pé/tratamento farmacológico , Doenças do Pé/microbiologia , Humanos , Infecções/diagnóstico , Infecções/etiologia , Masculino , Pessoa de Meia-Idade , Osteomielite/etiologia , Prognóstico , Estudos Retrospectivos , Cicatrização
17.
Chemosphere ; 260: 127600, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32758769

RESUMO

Granules initiation and development is the backbone of aerobic granular sludge technology. Feed composition can notably affect initiation and development of aerobic granules, and yield aerobic granules with distinct microbial community, morphology and structure. This paper reports an unexpected formation of aerobic granules in an aspartic acid fed SBR under unfavorable hydrodynamic selection conditions. Detailed characteristics of these aerobic granules were investigated in terms of morphology, structure, bioactivity and EPS. The results showed that due to the absence of favorable hydrodynamic selection pressure, the formed aerobic granules had an irregular shape with a rough outline and loose internal structure, which was quite different from mature aerobic granules. Bacteria in these aerobic granules were mainly presented in the form of microcolony with calcium and ß-polysaccharides responsible for its mechanical stability. The high N/C ratio of aspartic acid enabled the enrichment of significant amount of nitrifiers within aerobic granules and thus resulted in high nitrification activity of these aerobic granules. The negatively charged and hydrophilic aspartic acid also induced the bacteria to secrete more exopolysaccharides for contributing to more neutral and hydrophilic surface of the aerobic granules, which was beneficial for aspartic acid capture. As a result, polysaccharides, rather than proteins, became the major components of EPS in these aerobic granules. This paper provides us a foundation to better understand the granulation potential of proteinaceous substrates that is frequently encountered in industrial wastewaters.


Assuntos
Ácido Aspártico/química , Reatores Biológicos/microbiologia , Esgotos/microbiologia , Purificação da Água/métodos , Aerobiose , Análise da Demanda Biológica de Oxigênio , China , Matriz Extracelular de Substâncias Poliméricas/química , Hidrodinâmica , Microbiota , Modelos Teóricos , Nitrificação , Proteobactérias/isolamento & purificação , Esgotos/química , Propriedades de Superfície , Águas Residuárias/química
18.
Zhongguo Gu Shang ; 33(7): 643-8, 2020 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-32700488

RESUMO

OBJECTIVE: To observe effects of Tongluo Zhitong (, TLZT) gel preparation on p53, miR-502-5p, NF-κBp65 in synovial tissue of knee osteoarthritis (KOA), and to explore mechanism of TLZT gel preparation in treating KOA. METHODS: Thirthy-six Wistar rats aged 8 weeks and weighed 200 to 220 g (meaned 208 g) were randomly divided into normal group, model group and traditional Chinese medicine (TCM) group, 12 rats in each group. KOA model was established by modified Hulth method. After 4 weeks of modeling, TCM group treated with TLZT gel preparation for external use, 3 times daily for 2 weeks;normal group and model group were fed normally without intervention. After treatment, morphological changes of specimens in each group were observed, changes of miR-502-5p in synovial tissue were detected by qPCR, and contents of p53, NF-κBp65, IL-1ß, TNF-α, MMP-13 in synovial tissue were detected by qPCR and Western Blot respectively. RESULTS: (1)Morphological observation of specimens showed that the articular cartilage in model group was hyaline and uneven, the synovial membranes were hypertrophic and proliferative with a large number of inflammatory cells infiltrating, the joint fluid was thicker in texture;the articular cartilage in TCM group was more transparent and smooth, synovial hyperplasia was mild with a small amount of inflammatory cell infiltration, the texture of articular fluid was clear and sparse. (2) Compared with normal group, content of miR-502-5p of synovial tissue in model and TCM group were increased, mRNA and expression of p53 decreased, expression of NF-κBp65, IL-1ß, TNF-α, MMP-13 increased. (3)Compared with model group, content of miR-502-5p in synovial tissue of TCM group decreased (P<0.05), mRNA and protein expression of p53 increased (P<0.05), mRNA and protein expression of NF-κBp65, IL-1ß, TNF-α, MMP-13 decreased (P<0.05). CONCLUSION: Expression of p53, miR-502 -5p, NF -κBp65 in synovial tissue is closely related to synovial hyperplasia and inflammatory reaction, TLZT gel preparation may reduce proliferation and inflammatory reaction of KOA synovium by regulating the expression of p53, miR- 502-5p, NF-κBp65 in synovial tissues.


Assuntos
MicroRNAs , Osteoartrite do Joelho , Animais , Medicamentos de Ervas Chinesas , Ratos , Ratos Wistar , Membrana Sinovial , Proteína Supressora de Tumor p53
19.
Environ Res ; 187: 109488, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32470646

RESUMO

Macro-porous poly(lauryl acrylate) cryogel sheets as oil-sorbents were prepared through UV-radiation cryo-polymerizations in 1, 4-dioxane at low temperatures (-5, -2 and 0 °C) within 30 min. The influences of total monomer concentration, crosslinking monomer amount and polymerization temperature on the formation of cryogels were studied. The chemical structure and porous morphology were characterized through the techniques of Fourier transform infrared spectroscopy, thermal gravimetric analysis, contact angle measurement and scanning electron microscopy, confirming the features of high hydrophobicity, macro-porosity and good thermal stability. As well, the comparison between conventional gels prepared at room temperature and cryogels at lower temperatures was made, showing the higher rate of cryo-polymerization than conventional polymerization under the same UV-radiation condition. The swelling investigation was carried out with several organic solvents and oils. Enhanced performance of oil absorption was observed for those cryogels considering the absorption capacity and absorption rate. Variation of initiator amount and acrylate monomers could also modulate the absorption capacity. Those cryogel oil-sorbents exhibited wide adaptability, good reusability and high-temperature tolerance. Thus, this rapid and low-cost fabrication opens out a novel pathway to prepare efficient oil-sorbents used in waste water treatment.


Assuntos
Criogéis , Raios Ultravioleta , Adsorção , Microscopia Eletrônica de Varredura , Óleos , Porosidade
20.
Transl Psychiatry ; 10(1): 98, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-32184385

RESUMO

Genome-wide association studies (GWAS) of major depression and its relevant biological phenotypes have been extensively conducted in large samples, and transcriptome-wide analyses in the tissues of brain regions relevant to pathogenesis of depression, e.g., dorsolateral prefrontal cortex (DLPFC), have also been widely performed recently. Integrating these multi-omics data will enable unveiling of depression risk genes and even underlying pathological mechanisms. Here, we employ summary data-based Mendelian randomization (SMR) and integrative risk gene selector (iRIGS) approaches to integrate multi-omics data from GWAS, DLPFC expression quantitative trait loci (eQTL) analyses and enhancer-promoter physical link studies to prioritize high-confidence risk genes for depression, followed by independent replications across distinct populations. These integrative analyses identify multiple high-confidence depression risk genes, and numerous lines of evidence supporting pivotal roles of the netrin 1 receptor (DCC) gene in this illness across different populations. Our subsequent explorative analyses further suggest that DCC significantly predicts neuroticism, well-being spectrum, cognitive function and putamen structure in general populations. Gene expression correlation and pathway analyses in DLPFC further show that DCC potentially participates in the biological processes and pathways underlying synaptic plasticity, axon guidance, circadian entrainment, as well as learning and long-term potentiation. These results are in agreement with the recent findings of this gene in neurodevelopment and psychiatric disorders, and we thus further confirm that DCC is an important susceptibility gene for depression, and might be a potential target for new antidepressants.


Assuntos
Depressão , Estudo de Associação Genômica Ampla , Receptor DCC , Depressão/genética , Análise da Randomização Mendeliana , Receptores de Netrina , Netrina-1/genética , Locos de Características Quantitativas
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