Determinants of never-treated status in rural versus urban contexts for individuals with schizophrenia in a population-based study in China.

BACKGROUND: A goal of China's 2012 National Mental Health Law is to improve access to services and decrease urban versus rural disparities in services. However, pre-reform data is needed for objective evaluation of these reforms' effectiveness. Accordingly, this study compares the pre-reform utilization of medical services for the treatment of schizophrenia in rural and urban communities in China. METHODS: In a large community-based study in four provinces representing 12% of China's population conducted from 2001 to 2005, we identified 326 individuals with schizophrenia (78 never treated). Comparing those living in urban (n = 86) versus rural (n = 240) contexts, we used adjusted Poisson regression models to assess the relationship of 'never treated' status with family-level factors (marital status, family income, and number of co-resident family members) and illness severity factors (age of onset, symptom severity and functional impairment). RESULTS: Despite similar impairments due to symptoms, rural patients were less likely to have received intensive mental health services (i.e., use psychiatric inpatient services), and appeared more likely to be 'never treated' or to only have received outpatient care. Among rural patients, only having more than four co-resident family members was independently associated with 'never-treated' status (RR = 0.34; 95% CI, 0.12-0.94; p = 0.039). Among urban patients, only older age of onset was independently associated with 'never-treated' status (RR = 1.06; 95% CI 1.02-1.10, p = 0.003). CONCLUSIONS: Identifying differential drivers of service utilization in urban and rural communities is needed before implementing policies to improve the utilization and equity of services and to define metrics of program success.

[Serological and molecular study of a novel B(A) allele with multiple missense mutations].

OBJECTIVE: To explore the molecular basis for an individual suspected as AwB subtype through DNA sequencing. METHODS: ABO serology was carried out with the standard tube method. To identify the ABO gene haplotype, the amplicons of exon 7 were cloned and sequenced. RESULTS: Serological results showed that the forward typing was AwB and the reverse typing was B. Sequencing analysis revealed that the sample has contained an O01 allele in addition with c.297A>G, c.657C>T, c.796C>A, c.803G>C, c.930G>A variants as compared with the A101 allele. CONCLUSION: Through sequencing analysis, the sample with an AwB subtype by serological testing was identified as a novel B(A) phenotype, which was unreported previously.

[Construction and validation of eukaryotic expression vectors for human ABO subgroup genes].

OBJECTIVE To construct eukaryotic expression vectors for human ABO and subgroup genes A101, B101, CisAB01, Ael05, B(A)04 and Bw03, and validate their expression in vitro. METHODS Total RNA was isolated from individuals with the A101 and B101 subgroups. cDNA of A101 and B101 was synthesized by reverse transcription and amplified with specific primers. Subgroup genes CisAB01, Ael05, B(A)04 and Bw03 were then amplified with PCR for site-directed mutagenesis. Fragments of the ABO genes were directionally linked to pcDNA3.1 positive-eukaryotie expression vectors. After antibiotic screening, the sequences were analyzed. The vectors were transfected into Hela cells, and the expression of target proteins was detected by Western blotting and immunofluorescence assay. RESULTS Sanger sequencing has confirmed that pDNA3.1-A101, pDNA3.1-CisAB01, pDNA3.1-Ael05, pDNA3.1-B101, pDNA3.1- B(A)04, pDNA3.1-Bw03 positive-eukaryotic expression vector were successfully constructed. The results of Western blotting and immunofluorescence revealed clear presence of the expressed proteins. CONCLUSION Eukaryotic expression vectors for ABO subgroup genes were successfully constructed and worked well in Hela cells in vitro, which can facilitate further study of the ABO blood group proteins.

Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies.

BACKGROUND: Chinese men now smoke more than a third of the world's cigarettes, following a large increase in urban then rural usage. Conversely, Chinese women now smoke far less than in previous generations. We assess the oppositely changing effects of tobacco on male and female mortality. METHODS: Two nationwide prospective studies 15 years apart recruited 220,000 men in about 1991 at ages 40-79 years (first study) and 210,000 men and 300,000 women in about 2006 at ages 35-74 years (second study), with follow-up during 1991-99 (mid-year 1995) and 2006-14 (mid-year 2010), respectively. Cox regression yielded sex-specific adjusted mortality rate ratios (RRs) comparing smokers (including any who had stopped because of illness, but not the other ex-smokers, who are described as having stopped by choice) versus never-smokers. FINDINGS: Two-thirds of the men smoked; there was little dependence of male smoking prevalence on age, but many smokers had not smoked cigarettes throughout adult life. Comparing men born before and since 1950, in the older generation, the age at which smoking had started was later and, particularly in rural areas, lifelong exclusive cigarette use was less common than in the younger generation. Comparing male mortality RRs in the first study (mid-year 1995) versus those in the second study (mid-year 2010), the proportional excess risk among smokers (RR-1) approximately doubled over this 15-year period (urban: RR 1·32 [95% CI 1·24-1·41] vs 1·65 [1·53-1·79]; rural: RR 1·13 [1·09-1·17] vs 1·22 [1·16-1·29]), as did the smoking-attributed fraction of deaths at ages 40-79 years (urban: 17% vs 26%; rural: 9% vs 14%). In the second study, urban male smokers who had started before age 20 years (which is now typical among both urban and rural young men) had twice the never-smoker mortality rate (RR 1·98, 1·79-2·19, approaching Western RRs), with substantial excess mortality from chronic obstructive pulmonary disease (COPD RR 9·09, 5·11-16·15), lung cancer (RR 3·78, 2·78-5·14), and ischaemic stroke or ischaemic heart disease (combined RR 2·03, 1·66-2·47). Ex-smokers who had stopped by choice (only 3% of ever-smokers in 1991, but 9% in 2006) had little smoking-attributed risk more than 10 years after stopping. Among Chinese women, however, there has been a tenfold intergenerational reduction in smoking uptake rates. In the second study, among women born in the 1930s, 1940s, 1950s, and since 1960 the proportions who had smoked were, respectively, 10%, 5%, 2%, and 1% (3097/30,943, 3265/62,246, 2339/97,344, and 1068/111,933). The smoker versus non-smoker RR of 1·51 (1·40-1·63) for all female mortality at ages 40-79 years accounted for 5%, 3%, 1%, and <1%, respectively, of all the female deaths in these four successive birth cohorts. In 2010, smoking caused about 1 million (840,000 male, 130,000 female) deaths in China. INTERPRETATION: Smoking will cause about 20% of all adult male deaths in China during the 2010s. The tobacco-attributed proportion is increasing in men, but low, and decreasing, in women. Although overall adult mortality rates are falling, as the adult population of China grows and the proportion of male deaths due to smoking increases, the annual number of deaths in China that are caused by tobacco will rise from about 1 million in 2010 to 2 million in 2030 and 3 million in 2050, unless there is widespread cessation. FUNDING: Wellcome Trust, MRC, BHF, CR-UK, Kadoorie Charitable Foundation, Chinese MoST and NSFC.

Marriage outcome and relationship with urban versus rural context for individuals with psychosis in a population-based study in China.

PURPOSE: While social integration among individuals with psychosis differs by social context, this has rarely been investigated across urban vs. rural settings. For individuals with psychosis, marriage may be a key component of social integration. This study aims to compare marriage outcomes for individuals with psychosis in urban vs. rural settings in China, where marriage has been almost universal among individuals without psychosis. METHODS: In a large community-based study in four provinces representing 12% of China's population, we identified 393 individuals with psychosis (112 never treated). We used adjusted Poisson regression models to compare marriage status for those living in urban (n = 96) vs. rural (n = 297) contexts. RESULTS: While urban and rural residents had similar impairments due to symptoms, urban female residents were 2.72 times more likely to be unmarried than their rural counterparts (95% CI 1.19-6.22, p < 0.0176). Stratified analyses indicated that this marital disadvantage occurred primarily among urban females with an earlier age of onset. No differences were found among males. CONCLUSIONS: Our findings indicate that urban contexts impeded opportunities for marriage for female individuals with psychosis. These data suggest that urban women with earlier age of onset have difficulty in marrying which may be related to economic expectations of women in urban areas. Research examining contextual mechanisms that affect marriage may further understanding of social integration in China and other contexts.

Levels of polybrominated diphenyl ethers in settled house dust from urban dwellings with resident preschool-aged children in Nanjing, China.

We investigated the levels and possible determinants of polybrominated diphenyl ethers (PBDEs) in the settled house-dust (SHD) of urban dwellings with resident preschool-aged children in Nanjing, China. The possible neurodevelopmental effects of house-dust PBDEs were also explored. SHD was collected from 216 urban houses. Levels of 8 PBDEs were measured by gas chromatography-negative chemical ionization mass spectrometry. The Child Behavior Checklist and the Gesell Development Inventory were used to evaluate the child's development. BDE47, BDE99, BDE153, BDE18, and BDE209 were detected in the SHD of >90 % of houses, of which BDE209 predominated. Most PBDEs were found at significantly greater levels in indoor than in outdoor dust (P < 0.05). Levels of BDE28 and BDE154 in houses with solid-wood floors were significantly greater than those in houses with plywood floors (P < 0.05). BDE154 levels in houses with wallpaper were significantly greater than those without wallpaper (P < 0.05). Greater BDE47 concentrations were found in houses with less natural ventilation time (linear trend P < 0.05). After dichotomization at the geometric mean concentration, BDE209 and total BDEs showed significant risks for depressed behavior problems and lower personal social developmental quotients (DQs); BDE99 and BDE153 indicated a risk for lower personal social DQs. In conclusion, PBDEs (especially BDE209) are ubiquitous in urban SHD in Nanjing residences. Natural ventilation and floor materials potentially influence PBDE levels in SHD. The potential adverse effect of postnatal exposure to PBDEs on the behavior and neurodevelopment of preschool-age children requires follow-up in larger studies.

Genomic full-length sequence of the HLA-C*07:154 allele was identified by full-length group-specific sequencing.

Genomic full-length sequence of HLA-C*07:154 was identified by group-specific sequencing in a Chinese individual.

Genomic full-length sequence of the HLA-B*49:11 allele was identified in a Chinese bone marrow donor.

The genomic full-length sequence of HLA-B*49:11 was identified by a group-specific sequencing approach from China.

Employment outcome for people with schizophrenia in rural v. urban China: population-based study.

BACKGROUND: Although outcomes among people with schizophrenia differ by social context, this has rarely been examined across rural v. urban settings. For individuals with schizophrenia, employment is widely recognised as a critical ingredient of social integration. AIMS: To compare employment for people with schizophrenia in rural v. urban settings in China. METHOD: In a large community-based study in four provinces representing 12% of China's population, we identified 393 people with schizophrenia (112 never treated). We used adjusted Poisson regression models to compare employment for those living in rural (n = 297) v. urban (n = 96) settings. RESULTS: Although rural and urban residents had similar impairments due to symptoms, rural residents were three times more likely to be employed (adjusted relative risk 3.27, 95% CI 2.11-5.07, P<0.001). CONCLUSIONS: People with schizophrenia have greater opportunities to use their capacities for productive work in rural than urban settings in China. Contextual mechanisms that may explain this result offer a useful focus for future research.

A novel HLA-C*07 allele, HLA-C*07:1024, was identified in a Chinese individual.

One nucleotide replacement at nucleotide 397 of HLA-C*07:02:01:01 results in a new allele, HLA-C*07:1024.

A survey study of factors influencing elevated blood lead levels in donors from Qingdao, China.

BACKGROUND: That lead is harmful to multiple systems of the human body has been known since antiquity and numerous recent studies have shown that blood transfusion may be an important source of exposure to lead in blood recipients. In this study factors influencing elevated lead levels in blood samples from donors in Qingdao, a city in northern China were investigated to provide screening procedures for blood donors and safer blood transfusions for blood recipients. MATERIALS AND METHODS: In 2021, subjects from 15 blood donation sites in Qingdao were selected by stratified random sampling. Blood lead levels (BLL) were analyzed by graphite furnace atomic absorption spectrometry. Multiple linear regression and logistic regression models were used to analyze factors influencing BLL. RESULTS: Of 2,142 blood donors, 1,434 were male and 708 were female, with an average age of 34.8 years. The geometric mean of BLL was 26.03 µg/L (95% confidence interval: 25.52-26.56), and donors in the high blood lead group (≥35 µg/L) accounted for 25.6% of the study population. Multiple linear regression results showed BLL was associated with gender, age, place of residence, duration of residence, and smoking status. Multivariate logistic regression analysis showed that male, increasing age, living in Jimo, duration of residence ≥30 years, and smoking were risk factors for high BLL, with odds ratios (95% confidence intervals) being 2.10 (1.61-2.73), 1.03 (1.01-1.04), 3.89 (1.09-13.86), 1.64 (1.22-2.20), and 1.76 (1.40-2.22), respectively. DISCUSSION: Male, advanced age, living in Jimo, smoking, and duration of residence ≥30 years were associated with higher BLL. Infusion of blood with elevated lead concentration can be reduced by screening out donors presenting one or more of the above risk factors.

Genomic full-length sequence of the HLA-B*13:64 allele was identified in a Chinese bone marrow donor.

Genomic full-length sequence of HLA-B*13:64 was identified in a Chinese individual by sequence-based typing.

Genomic full-length sequence of the HLA-A*02:406 allele was identified by full-length group-specific sequencing.

Genomic full-length sequence of HLA-A*02:406 was identified by group-specific sequencing in a Chinese individual.

The genomic full-length sequence of the HLA-A*02:344 allele, identified by full-length group-specific sequencing.

The genomic full-length sequence of HLA-A*02:344 was identified by a group-specific sequencing approach from China.

The genomic full-length sequence of the HLA-A*02:304 allele, identified by full-length group-specific sequencing.

The genomic full-length sequence of HLA-A*02:304 was identified by a group-specific sequencing approach from China.

Genomic full-length sequence of the HLA-B*52:100 allele, identified by full-length group-specific sequencing.

Genomic full-length sequence of HLA-B*52:100 was identified by group-specific sequencing in a Chinese individual.

Genomic full-length sequence of the HLA-B*52:23 allele was identified by full length group-specific sequencing.

Genomic full-length sequence of HLA-B*52:23 was identified by a group-specific sequencing approach in a Chinese individual.

Genomic full-length sequence of the HLA-B*40:60 allele was identified by full-length group-specific sequencing.

Genomic full-length sequence of HLA-B*40:60 was identified by group-specific sequencing in a Chinese individual.

Genomic full-length sequence of the HLA-C*03:227 allele was identified by full length group-specific sequencing.

Genomic full-length sequence of HLA-C*03:227 was identified by a group-specific sequencing approach in a Chinese individual.