Association between perfluoroalkyl and polyfluoroalkyl substances and maternal thyroid-related hormones in pregnant women / 环境与职业医学

Background Exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) during pregnancy might affect thyroid-related hormone levels in pregnant women. However, most previous studies focused on the effects of PFAS containing 8-10 carbon atoms, and few studies have estimated the associations between PFAS with longer carbon chain and thyroid-related hormone levels. Objective To examine the associations between PFAS exposure and thyroid-related hormones in pregnant women. Methods The present study was based on the Jiashan Birth Cohort from September 2016 to April 2018. We analyzed 13 PFAS in maternal blood samples (n=781) by high-performance liquid chromatography-tandem mass spectrometry, as well as total triiodothyronine (T3), total thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TG-Ab), and thyroid peroxidase antibody (TPOAb) by electrochemiluminescence immunoassay. PFAS were divided into three groups:low concentration, medium concentration and high concentration according to the tertile of their concentrations. We estimated the associations between PFAS concentrations and thyroid-related hormones in pregnant women by multiple linear regression. Results In the multiple linear regression models, a change in perfluorododecanoic acid (PFDoA) concentrations from the low concentration group to the high concentration group was associated with a −0.10 (95%CI: −0.20, 0) nmol·L−1 change in T3, −0.15 (95%CI: −0.28, −0.02) pmol·L−1 change in FT3, and −3.02 (95%CI: −5.66, −0.39) pmol·L−1 change in FT4, respectively. A change in perfluorotridecanoic acid (PFTrDA) concentrations from the low concentration group to the high concentration group was associated with a −0.10 (95%CI: −0.20, 0) nmol·L−1 change in T3. Compared with the low concentration group, the concentration of T4 in the medium concentration group of perfluorohexane sulfonate (PFHxS) increased by 6.10 (95%CI: 0.44, 11.75) nmol·L−1. No statistically significant associations were found between PFAS and TSH concentration. The negative associations of PFAS with thyroid-related hormones were more pronounced in pregnant women with positive TG-Ab and/or TPOAb. Conclusion Exposure to PFAS during pregnancy may affect thyroid-related hormone homeostasis in pregnant women, and the effect is stronger in TG-Ab and/or TPOAb-positive pregnant women.

Depression as the first manifestation of primary hyperparathyroidism: A case report and literature review / 中华内分泌代谢杂志

We report a case of primary hyperparathyroidism(PHPT) with depressive symptoms as initial manifestation. Literature review was conduct to further analyze the etiology, clinical manifestations, diagnosis, treatment and prognosis of the disease. The initial symptoms of the patients was the mental system depression and kidney stones was found by physical examination. She first visited a doctor in the urology department after a kidney stones was found. Blood calcium 2.86 mmol/L was found. At second visit, a doctor from endocrinology department conducted a comprehensive examination on the patient′s coexisting mental and renal system symptoms, clearly identified, her as PHPT. The clinical manifestations of PHPT are diverse. Symptoms such as depression, anxiety, mood swings, etc. are rarely evaluated. PHPT patients with onset or accompanied by psychiatric symptoms should be paid attention to by doctors, Measures should be taken to improve the quality of life and prognosis of patients through early screening of blood calcium and parathyroid hormone for timely diagnosis.

A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old / 中华流行病学杂志

Objective To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old.Methods In the present study,a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December,2012.Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy,as well as at 6 months and 12 months postpartum.Neurodevelopment at 2 years was assessed,using the Child Behavior Checklist.We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95％CIs,on children's behavioral problems at 2 years of age.Sensitivity analyses were performed among participants without postpartum depressive symptoms.Results After adjustment on factors as maternal age,gestation week,average monthly income per person,parental education and children's gender etc.,maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR =2.61,95％ CI:1.36-4.99) and internalizing problems (RR=1.94,95％ CI:1.22-3.08).However,maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46,95％CI:3.09-13.53),withdrawn (RR=2.42,95％CI:1.16-5.02),aggressive (RR=2.93,95 ％CI:1.45-5.94),internalizing (RR =1.79,95 ％CI:1.01-3.16) or externalizing problems (RR =2.56,95％ CI:1.49-4.42).In sensitivity analysis,antenatal maternal depression was found positively associated with children's emotional,internalizing and externalizing problems and the differences all statistically significant.Conclusions Maternal depression during pregnancy might increase the risks of children's behavioral problems.In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status,monitoring program regarding maternal mental health care should be strengthened.

A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old / 中华流行病学杂志

Objective: To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old. Methods: In the present study, a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December, 2012. Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy, as well as at 6 months and 12 months postpartum. Neurodevelopment at 2 years was assessed, using the Child Behavior Checklist. We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95%CIs, on children's behavioral problems at 2 years of age. Sensitivity analyses were performed among participants without postpartum depressive symptoms. Results: After adjustment on factors as maternal age, gestation week, average monthly income per person, parental education and children's gender etc., maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR=2.61, 95%CI: 1.36-4.99) and internalizing problems (RR=1.94, 95%CI: 1.22-3.08). However, maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46, 95%CI: 3.09-13.53), withdrawn (RR=2.42, 95%CI: 1.16-5.02), aggressive (RR=2.93, 95%CI: 1.45-5.94), internalizing (RR=1.79, 95%CI: 1.01-3.16) or externalizing problems (RR=2.56, 95%CI:1.49-4.42). In sensitivity analysis, antenatal maternal depression was found positively associated with children's emotional, internalizing and externalizing problems and the differences all statistically significant. Conclusions: Maternal depression during pregnancy might increase the risks of children's behavioral problems. In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status, monitoring program regarding maternal mental health care should be strengthened.

A survey of HIV, HBV and HCV infections in children aged 1-13 years in Yi ethnic area,Sichuan province / 中华流行病学杂志

Objective To investigate the prevalence of HIV,HBV and HCV infections in children aged 1-13 years in Yi ethnic area in Sichuan province.Methods A cross-sectional study was conducted in the form of field survey in four townships selected from Yi ethnic area of Sichuan during 2014-2015.Participants were children aged 1-13 years by sample size of 900 and were screened for HIV antibody,HBV surface antigen and HCV antibody,and laboratory comfirmation was conducted.The area,age,gender and ethnic group specific infection rates were compared by using Fisher' s exact test,and multiple comparisons were corrected by using Bonferroni correction.Results A total of 677 children aged 1-13 years were surveyed.The infection rates of HIV,HBV and HCV were 1.03％ (7/677,95％CI:0.42％-1.12％),6.65％ (45/677,95％CI:4.89％-8.79％) and 0.15％ (1/677,95％CI:0％-0.82％),respectively.The infection rates of HIV differed among townships (P=0.000),the infection rate was higher in township D than in township B,the difference was significant (P＜0.001).The differences in HIV infection rate among different age,gender and ethnic groups were not significant.The differences in HBV and HCV infections were not significant among different townships,age,gender and ethnic groups.The difference in HBV viral load between age group 5-9 years and age groups 10-13 years was not significant (U=115.000,P=0.967).Conclusions The burden of HIV and HBV infections in children aged 1-13 years was heavy in rural area of Yi ethnic area in Sichuan.Therefore,it is necessary to take effective measures to block the vertical transmission of HIV and HBV as well as to increase the coverage of HBV vaccination.

A survey of HIV, HBV and HCV infections in children aged 1-13 years in Yi ethnic area,Sichuan province / 中华流行病学杂志

Objective To investigate the prevalence of HIV,HBV and HCV infections in children aged 1-13 years in Yi ethnic area in Sichuan province.Methods A cross-sectional study was conducted in the form of field survey in four townships selected from Yi ethnic area of Sichuan during 2014-2015.Participants were children aged 1-13 years by sample size of 900 and were screened for HIV antibody,HBV surface antigen and HCV antibody,and laboratory comfirmation was conducted.The area,age,gender and ethnic group specific infection rates were compared by using Fisher' s exact test,and multiple comparisons were corrected by using Bonferroni correction.Results A total of 677 children aged 1-13 years were surveyed.The infection rates of HIV,HBV and HCV were 1.03％ (7/677,95％CI:0.42％-1.12％),6.65％ (45/677,95％CI:4.89％-8.79％) and 0.15％ (1/677,95％CI:0％-0.82％),respectively.The infection rates of HIV differed among townships (P=0.000),the infection rate was higher in township D than in township B,the difference was significant (P＜0.001).The differences in HIV infection rate among different age,gender and ethnic groups were not significant.The differences in HBV and HCV infections were not significant among different townships,age,gender and ethnic groups.The difference in HBV viral load between age group 5-9 years and age groups 10-13 years was not significant (U=115.000,P=0.967).Conclusions The burden of HIV and HBV infections in children aged 1-13 years was heavy in rural area of Yi ethnic area in Sichuan.Therefore,it is necessary to take effective measures to block the vertical transmission of HIV and HBV as well as to increase the coverage of HBV vaccination.

Temporal and spatial distribution of Schistosoma infection of population and its risk factors in Eastern Dongting Lake area in 2012 and 2014 / 中国血吸虫病防治杂志

Objective To investigate the temporal and spatial distribution of Schistosoma infection of population and its risk factors in Eastern Dongting Lake area in 2012 and 2014,so as to provide the reference for formulating effective intervention mea-sures. Methods Junshan District was selected as a study field in Eastern Dongting Lake area. The method of spatial autocorre-lation analysis was applied to analyze the change of spatial distribution of Schistosoma infection in Junshan District in 2012 and 2014. The spatial regression model was fitted to detect the risk factors for human infection. Results The livestock infection rate in 2013 was lower than that in 2011. The average infection rate of schistosome was reduced to 0.55%in 2014. The spatial auto-correlation existed on the distribution of schistosomiasis in Junshan District in both 2012 and 2014 and 4 high incidence villages were identified. The results of the spatial error model showed that the prevalence of human infection was positively correlated with the infection rate of the livestock and the area of the susceptible environment in 2012. The spatial lag model showed that the prevalence of human schistosomiasis was positively correlated with the area of the susceptible environment ,but not with the in-fection rate of livestock. Conclusion The measures involving grazing prohibition and phasing out cattle and sheep are remark-ably effective and should continue on the basis of the current spatial distribution of schistosomiasis in this area.

Advances in researches of molluscicidal microorganisms against Oncomela-nia hupensis / 中国血吸虫病防治杂志

The elimination of Oncomelania hupensis snails is important to schistosomiasis control. Recently,the application of molluscicidal organisms is considered as a safe and efficient method for snail elimination. In order to provide scientific evi?dences for effective control of O. hupensis and schistosomiasis,this paper summarizes the researches of molluscicidal microor?ganisms against O. hupensis.

Analysis of Electrocardiographic Characteristics in 84 Patients With Primary Hyperparathyroidism / 中国循环杂志

Objective: To analyze the electrocardiographic (ECG) characteristics in patients with primary hyperparathyroidism (PHPT) and meanwhile, to explore the relationship between ECG abnormality and serum calcium level in relevant patients. Methods: Our study included 2 groups: Observation group,n=84 PHPT patients treated in our hospital from 2010-01 to 2014-04 and Control group,n=80 normal subjects from regular physical examination at the same period. The ECG manifestation was compared between 2 groups. Meanwhile, according to tertile levels of serum calcium, PHPT patients were further divided into 3 subgroups:①Ca2+ level (2.0-2.8) mmol/L,②Ca2+ level (2.8-3.1) mmol/L,③Ca2+ level >3.1 mmol/L andn=28 in each subgroup. The ECG abnormalities were compared among 3 subgroups and the relationship between ECG changes and serum calcium levels were studied. Results: The ECG abnormality rates in Observation group and Control group were as 83.3% vs 18.8%, P<0.001. Compared with Control group, Observation group presented more frequent ST-T changes, QRS duration widening, high left ventricular pressure and QT interval shortening,P<0.001 orP<0.05. In observation group, with the rising of serum calcium, the incidences of ST-T changes and high left ventricular pressure were increased accordingly, the ST-T changes among 3 subgroups were significant,P<0.05; while with the rising of serum calcium, the QT interval was shortened and QRS duration was widened accordingly, the differences were obvious among 3 subgroups, allP<0.05.Conclusion: PHPT patients have the higher incidence with abnormal ECG, while ECG abnormality has beenrelated to serum calcium level in relevant patients.

Comparative analysis of epidemiological situation and trategies to control schistosomiasis between China and African countries / 中国血吸虫病防治杂志

Schistosomiasis is a neglected tropical disease which is socioeconomically devastating and a significant cause of morbidity in endemic countries or regions. Some countries and regions have brought down the prevalence of schistosomiasis through positive prevention and control programs. However in the past few years with the social and economic development and globalization re?emergence and spread of schistosomiasis led to a growing concern that new endemic areas may occur. This article analyzes the epidemiological situation and the strategies to control schistosomiasis in China and African countries.

Analysis of relationship between natural death of Oncomelania hupensis snails and water level in Eastern Dongting Lake district / 中国血吸虫病防治杂志

Objective To study the reasons of natural death of Oncomelania hupensis snails by comparing the differences of the indicator days covered with water DCW in snail marshland and non?snail marshland around the build of Three Gorges Dam in Eastern Dongting Lake areas. Methods Two marshlands were selected one was a non?snail marshland Qianliang Lake and another was a snail marshland Junshan Park . The measuring points were set through the mechanical sampling. The snails and elevation of the points were surveyed and the data of the water levels from the hydrological station were collected and then DCWs were calculated. Results From 1995 to 2013 DCWs of the marshland of natural death of snails were all more than that of the snail marshland P<0.01 . In Qianliang Lake marshland the difference between DCW before natural death and DCW from natural death until the dam was not significant P=0.23 while DCWs of the two stages both were more than that after the dam P1=0.045 P2=0.002 . Before the build of the dam DCW of the Qianliang Lake marshland of natural death of snails was more than that after the build of the dam P=0.013 and there was the same situation in Junshan Park marshland P=0.005 . The relationship between snail density and DCW was not significant in Junshan Park marshland rs=0.008 P=0.914 and the reference range of DCW of all the measuring points was 76-251 days. Conclusion In the eastern Dongting Lake district the build of Three Gorges Dam and DCW may be not the direct factors affecting the natural death of snails and the latter may change the distribution of snails.

A cross-sectional and factor analysis study on HIV, HBV and HIV/HBV infection in a Yi Prefecture, southwest China / 中华流行病学杂志

Objective To understand the epidemiological characteristics and related risk factors on HIV,HBV infection of people from the southwest province of China and to provide basic data for the development of related strategies.Methods According to the information on current HIV epidemics,one township from the area was selected as the study field and all the adult population were surveyed using a questionnaire to collect social demographic data and information on infection-related factors.Results A total of 2 290 adults were investigated and data showed as follows:the average HIV infection rate as 7.9％,the average HBV infection rate as 3.1％,and the average HIV/HBV co-infection rate as 1.2％.As for HIV infection,people whose yearly family gross income between 1 000 and 3 000 Yuan (OR=0.28) or more than 5 000 Yuan (OR=0.14) were less likely to be infected with HIV than those people whose annual family gross income less than 1 000 Yuan.People with educational level of primary school and above were more likely to carry HIV than those who were illiterate (OR =3.28).People who had the history of migration were less likely to carry HIV than those who had not (OR=0.33).People who had the history of being drug abusers were more likely to infect HIV than those who had not (OR=46.32).People whose spouses had the history of using drugs were more likely to infect HIV than those who had not (OR=3.52).People whose spouses had been infected with HIV were more likely to infect HIV than those who had not (OR=9.56).As for HBV infection,people who had the history of migration were more likely to infect HBV (OR =2.48).As for HIV/HBV co-infection,people whose spouses had the history of HIV infection were more likely to infect HIV/HBV co-infection than others who did not have the history (OR=6.04).Conclusion There had been a serious HIV/AIDS epidemic in our study field.Other than taking measures as detection and vaccination on HBV,health education should be strengthened,together with measurements as needle exchange and methadone substitution therapy,to control the spread of AIDS.

Contrastive analysis of environmental factors between Oncomelania hupensis snail marshland and snail natural death marshland in Eastern Dongting Lake schistosomiasis endemic areas / 中国血吸虫病防治杂志

Objective To study the reasons of natural death of Oncomelania hupensis snails in marshland by comparing the differences of environmental factors between snail marshland and non-snail marshland in East Dongting Lake schistosomiasis en-demic areas. Methods Two adjoining marshlands were selected,one was a snail marshland and another was a non-snail marsh-land. The measuring points were set by grid of“20m × 20m”. The soil moisture,elevation,soil pH and temperature of the points were measured,and the snails of the points were surveyed. Results The elevation,soil pH and temperature of the snail natural death marshland were all lower than those of the snail marshland(P<0.01). The soil moisture,elevation,soil pH and temperature of different snail densities in the snail marshland were different(P<0.05). The soil moisture of the non-snail group was higher than that of other four groups(P<0.01)and the soil moisture of the group with 0-11 snails per frame was lower than that of other four groups(P<0.01). The elevation of the group with 0-11 snails per frame was lower than that of the group with 24-39 snails per frame and the group with more than 39 snails per frame(P<0.05). The soil pH of the group without snails was higher than that of other four groups(P<0.01)and the soil temperature of the group with 0-11 snails per frame was lower than that of the group with 24-39 snails per frame. The differences of soil moisture and elevation of different death snail densities were not significant, while the differences of soil pH and temperature were significant. The soil pH of the non-snail died group was higher than that of the 2-died,3-died and more than 3-died groups(P<0.05). The soil temperature of the non-snail died group was higher than that of other four groups(P<0.05). Conclusion The elevation,soil pH and soil temperature within the range of the research may be the factors affecting the snail natural death and the soil moisture,elevation,soil pH and soil temperature may be the factors affect-ing the distribution of snails.

Distribution of univalvia molluscs in area with natural decline of Oncomela-nia hupensis snails in Eastern Dongting Lake area / 中国血吸虫病防治杂志

Objective To understand the distribution of univalvia molluscs in Eastern Dongting lake area where the Oncome-lania hupensis is extinct,so as to explore the causes of extinction and to provide the evidence for formulating schistosomiasis con-trol strategy. Methods The univalvia molluscs of the Qianliang Lake district,Jianxin District and Junshan Park were investigat-ed in August of 2013. All the collected snails were classified and identified. The data were analyzed by using the method of Shapiro-Wilk normality test and non-parametric test. The ecological biodiversity differences from each district were compared by the biodi-versity indexes. Results The univalvia molluscs collected were from 6 species in 3 families in Gastropoda class,namely Oncome-lania hupensis Gredler in Pomatiopsidae family,Parafossarulus striatulus,Alocinma longicornis,Parafossarulus sinensis,Bithynia fuchsisana in Bithyniidae family,and one genus provisionally named Radix in Lymaneidae family. In Junshan Park ,a total of 4 553 snails were collected,among which 1 264 were Oncomelania snails. In Jianxin District,336 univalvia molluscs were collect-ed,and no Oncomelania snails were found. In Qianliang Lake district,there were only 7 Alocinma longicornis snails,2 Parafossa-rulus sinensis snails and 1 Parafossarulus striatulus snail collected. There were significant differences among the distributions of the samples from the three districts(χ2=166.225,P<0.01).The Simpson’s diversity indexes in Qianliang Lake area,Jianxin Dis- trict and Junshan Park were 0.402 8,0.718 6 and 0.678 8,respectively,and the Shannon-Wiener indexes of the 3 areas were 0.721 5,1.431 3 and 1.199 9,respectively. Conclusions With the extinction of Oncomelania snails,the species and quanti-ties of other snails become rare in Qianliang Lake area. Whether their causes are relevant is worth further studying.

Carotid artery intima-media thickness and insulin resistance in type 2 diabetes mellitus / 中国糖尿病杂志

The study of 102 T2DM patients and 55 non-diabetes subjects showed that the average and largest IMT of carotid arterier had positive relation with age and HOMA-IR, and negative relation with insulin sensitivity.

The components of metabolic syndrome analyzed by factor analysis / 中国糖尿病杂志

Objective To evaluate the clustered characteristics of the components of metabolic syndrome. Methods 483 subjects (242 men, 241 women, aged 53±12 years ) in Beijing area underwent a 75g oral glucose tolerance test (OGTT) for screening of diabetes.203 subjects were diagnosed as diabetes through OGTT.Factor analysis was performed using the variables of insulin/blood glucose, total cholesterol (CHO), LDL-C, HDL-C, triglycerides (TG), systolic blood pressure, diastolic blood pressure, BMI, waist-to-hip ratio and waist circumference. Results Five factors, including obesity, insulin resistance/hyperglycemia, CHO/LDL-C, dyslipidemia (elevated TG and decreased HDL) and hypertension, could explain 72.2% of total variance.The most important component was obesity, which could explain 29.8% of total variance.The obesity factor was associated with dyslipidemia factor through C-reactive protein (CRP).Dyslipidemia factor also associated with insulin resistance/hyperglycemia factor.Hypertension factor and CHO/LDL-C factor were isolated from other factors. Conclusions Obesity factor is the most important component of metabolic syndrome.The pathophysiologic mechanism of metabolic syndrome is complex.Insulin resistance alone could not explain all features of the metabolic syndrome.Its pathophysiology maybe include the factors of obesity, insulin resistance and inflammatory reaction.