Efficacy and safety of intratonsillar immunotherapy for allergic rhinitis: A randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: A lower adherence rate existed in patients receiving allergen-specific immunotherapy due to its lengthy period and adverse effects even though it is the only curative treatment for IgE-mediated allergies. Therefore, exploring innovative allergen-specific immunotherapy routes is necessary. OBJECTIVE: To explore the efficacy and safety of the intratonsillar injection of house dust mite (HDM) extract in patients with HDM-induced allergic rhinitis (AR). METHODS: A randomized, double-blind, placebo-controlled clinical trial was conducted. A total of 80 patients with HDM-induced AR were randomized to receive 6 intratonsillar injections with HDM extract or placebo in 3 months. The total nasal symptom score (TNSS), visual analogue scale of nasal symptoms, combined symptom and medication score, mini rhinoconjunctivitis quality of life questionnaire, and serum allergen-specific IgG4 to Dermatophagoides pteronyssinus were all monitored at baseline and 3 months, 6 months, and 12 months after the treatment was finished. The intent-to-treat and per-protocol set (PPS) are both analyzed. RESULTS: The primary end points TNSS and ΔTNSS were improved significantly at 3 months after the patients with AR finished a 3-month 6-injection intratonsillar immunotherapy compared with those in the placebo treatment in both intent-to-treat and PPS. Results of visual analogue scale, combined symptom and medication score, and mini rhinoconjunctivitis quality of life questionnaire were also improved significantly at 3 months after the treatment in PPS. However, the improvement effect of intratonsillar immunotherapy at 6 and 12 months was limited and uncertain based on the data. The increase of serum Der p IgG4 in the active group was significantly higher than that in the placebo group at 3, 6, and 12 months after the treatment was finished. Adverse events were monitored, and no systemic adverse reactions were observed. CONCLUSION: The clinical trial revealed that intratonsillar injection with HDM extract was safe and effective in patients with AR. Optimizing the protocol and allergen formulations is expected to increase and maintain the efficacy of this novel approach. TRIAL REGISTRATION: https://www.chictr.org.cn/index.html, identifier: ChiCTR-TRC-13003600.

The changes in socioeconomic inequalities and inequities in health services utilization among patients with hypertension in Pearl River Delta of China, 2015 and 2019.

BACKGROUND: Assessing inequities in health services utilization contributes to build effective strategies for health equity promotion. This study aimed to evaluate the socioeconomic inequalities and inequities in health services utilization among hypertensive patients and explore the changes between 2015 and 2019 in Pearl River Delta of China. METHODS: The cross-sectional surveys were conducted using the questionnaire. Eight hundred thirty and one thousand one hundred sixty-six hypertensive patients in 2015 and 2019 were interviewed, respectively. The concentration index (CI) and the horizontal inequity index (HI) were used to access the socioeconomic inequalities and horizontal inequities in outpatient and inpatient health services use. The contribution of influential factors to the overall inequalities was estimated via the concentration index decomposition. Oaxaca-type decomposition technique was utilized to measure the changes in socioeconomic inequalities between the observation periods. RESULTS: In 2015 and 2019, the CIs for outpatient and inpatient utilization decreased from 0.1498 to 0.1198, 0.1982 to 0.1648, respectively, and the HIs for outpatient and inpatient utilization decreased from 0.1478 to 0.1078, 0.1956 to 0.1390, respectively. Economic status contributed the maximum ratio of the socioeconomic inequalities in the use of outpatient service (81.05% in 2015, 112.89% in 2019) and inpatient service (82.46% in 2015, 114.68% in 2019) in these 2 years. Oaxaca decomposition revealed that educational level (78.30% in outpatient, 53.79% in inpatient) and time to the nearest health facilities (66.78% in outpatient, 31.06% in inpatient) made the main positive contributions to decline the inequalities. While the main factor pushing the equalities toward deterioration was economic status (- 46.11% in outpatient, -76.56% in inpatient). CONCLUSION: There were certain declines in the socioeconomic inequalities and inequities in health services utilization by hypertensive patients in Pearl River Delta of China over time. The widening economic gap was the largest contribution to the observed inequalities. Interventions to protect the vulnerable group deserve further concern from policy makers.

Prevalence of urolithiasis among the Uyghur children of China: a population-based cross-sectional study.

OBJECTIVES: To investigate the prevalence and associated factors of urolithiasis amongst Uyghur children. SUBJECTS AND METHODS: A cross-sectional survey was conducted of Uyghur children (aged ≤14 years) in the Kashgar Region of China, from July to December 2016. Children were selected by a two-stage random clustered sampling method, evaluated by urinary tract ultrasonography, low-dose computed tomography (CT) examination, blood and urine analysis, and a questionnaire. The prevalence by CT, the prevalence by self-report in the questionnaires, and the lifetime prevalence were evaluated. Binary logistic regression was used to estimate the associated factors. RESULTS: A total of 5605 children were selected and invited to participate in the study. In all, 4813 Uyghur children (2471 boys and 2342 girls), with an mean (SD; range) age of 75.79 (43.81; 2-177) months, were included in the final analysis, with a response rate of 85.9%. The prevalence of paediatric urolithiasis was 1.8% (95% confidence interval [CI] 1.5-2.2) by CT, 2.3% (95% CI 1.9-2.7) by self-report, and 3.6% (95% CI 3.0-4.1) for the overall life-time. The age-sex adjusted prevalence was 2.0% (95% CI 1.6-2.4) by CT. Binary logistic regression analysis showed that body mass index, urinary tract infection, a family history of urolithiasis, and excessive sweating could increase the risk of stone formation, whilst breast feeding and drinking water at midnight could decrease the risk. CONCLUSIONS: Urolithiasis is a major public health problem amongst Uyghur children, and strategies aimed at the prevention of urolithiasis are needed.

Development of an in silico prediction model for chemical-induced urinary tract toxicity by using naïve Bayes classifier.

The urinary tract toxicity is one of the major reasons for investigational drugs not coming into the market and even marketed drugs being restricted or withdrawn. The objective of this investigation is to develop an easily interpretable and practically applicable in silico prediction model of chemical-induced urinary tract toxicity by using naïve Bayes classifier. The genetic algorithm was used to select important molecular descriptors related to urinary tract toxicity, and the ECFP-6 fingerprint descriptors were applied to the urinary tract toxic/non-toxic fragments production. The established naïve Bayes classifier (NB-2) produced 87.3% overall accuracy of fivefold cross-validation for the training set and 84.2% for the external test set, which can be employed for the chemical-induced urinary tract toxicity assessment. Furthermore, six important molecular descriptors (e.g., number of N atoms, AlogP, molecular weight, number of H acceptors, number of H donors and molecular fractional polar surface area) and toxic and non-toxic fragments were obtained, which would help medicinal chemists interpret the mechanisms of urinary tract toxicity, and even provide theoretical guidance for hit and lead optimization.

Prevalence of kidney stones in China: an ultrasonography based cross-sectional study.

OBJECTIVES: To investigate the prevalence and associated factors of kidney stones among adults in China. SUBJECTS AND METHODS: A nationwide cross-sectional survey was conducted among individuals aged ≥18 years across China, from May 2013 to July 2014. Participants underwent urinary tract ultrasonographic examinations, completed pre-designed and standardised questionnaires, and provided blood and urine samples for analysis. Kidney stones were defined as particles of ≥4 mm. Prevalence was defined as the proportion of participants with kidney stones and binary logistic regression was used to estimate the associated factors. RESULTS: A total of 12 570 individuals (45.2% men) with a mean (sd, range) age of 48.8 (15.3, 18-96) years were selected and invited to participate in the study. In all, 9310 (40.7% men) participants completed the investigation, with a response rate of 74.1%. The prevalence of kidney stones was 6.4% [95% confidence interval (CI) 5.9, 6.9], and the age- and sex-adjusted prevalence was 5.8% (95% CI 5.3, 6.3; 6.5% in men and 5.1% in women). Binary logistic regression analysis showed that male gender, rural residency, age, family history of urinary stones, concurrent diabetes mellitus and hyperuricaemia, increased consumption of meat, and excessive sweating were all statistically significantly associated with a greater risk of kidney stones. By contrast, consumption of more tea, legumes, and fermented vinegar was statistically significantly associated with a lesser risk of kidney stone formation. CONCLUSION: Kidney stones are common among Chinese adults, with about one in 17 adults affected currently. Some Chinese dietary habits may lower the risk of kidney stone formation.

Genomic analysis and experimental pathogenic characterization of Riemerella anatipestifer isolates from chickens in China.

Waterfowl have a high likelihood of being infected with Riemerella anatipestifer. Although the pathogen is found in domestic ducks, turkeys, geese, and wild birds, there is little information available about the consequences of infection during egg laying and hatching in chickens. Here, we present the first report of a novel sequence type of R. anatipestifer S63 isolated from chickens in China. On the basis of pan-genome analysis, we showed S63's genome occupies a distinct branch with other R. anatipestifer isolates from other hosts. Galleria mellonella larval tests indicated that S63 is less virulent than R. anatipestifer Ra36 isolated from ducks. Ducks and hens are susceptible to S63 infection. There is no mortality rate for chickens or ducks, but adult chickens experience neurological symptoms that reduce egg production and hatching rates. In chickens, S63 might be passed vertically from parents to offspring, resulting in "jelly-like" lifeless embryos. Using quantitative PCR, S63 was detected in the brain, liver, reproductive organs, and embryos. As far as we know, this is the first report of R. anatipestifer in hens, a disease that can reduce egg productivity, lower hatching rates, and produce jelly-like lifeless embryos, and the first report to raise the possibility that hens can be infected by roosters via semen.

Health benefits by attaining the new WHO air quality guideline targets in China: A nationwide analysis.

To reduce the high disease burden caused by air pollution, World Health Organization (WHO) issued a new air quality guideline (AQG) on the 22nd September 2021. A timely quantitative assessment of health benefits by meeting these targets is a key measure to advocate and inform national and regional disease control policies. We collected daily major air pollution data in 315 Chinese cities from the 1st January to the 31st December 2019, and the corresponding annual population and mortality rate in the whole population of each city. Then, the mortality benefits were estimated when daily air pollution levels attained WHO's new AQG targets (15 µg/m3 for PM2.5, 25 µg/m3 for NO2 and 100 µg/m3 for O3) in 315 Chinese cities and 31 provinces by using pollutant- and cause-specific concentration-response functions. In total, 134,025 (95%CI: 92,768; 173,029) air pollution-associated non-accidental deaths could be avoided in 315 Chinese cities in 2019 by attaining WHO's new AQG targets, with 43,800 (95%CI: 29,945; 55,616) avoidable deaths from PM2.5, 58,070 (95%CI: 45,333; 70,714) from NO2, and 32,155 (95%CI: 17,490; 46,699) from O3. Cardiovascular diseases and respiratory diseases accounted for 72,698 (95%CI: 46,561; 101,680) and 17,726 (95%CI: 8603; 26,925) avoidable deaths, respectively. Health benefits from reduction in air pollution levels were 99.26 avoided non-accidental deaths per million population at national level, ranging from 12.48 per million in Tibet to 166.26 per million in Hebei. These findings suggest that the compliance with the WHO updated AQG standards would save substantial amount of air pollution-related premature deaths in China. More stringent air pollution control and management measures are urgently warranted to reduce the disease burden from air pollutants in China, particularly for the worsening O3 pollution.

Natural polysaccharide-based biodegradable polymeric platforms for transdermal drug delivery system: a critical analysis.

Natural biodegradable polymers generally include polysaccharides (starch, alginate, chitin/chitosan, hyaluronic acid derivatives, etc.) and proteins (collagen, gelatin, fibrin, etc.). In transdermal drug delivery systems (TDDS), these polymers play a vital role in controlling the device's drug release. It is possible that natural polymers can be used for TDDS to attain predetermined drug delivery rates due to their physicochemical properties. These polymers can be employed to market products and scale production because they are readily available and inexpensive. As a result of these polymers, new pharmaceutical delivery systems can be developed that is both regulated and targeted. The focus of this article is the application of a biodegradable polymeric platform based on natural polymers for TDDS. Due to their biocompatibility and biodegradability, natural biodegradable polymers are frequently used in biomedical applications. Additionally, these natural biodegradable polymers are being studied for their characteristics and behaviors.

Exosomes with low miR-34c-3p expression promote invasion and migration of non-small cell lung cancer by upregulating integrin α2ß1.

Exosomes play critical roles in regulating various physiological and pathological processes, including immune stimulation, immune suppression, cardiovascular diseases, and cancers. Recent studies show that exosomes that transport specific microRNAs (miRNAs) are involved in tumor development. However, the molecular mechanism by which tumor invasion and migration are regulated by exosomes from non-small cell lung cancer (NSCLC) is not well understood. Here, we show that exosomes shuttling low levels of miR-34c-3p are involved in NSCLC progression. Our results showed that exosomes derived from NSCLC cells carrying low levels of miR-34c-3p could be transported into the cytoplasm of NSCLC cells and accelerate NSCLC invasion and migration by upregulating integrin α2ß1. A luciferase assay revealed that integrin α2ß1 was the direct target of miR-34c-3p, and overexpression of integrin α2ß1 could promote the invasion and migration of NSCLC cells. The analysis of exosomes derived from clinical serum samples indicated that the expression of miR-34c-3p was significantly downregulated in exosomes from NSCLC patients compared with that of normal controls. A549-derived exosomes promoted NSCLC cells lung metastases in vivo. Exosomes shuttling low levels of miR-34c-3p were associated with the progression of NSCLC in vitro and in vivo. Our data demonstrate that exosomes shuttling low levels of miR-34c-3p can accelerate the invasion and migration of NSCLC by upregulating integrin α2ß1. MiR-34c-3p can be a diagnostic and prognostic marker for NSCLC. High expression of integrin α2ß1 is positively related to the migration and metastasis of NSCLC cells.

Association between early-life exposure to the Great Chinese Famine and poor physical function later in life: a cross-sectional study.

OBJECTIVES: This study aimed to evaluate the association between early-life exposure to the Great Chinese Famine (1959-1961) and the prevalence of poor physical function in midlife. DESIGN: A population-based historical prospective study was performed as part of a wider cross-sectional survey. Exposure to famine was defined by birthdate, and participants were divided into non-exposed group, fetal-exposed group and infant-exposed group. SETTING AND PARTICIPANTS: A total of 3595 subjects were enrolled into the study from the China Health and Retirement Longitudinal Study (CHARLS) 2015 based on random selection of households that had at least one member aged 45 years old and older in 28 provinces of mainland China. MAIN OUTCOME MEASURES: Physical function status was assessed by a six-item self-report on the Barthel scale which rated basic activities of daily living (BADL). RESULTS: 743 (20.7%) out of all participants were exposed to the Great Chinese Famine in their fetal periods, while 1550 (43.1%) participants were exposed at the age of an infant. The prevalence of poor physical function in the non-exposed group, fetal period-exposed group and infant period-exposed group were 12.3%, 15.5% and 17.0%, respectively. Among males, after stratification by gender and severity of famine, the prevalence of poor physical function in the fetal period was significantly higher (OR 2.40, 95% CI 1.18 to 4.89, p=0.015) than the non-exposed group in severely affected areas, even after adjusting for the number of chronic diseases, place of residence, smoking and alcohol drinking habits, marital status, educational level and body mass index. A similar connection between prenatal and early postnatal exposure to the Great Chinese Famine and the prevalence of poor physical function in midlife, however, was not observed from female adults. CONCLUSIONS: Males who were exposed to the Great Chinese Famine (1959-1961) present considerably decreased physical function in their later life.

Interaction of lipid accumulation product and family history of hypertension on hypertension risk: a cross-sectional study in the Southern Chinese population.

OBJECTIVES: This study aimed at investigating the applicability of a novel index based on waist circumference (WC) and triglyceride (TG) which was named lipid accumulation product (LAP) in the Southern Chinese population, and compared the predictive effects of LAP and other obesity indicators on hypertension risk. Moreover, this study investigated the interactive effects of LAP and family history of hypertension. METHODS: A total number of 2079 of community-dwelling adults in Southern China were enrolled in this cross-sectional study. The participants underwent questionnaire surveys, anthropometric tests and laboratory examinations. Themultinomial logistic regression model and receiver operating characteristic curves, including LAP, body mass index (BMI), waist-to-hip ratio (WHR), WC and TG, were used to assess the association between hypertension risk and obesity indexes. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS: Higher LAP levels have a relatively higher risk of having hypertension in both sexes (males: adjusted OR=2.79 per SD increase, 95% CI 1.43 to 5.44, p<0.001; females: adjusted OR=3.15, 95% CI 1.56 to 6.39, p<0.001). LAP (area under the curve=0.721; 95% CI 0.680 to 0.761) is a better indicator in identifying hypertension risk than BMI, WHR and TG in females, but WC performed better in males. A significant interaction between LAP and family history of hypertension was observed in males (RERI=1.652, 95% CI 0.267 to 3.037; AP=0.516, 95% CI 0.238 to 0.794; SI=3.998, 95% CI 0.897 to 17.820), but there is no statistically significant difference in females. CONCLUSIONS: LAP significantly associates with hypertension risk in the Southern Chinese population. It has better performance than BMI, WHR and TG on predicting hypertension risk of the Southern Chinese female population. Moreover, LAP and family history of hypertension might synergistically increase the risk of hypertension.

Development and evaluation of in silico prediction model for drug-induced respiratory toxicity by using naïve Bayes classifier method.

Respiratory toxicity is considered as main cause of drug withdrawal, which could seriously injure human health or even lead to death. The objective of this investigation was to develop an in silico prediction model of drug-induced respiratory toxicity by using naïve Bayes classifier. The genetic algorithm was used to select important molecular descriptors related to respiratory toxicity, and the ECFP_6 fingerprint descriptors were applied to the respiratory toxic/non-toxic fragments production. The established prediction model was validated by the internal 5-fold cross validation and external test set. The naïve Bayes classifier generated overall prediction accuracy of 91.8% for the training set and 84.3% for the external test set. Furthermore, six molecular descriptors (e.g., number of O atoms, number of N atoms, molecular weight, Apol, number of H acceptors and molecular polar surface area) considered as important for the drug-induced respiratory toxicity were identified, and some critical fragments related to the respiratory toxicity were achieved. We hope the established naïve Bayes prediction model could be used as a toxicological screening of chemicals for respiratory sensitization potential in drug development, and these obtained important information of respiratory toxic chemical structures could offer theoretical guidance for hit and lead optimization.

Prevalence of fatty liver disease and its risk factors in the population of South China.

AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province, China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province, China. Questionnaires, designed by co-working of epidemiologists and hepatologists, included demographic characteristics, current medication use, medical history and health-relevant behaviors, i.e. alcohol consumption, smoking habits, dietary habits and physical activities. Anthropometric measurements, biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects, 609 (17.2%) were diagnosed having FLD (18.0% males, 16.7% females, P > 0.05). Among them, the prevalence of confirmed alcoholic liver disease (ALD), suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%, 1.8%, and 15.0%, respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age, gender and residency, the standardized prevalence of FLD in adults was 14.5%. Among them, confirmed ALD, suspected ALD and NAFLD were 0.5%, 2.3%, and 11.7%, respectively, in adults and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%, P < 0.001). However, the opposite phenomenon was found over the age of 50 years (20.6% vs 27.6%, P < 0.05). Multivariate and logistic regression analysis indicated that male gender, urban residency, low education, high blood pressure, body mass index, waist circumference, waist to hip ratio, serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD, especially NAFLD, is prevalent in South China. There are many risk factors for FLD.

Parthenolide suppresses non-small cell lung cancer GLC-82 cells growth via B-Raf/MAPK/Erk pathway.

Non-small cell lung cancer (NSCLC), one type of lung cancer, owns high rates of morbidity and mortality. B-Raf is one of the promising oncogenic drivers of NSCLC. Parthenolide, a natural product, is mainly extracted from the herbal plant Tanacetum parthenium. The effect of parthenolide on NSCLC cells and its potential as B-Raf inhibitor were studied in this study. It's shown that parthenolide exhibited the strong cytotoxicity against NSCLC cells with IC50 ranging from 6.07 ± 0.45 to 15.38 ± 1.13 µM. Parthenolide was also able to induce apoptosis, suppress proliferation and invasion in NSCLC cells. In terms of the involved mechanism, parthenolide suppressed GLC-82 cell response via targeting on B-Raf and inhibiting MAPK/Erk pathway signaling. The effect of parthenolide on B-Raf and MAPK/Erk pathway was further confirmed by RNA interference of B-Raf. Decreased expression of c-Myc in protein and mRNA level was also discovered, which is considered as the further downstream of the MAPK/Erk pathway. In addition, STAT3 activity inhibition by parthenolide contributed to its effect on GLC-82 cells, which is independent of PI3K pathway signaling and GSK3. All above provide an insight to understand the action of parthenolide as a potential B-Raf inhibitor in treatment of NSCLC.

Economic cost analysis of malaria case management at the household level during the malaria elimination phase in The People's Republic of China.

BACKGROUND: In China, malaria has been posing a significant economic burden on households. To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China. METHODS: A number of study sites (eight counties in five provinces) were selected from the malaria endemic area in China, representing the different levels of malaria incidence, risk classification, economic development. A number of households with malaria cases (n = 923) were surveyed during the May to December in 2012 to collect information on malaria economic burden. Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender, age group, occupation and malaria type. The malaria economic costs were evaluated by direct and indirect costs. Comparisons were carried out by using the chi-square test (or Z-test) and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients, hospitalized/out patients, and treatment hospitals. RESULTS: The average cost of malaria per case was 1 691.23 CNY (direct cost was 735.41 CNY and indirect cost was 955.82 CNY), which accounted for 11.1 % of a household's total income. The average costs per case for local and imported malaria were 1 087.58 CNY and 4271.93 CNY, respectively. The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above (3 975.43 CNY) was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital (938.80 CNY). CONCLUSION: This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs. There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria, especially of imported infections, in order to eliminate the disease in China.

Influence of self-reported chronic rhinosinusitis on health-related quality of life: a population-based survey.

Chronic rhinosinusitis (CRS) is a frequently occurring chronic respiratory disease. There is evidence that effective treatment of CRS can improve patients' quality of life, but the data regarding the extent to which CRS impairs patients' quality of life (QoL) is sparse. This study aimed to evaluate the effect of self-reported CRS on health-related QoL and to determine whether the influence was associated with gender, age and socio-economic status. A four-stage random sampling method was used to select the participants from the general population in Guangzhou, China. All participants were interviewed face-to-face at their homes using a standardized questionnaire. The health-related QoL of each participant was assessed using the SF-36 Health Survey. The scores of the SF-36 after adjusting for gender, age, socioeconomic conditions, smoking and some important comorbid conditions were compared between the CRS group and the non-CRS group using analysis of covariance. A multiple linear regression model with interaction terms was established to determine whether CRS affected QoL to the same degree across the different subpopulations. Among a total of 1,411 participants aged at least 15 years, 118 persons (8.4%) had self-reported CRS. Subjects with CRS had an increased prevalence of allergic rhinitis, chronic obstructive pulmonary disease and gout than subjects without CRS. The CRS group had lower scores in all eight domains and the physical and mental component summary than those without CRS (P<0.05), and the greatest differences were in role emotional function (RE), general health (GH) and role physical function (RP). The impairments of the CRS participants in RE and RP were greater among the females than the males. Moreover, physical domains were affected to greater degrees among the elderly and those with high-level education. In conclusion, CRS is a common chronic disorder. Persons with self-reported CRS perceived themselves as having impaired QoL in both the physical and mental domains. These findings shed new light on the health burden of CRS and should be taken into account by clinicians involved in the care of CRS patients.

Neuropsychological performance in bipolar I, bipolar II and unipolar depression patients: a longitudinal, naturalistic study.

BACKGROUND: It has been suggested that cognitive deficits existed in mood disorders. Nevertheless, whether neuropsychological profiles differ three main subtypes of mood disorder (Bipolar I, Bipolar II and UP) remain understudied because most current studies include either mixed samples of bipolar I and bipolar II patients or mixed samples of different states of the illness. The main aim of the present study is to determine whether, or to some extent, specific cognitive domains could differentiate the main subtypes of mood disorders in the depressed and clinically remitted status. METHOD: Three groups of bipolar I (n=92), bipolar II (n=131) and unipolar depression (UP) patients (n=293) were tested with a battery of neuropsychological tests both at baseline (during a depressive episode) and after 6 weeks of treatment, contrasting with 202 healthy controls on cognitive performance. The cognitive domains include processing speed, attention, memory, verbal fluency and executive function. RESULTS: At the acute depressive state, the three patient groups (bipolar I, bipolar II and UP) showed cognitive dysfunction in processing speed, memory, verbal fluency and executive function but not in attention compared with controls. Post comparisons revealed that bipolar I depressed patients performed significantly worse in verbal fluency and executive function than bipolar II and UP depressed patients. No difference was found between bipolar II and UP depressed patients except for the visual memory. After 6 weeks of treatment, clinically remitted bipolar I and bipolar II patients only displayed cognitive impairment in processing speed and visual memory. Remitted UP patients showed cognitive impairment in executive function in addition to processing speed and visual memory. The three remitted patient groups scored similarly in processing speed and visual memory. LIMITATION: Clinically remitted patients were just recovered from a major depressive episode after 6 weeks of treatment and in relatively unstable state. CONCLUSION: Bipolar I, bipolar II and UP patients have a similar pattern of cognitive impairment during the state of acute depressive episode, but bipolar I patients experience greater impairment than bipolar II and UP patients. In clinical remission, both bipolar and UP patients show cognitive deficits in processing speed and visual memory, and executive dysfunction might be a status-maker for bipolar disorder, but a trait-marker for UP.

[Study on the ecological association between natural radioactivity and childhood leukemia in Guangdong province].

OBJECTIVE: This study was undertaken to evaluate the ecological association between terrestrial natural radionuclide, indoor radon concentration, natural radioactivity and leukemia incidence among children under 18 years of age. METHODS: Data were gathered from the disease surveillance program and literature reading while software SPSS 13.0 was used to calculate the Spearman's correlation. RESULTS: The incidence rates of childhood (0-18 year) leukemia showed significant differences in different places with the highest as 3.13/10(5) in Jiangmen area and the lowest as 0.42/10(5) in Maoming area. The incidence in Jiangmen was 7.45 times higher than that in Maoming. There was a rank correlation between the incidence of childhood leukemia and the mean concentrations of natural radio-nuclides in soil (226Ra and 232Th), with a positive correlation observed for overall leukemia (r(s) = 0.70, P = 0.011; r(s) = 0.66, P= 0.02 for 226 Ra and 232Th respectively) and acute lymphoblastic leukemia (ALL) (r(s) = 0.66, P = 0.019; r(s) = 0.64, P = 0.025 for 226 Ra and 232Th respectively). Associations between the incidence of childhood leukemia and the indoor gamma radiation dose rate, the total annual average effective dose equivalent from natural background radiationwere also analyzed (both r(s) = 0.59, P = 0.042). CONCLUSION: The natural radioactivity was likely to be a causative factor for childhood leukemia in Guangdong.