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BACKGROUND: Quadratus lumborum block (QLB) has been found to be advantageous for laparoscopic colorectal surgery. This study hypothesized that preoperative anterior QLB at lateral supraarcuate ligament (QLB-LSAL) would decrease postoperative opioid usage and offer improved analgesia within the context of multimodal analgesia compared with lateral QLB (LQLB) for laparoscopic colorectal surgery. STUDY DESIGN: In this randomized controlled trial, 82 American Society of Anesthesiologists physical status I to III class colorectal cancer patients undergoing laparoscopic radical resection were enrolled and randomly assigned to receive either LQLB or QLB-LSAL (0.375% ropivacaine 0.3 mL/kg bilaterally for each group). The primary outcomes were the total intravenous morphine equivalent consumption at 24 hours postoperatively. RESULTS: Intravenous morphine equivalent consumption at 24 hours postoperatively was significantly reduced in the QLB-LSAL group compared with that in the LQLB group with per-protocol analysis (29.2 ± 5.8 vs 40.5 ± 9.6 mg, p < 0.001) and intention-to-treat analysis (29.6 ± 6.1 vs 40.8 ± 9.5 mg, p < 0.001). Time to first patient-controlled analgesia request was notably longer in the QLB-LSAL group than that in the LQLB group (10.4 ± 3.9 vs 3.7 ± 1.5 hours, p < 0.001). CONCLUSIONS: Preoperative bilateral ultrasound-guided QLB-LSAL reduces morphine usage and extends the duration until the first patient-controlled analgesia demand within the framework of multimodal analgesia when compared with LQLB after laparoscopic colorectal surgery. [ABSTRACT FROM AUTHOR]

Purpose: To describe the rationale, design, methodology and baseline characteristics of Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), a community-based prospective cohort study in patients with type 2 diabetes mellitus (T2DM) living in northeast China. Methods: Patients with T2DM, aged 30 years and above from communities of Fushun city, Liaoning province, China, were recruited. The presence and severity of the diabetic retinopathy (DR) were determined by a modified Early Treatment Diabetic Retinopathy Study (ETDRS) retinopathy scale of 6 fields fundus photographs. Detailed ocular examinations and questionnaires were collated, in addition to blood and urine sample collection. Results: Of the 2224 subjects eligible for the FS-DIRECT, 2033 (91.4%) participated in the study. The majority of participants were female (58.9%), the average age was 62.1 ± 9.1 years. The overall prevalence rates of DR, non-proliferative DR, proliferative DR, diabetic macular edema, and vision-threatening retinopathy were 44.3%, 40.0%, 4.3%, 15.2%, and 12.3%, respectively. Compared to the patients without DR, patients with DR had lower income, an earlier onset of diabetes, a longer duration of diabetes, higher proportion of insulin use, higher fasting plasma glucose, HbA1c, systolic blood pressure, total cholesterol and high density lipoprotein, as well as a higher level of urine protein (all P <.05). Conclusion: The baseline data of FS-DIRECT showed a high prevalence of DR in a community of northeast China. Further investigation will provide key information about the risk factors, impact, and trends of DR in this region. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pesticides have been associated with reproductive disorders, but there is limited research on pesticide exposures and human fertility. OBJECTIVE: We aimed to investigate the effects of preconception exposure to pesticides on time to pregnancy (TTP) and on infertility in a general population of couples planning to become pregnant in Shanghai, China. METHODS: A total of 615 women who were planning a pregnancy were enrolled before conception and were prospectively followed for 1 y to observe their TTP. Preconception pesticide exposures were assessed by measuring urinary metabolites of organophosphates (OPs) and pyrethroids (PYRs). Fecundability odds ratios (FORs) and odds ratios (ORs) of infertility were estimated using Cox and logistic regression models, respectively. All analyses were repeated after restricting the sample to nulliparous women (n=569). RESULTS: After adjusting for age, prepregnancy BMI, current smoking, education, annual household income, age at menarche, and two items from the Perceived Stress Scale (PSS-10), women in the highest quartile of diethylthiophosphate (DETP; an OP metabolite) had significantly longer TTP [adjusted FOR=0:68 (95% CI: 0.51, 0.92)] and increased infertility [adjusted OR=2:17 (95% CI: 1.19, 3.93)] compared with women in the lowest quartile. The highest versus lowest quartile of 3-phenoxybenzoic acid (3PBA; a PYR metabolite) was associated with longer TTP and infertility, with significant associations in nulliparous women [adjusted FOR=0:72 (95% CI: 0.53, 0.98); adjusted OR for infertility=2:03 (95% CI: 1.10, 3.74)]. CONCLUSION: Our study provides some of the first evidence that preconception OP and PYR exposures are associated with decreased fertility in Chinese couples. Given that OPs and PYRs are rapidly metabolized in humans, more studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

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Objective: The exposure conditions with regard to 10-year ischemic cardiovascular disease (ICVD) risk among residents aged 45-59 years treated in Hudong Community Health Service Center were surveyed to provide an objective basis for further studies on the relation between risk factors and ICVD events. Methods: The survey was conducted from October 2013 to March 2014 with use of the principle of cluster sampling. Our investigation involved questionnaire and laboratory tests. All residents were evaluated according to the table of National 10-Year Risk Assessment for ICVD to forecast the 10-year risk. The community intervention methods were medication and lifestyle intervention based on the relevant guidelines. Results: The body mass index and smoking rate were significantly higher in men than in women. The 10-year ICVD risk was 6.1% for moderate risk or above. We performed intervention in such residents for 1 year, with the result that the blood pressure and total cholesterol levels were significantly decreased (P<0.05). Conclusion: It is imperative that early prediction and intervention be conducted for the residents with risk factors. After the intervention, we found that the risk declined in 79.41% of the residents with moderate risk and or above and that the 10-year ICVD risk score decreased. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of daily use of Gerovital H3 (G.H.3.) tablets on relieving mental symptoms and improving health-related quality of life among Chinese older adults population.Methods: In a randomized, placebo-controlled, double-blinded study, totally 100 eligible participants were randomly allocated into the G.H.3. group or the placebo group, administered either G.H.3. or placebo tablets and were followed up for three months. All of the participants were required to report their subjective feelings about quality of life, low mood, and anxiety by filling out Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and a 36-item Short-Form Health Survey (SF-36 scale). Physicians were responsible for evaluating the related mental health indications through physical examinations at the baseline and at the end of the intervention period.Results: Participants were men and women between 50 and 89 years of age, with a median of 62.53 years. Before the intervention, the demographic characteristics and the baseline SF-36 scores, low mood, and anxiety statuses were comparable (p > 0.05). After the 12-week intervention, the scores of role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), mental health (MH) and health transition (HT), mental composite score (MCS) of the G.H.3. group were higher than the placebo group (p < 0.05), There were no significant differences in other domains in SF-36 and PCS between the two groups(p > 0.05), the scores of SDS and SAS in the G.H.3. group were both lower than the placebo group(p < 0.01), the prevalence rates of low moods in the G.H.3. group and the placebo group were 20.8 % and 34.0 % respectively, no significant difference was found (χ (2) =2.127,p = 0.145), while the prevalence rate of clinical anxiety concerns in the G.H.3. group was 2.1 %, which was significantly lower than the placebo group, 22.0 % (χ (2) =9.040,p < 0.001).Conclusions: Preliminarily use of G.H.3. shows positive effects in supporting mental health and improving general health and well-being while promoting the recovery of cognitive function among older adults. Most of SF-36 domains including PF, RP, BP, GH, VT, RE, MH, and HT, as well as the overall quality of life in MCS might benefit from taking G.H.3. tablets. Average levels of low moods and anxiety concerns were both reduced and the prevalence rate of clinical anxiety concerns were reduced. [ABSTRACT FROM AUTHOR]

Background: High prevalence of risky sexual behaviors and lack of information, skills and preventive support mean that, adolescents face high risks of HIV/AIDS. This study applied the information-motivation-behavioral skills (IMB) model to examine the predictors of consistent condom use among senior high school students from three coastal cities in China and clarify the relationships between the model constructs. Methods: A cross-sectional study was conducted to assess HIV/AIDS related information, motivation, behavioral skills and preventive behaviors among senior high school students in three coastal cities in China. Structural equation modelling (SEM) was used to assess the IMB model. Results: Of the 12313 participants, 4.5% (95% CI: 4.2-5.0) reported having had premarital sex and among them 25.0% (95% CI: 21.2-29.1) reported having used a condom in their sexual debut. Only about one-ninth of participants reported consistent condom use. The final IMB model provided acceptable fit to the data (CFI = 0.981, RMSEA = 0.014). Consistent condom use was significantly predicted by motivation (β = 0.175, P < 0.01) and behavioral skills (β = 0.778, P < 0.01). Information indirectly predicted consistent condom use, and was mediated by behavioral skills (β = 0.269, P < 0.05). Conclusions: The results highlight the importance of conducting HIV/AIDS preventive health promotion among senior high school students in China. The IMB model could predict consistent condom use and suggests that future interventions should focus on improving motivation and behavioral skills. [ABSTRACT FROM AUTHOR]

Objective. To investigate the correlation between presbycusis and kidney deficiency as defined by traditional Chinese medicine (TCM) and its material basis from the perspective of metabolism. Methods. Pure-tone audiometry was used to test auditory function. A kidney deficiency symptoms coring table was used to measure the kidney deficiency accumulated scores of the research subjects. Gas chromatography/mass spectrometry (GC/MS) was used to measure the metabolites in the urine samples from 11 presbycusis patients and 9 elderly people with normal hearing. Results. Hearing loss in the elderly was positively correlated with kidney deficiency score in TCM. There were significant differences in urine metabolite profile between the presbycusis patients and the controls. A total of 23 differentially expressed metabolites were found. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that these metabolites were related to glutathione metabolism, amino acid metabolism, glucose metabolism, the N-methyl-D-aspartic acid (NMDA) receptor pathway, and the γ-aminobutyric acid (GABA) receptor pathway. Conclusion. Glutathione metabolism, amino acid metabolism, glucose metabolism, NMDA receptors, and GABA receptors may be related to the pathogenesis of presbycusis and may be the material basis underlying the correlation between presbycusis and kidney deficiency in TCM. [ABSTRACT FROM AUTHOR]

Significant amounts of pyrethroid pesticides are used throughout China. Previous studies have suggested that exposure to pesticides may increase the risk of childhood cancer; however, few studies have focused on pyrethroid metabolites. We investigated five nonspecific metabolites of pyrethroid pesticides found in children's urine and examined the correlation with childhood leukemia. We conducted a hospital-based case-control study of childhood acute lymphocytic leukemia (ALL) in Shanghai between 2010 and 2011. The study included 176 children aged 0-14 years and 180 controls matched for age and sex. Compared with those in the lowest quartiles of total and individual metabolites, the highest quartiles were associated with an approximate 2-fold increased risk of ALL [total metabolites: odds ratio (OR) = 2.75, 95% confidence interval (CI), 1.43-5.29; cis-DCCA: OR = 2.21, 95% CI, 1.16-4.19; trans-DCCA: OR = 2.33, 95% CI, 1.23-4.41; and 3-PBA: OR = 1.84, 95% CI, 1.00-3.38], and most of the positive trends were significant (p < 0.05). Our findings suggest that urinary levels of pyrethroid metabolites may be associated with an elevated risk of childhood ALL and represent a previously unreported quantitative exposure assessment for childhood leukemia. [ABSTRACT FROM AUTHOR]

Background: China is currently facing a rapid and widespread increase in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The activities of female sex workers (FSWs) have contributed to the mounting epidemic of HIV/AIDS and other sexually transmitted diseases (STDs). Therefore, this study aimed to assess the HIV/AIDS-related knowledge, attitude and risk behaviors among FSWs operating in Shanghai China.Methods: A cross-sectional study was conducted in five districts of Shanghai, including three suburbs and two downtown locales. We adopted a cluster randomized sampling method to obtain ten geographic sites which consisted of one or more communities/villages proximal to a location where FSWs were accessible. A total of 324 FSWs from 109 Xitou Fang, massage parlors and hair salons who explicitly provided sexual services were enrolled in the study. Each participant completed a questionnaire survey and interview aimed to collect information on the individual's knowledge, attitude, and behaviors associated with risk for HIV/AIDs.Results: The overall correct answer rate of HIV/AIDS-related knowledge was 60.8%, and the knowledge of FSWs from downtown areas was significantly higher than those from suburban areas (P < 0.05). The percentage of FSWs who reported having experiences in commercial sexual services without the use of condoms was 33.6%. Condom slippage or breakage was reported as having occurred at least once by 51.2% of the FSWs. FSWs from suburban areas were found to more often engage in high-risk behaviors, including oral and anal sex, than those from downtown areas (P < 0.001). Many of the FSWs (65.7%) reported having non-client sexual partners (most were identified as boyfriends or husbands); however, condom usage with these partners were lower (34.3%).Conclusions: Based on the findings from our survey, we advise that promotion of HIV/AIDS-related knowledge be targeted towards FSWs in Shanghai, especially those operating in the suburbs. HIV prevention efforts, such as urging constant condom usage with both clients and steady partners, should be sustained and reinforced among the female sex workers population. [ABSTRACT FROM AUTHOR]

Background: The CAV1-CAV2 locus has been associated with primary open-angle glaucoma (POAG) and intraocular pressure. However, its association with normal-tension glaucoma (NTG) was inconclusive. Therefore, we evaluated this association in Chinese and Japanese., Methods: Two single-nucleotide polymorphisms (SNPs, rs4236601 and rs1052990) from previous genome-wide association studies of POAG were genotyped in a total of 2220 study subjects: a Hong Kong Chinese cohort of 537 NTG patients and 490 controls, a Shantou Chinese cohort of 102 NTG and 731 controls and an Osaka Japanese cohort of 153 NTG and 207 controls. Subgroup analysis by gender was conducted. Outcomes from different cohorts were combined using meta-analysis., Results: SNP rs4236601 was significantly associated with NTG in the two Chinese cohorts (P meta = .0019, OR = 4.55, I 2 = 0). In contrast, rs4236601 was monomorphic in the Osaka cohort. The association of rs1052990 was insignificant in a meta-analysis combining Chinese and Japanese cohorts (P meta = .81, OR = 1.05; I 2 = 64%), and the OR tended towards opposite directions between Chinese (OR = 1.26) and Japanese (OR = 0.69). Gender-specific effects of the SNPs were not statistically significant in the logistic regression or Breslow-day tests of ORs (P > .05), although rs4236601 was significant in males (P = .0068; OR = 10.30) but not in females (P = .14; OR = 2.65) in the meta-analysis of Chinese subjects., Conclusions: In this study, we confirmed the association of rs4236601 at the CAV1-CAV2 locus with NTG in Chinese. SNP rs4236601 is monomorphic, and rs1052990 tends towards a different direction in the Japanese cohort. Further studies are warranted to verify the ethnic difference and gender-specific effects of this locus., (© 2020 Royal Australian and New Zealand College of Ophthalmologists.)

The purpose of the study was to evaluate the association profiles of the SIX6 locus with primary open-angle glaucoma (POAG) in southern Chinese and Japanese. In this study, we tested single marker and haplotype-based associations of 11 tagging single nucleotide polymorphisms (SNPs) covering the SIX6 locus with POAG in a Hong Kong Chinese cohort (N = 1402). A novel SNP (i.e., rs12436579) and two SNPs (i.e., rs33912345 and rs10483727) from previous genome-wide association studies were further tested in a Chinese cohort from Shantou (N = 888) and a Japanese cohort from Osaka (N = 463). Results from the three cohorts were meta-analysed using a random-effect model. We found rs12436579, which has not been previously reported, was associated with POAG in Hong Kong and Shantou Chinese (P combined  = 4.3 × 10 -5 , OR = 0.72, I 2  = 0). Additionally, we replicated the association of one known SNP, rs33912345 (P combined  = 0.0061, OR = 0.69, I 2  = 45%), with POAG in the Chinese cohorts but not in the Japanese cohort (P > 0.6). Another known SNP, rs10483727, was nominally associated with POAG in the two Chinese cohorts (P combined  = 0.017, OR = 0.70, I 2  = 53%). All these three SNPs were significantly associated with POAG when the three cohorts were combined in meta-analysis (P combined <0.005). Furthermore, two haplotypes, C-C (P combined  = 1.13 × 10 -5 , OR = 1.41, I 2  = 0) and A-A (P combined  = 0.045, OR = 0.68, I 2  = 70%), defined by rs33912345-rs12436579 were associated with POAG in Chinese but not in Japanese. In conclusion, this study confirmed the association between two GWAS SNPs in SIX6 (rs33912345 and rs10483727) and POAG. Also, a SNP, rs12436579, not associated with POAG before, was found to be associated with POAG in Chinese. Further studies are warranted to elucidate the role of this novel SNP in POAG., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

A single-nucleotide polymorphism (SNP) rs4236601 at the CAV1/CAV2 locus is associated with primary open-angle glaucoma (POAG). Rs4236601 is common in Caucasians but rare in East Asians. Here we conducted a haplotype-tagging SNP analysis followed by replication in a total of 848 POAG cases and 1574 controls drawn from 3 cities in China and 1 city in Japan. Two SNPs, rs4236601 (odds ratio [OR] = 6.25; P = 0.0086) and a tagging-SNP rs3801994 (OR = 1.32; P = 0.042), were associated with POAG in the Hong Kong Chinese cohort after age and gender adjustments. Rs4236601 was associated with POAG also in Shantou (OR = 6.09; P = 0.0037) and Beijing (OR = 3.92; P = 0.030) cohorts after age and gender adjustment, with a pooled-OR of 5.26 (P = 9.0 × 10(-6)) in Chinese; but it is non-polymorphic in the Osaka cohort. SNP rs3801994 showed a similar trend of effect in the Shantou and Beijing cohorts, with a pooled-OR of 1.23 (P = 0.022) and 1.20 (P = 0.063) in Chinese, prior to and after age and gender adjustment, respectively; but it showed a reverse effect in the Osaka cohort (OR = 0.58; P = 0.033) after the adjustments. We have thus confirmed the association of rs4236601 with POAG in different Chinese cohorts. Also, we found a common SNP rs3801994 of diverse associations with POAG between Chinese and Japanese.

China has a large burden of primary angle-closure glaucoma (PACG) and the approach to treatment is different from that in most parts of the world. In China, trabeculectomy is a mainstay of initial treatment for PACG and laser peripheral iridotomy is reserved for PAC and PACG with peripheral angle synechiae ≤180 degrees. The greater reduction of and more stable IOP, lower frequency of acute angle closure, decreased progression of peripheral anterior synechia and glaucoma, and the reduction of ocular complications associated with long-term use of glaucoma medications support the use of initial trabeculectomy in PACG without significant lens opacities. Further study is required to determine the indications and effectiveness of initial trabeculectomy for PACG in a developing country setting.

Aims: To report the refractive error difference (RED) between parents and their children and the estimated single generational myopic shift in an urban area in China., Methods: 395 children aged 6-17 years and their parents, who had been enrolled in the Beijing Myopia Progression Study were included. Cycloplegic and non-cycloplegic refraction of the children and parents were performed, respectively. RED was defined as the difference between the average parental spherical equivalent (SE) and the average SE of their children. Binomial fitted curves of RED were plotted as a function of the children's age. Generational myopic shift was defined as the estimated RED according to the prediction model at the age of 18 years., Results: 395 families were enrolled. The RED was positively correlated with the children's age (rspearman=0.58, p<0.001). The RED (median (25th and 75th percentile)) was -1.88 (-3.23 to -1.00) dioptres (D) in children at 6.0-7.9 years of age, and it increased to 1.53 (-0.12 to 3.44) D in children at 16.0-17.9 years of age. The SE of the children approached the average SE of their parents at the age of 11 years. At the age of 18 years, the children's estimated myopic shift would be 1.94 D., Conclusions: In this sample, children's refractive errors at the age of 11 years were already similar to their parents. Moreover, the estimated myopia in children at the age of 18 years would be up to 2.0 D higher than their parents. This remarkable single-generation myopic shift indicates that there are likely effects of environmental factors on myopia development in urban Chinese children.

A large amount of organophosphate pesticides (OPs) is used throughout China. Animal studies have suggested that even moderate doses are toxic to neurodevelopment, but there are a few studies in humans. We investigated both the urinary levels of OP metabolites in children and their relationship with child neurodevelopment. Participating 301 young children (23-25 months of age) were recruited from two community hospitals in Shanghai between February and October 2008. We measured five nonspecific dialkyl phosphate (DAP) metabolite levels of OPs in the children's urine and examined their association with the children's developmental quotients (DQs) based on the Gesell Developmental Schedules (GDS). The creatinine-adjusted geometric means (GMs) of OP metabolites in urine samples were 11.27 μg/g for DMP; 6.99 μg/g for DMTP; 7.96 μg/g for DEP; 14.19 μg/g for DETP; and 4.55 μg/g for DEDTP. The children had relatively higher levels of OP urinary metabolites compared with those reported in developed countries, no association was found between child urinary levels of OP metabolites and any of the DQ scores. However, our results should be interpreted with caution, and more studies of children living in China are warranted given the relatively high levels of child OP urinary metabolites in Shanghai.