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The potential association between maternal exposure to PM10 ranging from 3 months prior to conception to the end of the early trimester and the risk of anorectal atresia/stenosis in offspring has not been established. Thus, we determined the association between maternal exposure to PM10 and risk of anorectal atresia/stenosis in offspring in this study. We recruited 713 patients including 480 male and 233 female with anorectal atresia/stenosis and 7950 randomly selected healthy offspring from the Maternal and Child Health Certificate Registry of Liaoning Province and delivered between 1 January 2010 and 31 December 2015. Monthly PM10 concentrations were retrieved from the Environment Protection Bureau of each city in Liaoning Province. We established a multivariable logistic regression model to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Maternal exposure to PM10 was associated with an increased risk for anorectal atresia/stenosis in offspring during the 3 months prior to conception (per 10 μg/m3 increment: OR = 1.15, 95% CI = 1.03–1.20; per SD [27 μg/m3] increment: OR = 1.33, 95% CI = 1.09–1.63) and the first trimester (per 10 μg/m3 increment: OR = 1.08, 95% CI = 1.00–1.17; per SD [28 μg/m3] increment: OR = 1.26, 95% CI = 1.01–1.57). Evaluation of the association with a shorter exposure window (1 month) revealed a positive association between anorectal atresia/stenosis and PM10 from the 3rd month prior to pregnancy to each month of the 1st trimester. Maternal exposure to PM10 3 months prior to conception and during the 1st trimester was associated with an increased risk of anorectal atresia/stenosis in the offspring. Future perspective cohort studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Cognitive impairments are core aspects of schizophrenia and are highly related to poor outcomes. However, the effect of therapy on cognitive impairments remains unsatisfactory as its biological mechanisms are not fully understood. The purpose of this study was to investigate the disrupted intrinsic neural activity of the frontal areas and to further examine the functional connectivity of frontal areas related to cognitive impairments in schizophrenia. We collected brain imaging data using a 3T Siemens Prisma MRI system in 32 patients with schizophrenia and 34 age- and sex-matched healthy controls. The mean fractional amplitude of low-frequency fluctuation (mfALFF) in the frontal regions was calculated and analyzed to evaluate regional neural activity alterations in schizophrenia. Seed regions were generated from clusters showing significant changes in mfALFF in schizophrenia, and its resting-state functional connectivity (rs-FC) with other brain regions were estimated to detect possible aberrant rs-FC indicating cognitive impairments in schizophrenia. We found that mfALFF in the bilateral frontal cortices was increased in schizophrenia. mfALFF-based rs-FC revealed that decreased rs-FC between left middle frontal gyrus (MFG) and left medial superior frontal gyrus (MFSG) was associated with poor delayed memory (r = 0.566, Bonferroni-corrected p = 0.012). These findings demonstrate increased neural activity in the frontal cortices in schizophrenia. FC analysis revealed a diminished rs-FC pattern between the left MFG and left MSFG that was associated with cognitive impairments. These findings have provided deeper insight into the alterations in brain function related to specific domains of cognitive impairment and may provide evidence for precise interventions for cognitive deficits in schizophrenia. [ABSTRACT FROM AUTHOR]

Choline metabolite trimethylamine N-oxide (TMAO) has been recognized as a risk factor of gestational diabetes mellitus (GDM), but its exact role in GDM has not been reported. In this study, we focused on the placenta development to reveal the role of TMAO in GDM. We found that the TMAO levels in peripheral and cord plasma were increased in women with GDM and that TMAO levels were positively correlated with newborn weight and placental thickness. Neutrophil extracellular traps (NETs) in the peripheral and cord plasma and the myeloperoxidase expression in the placenta of women with GDM also increased. NETs could inhibit the proliferation, migration, invasion, and angiogenesis of HTR-8/Svneo cells. However, TMAO not only could inhibit the formation of NETs but also could enhance the biological function of HTR-8/Svneo cells. With induction of GDM in NETs-deficient PAD4-/- and wild-type mice, the placental weight of PAD4-/- mice increased significantly. TMAO feeding also inhibited the formation of NETs and further increased the weight of the placenta and fetuses, and this increase did not affect the placental structure. Our data indicate that higher TMAO levels and the formation of abnormal NETs were associated with GDM. TMAO not only could promote the development of the placenta and fetuses but also could inhibit the formation of NETs. [ABSTRACT FROM AUTHOR]

There is limited and equivocal epidemiological evidence relating to the association between maternal sulfur dioxide (SO2) exposure and the risk of oral clefts (OCs) in offspring. We performed a population-based case-control study in Liaoning province to evaluate aforementioned relationship during 3 months before conception, the first trimester of pregnancy, and their single months. The study involved 3086 patients with OCs and 7950 controls. Data relating to SO2 concentration was acquired from air monitoring stations throughout the study period. We used a multivariable logistic regression model to evaluate the association between exposure to SO2 and the risk of OCs during the exposure windows. Maternal SO2 exposure was positively related to OCs during the 3 months before conception (odds ratio = 1.38, 95% confidence interval: 1.15–1.65; P for trend < 0.01). Positive relationships were obtained from the first and second months before conception and the first month of pregnancy. Thus, our research reflects a relationship between SO2 exposure and the risk of OCs. Future studies are now required to verify the association between SO2 exposure and OCs during pregnancy and indicate the most relevant vulnerable exposure time windows. [ABSTRACT FROM AUTHOR]

Primary aldosteronism (PA) is one of the most common forms of secondary hypertension. Recent studies suggest that, compared with essential hypertension (EH), PA presents more severe disorders of glycolipid metabolism and organ damages. This case-control retrospective study aimed to ascertain clinical features and metabolic parameters between Chinese patients of PA and EH. 174 PA patients and 174 matched EH patients were recruited. Their clinical features, biochemistry parameters, the ventricular septal thickness, and left ventricular mass index (LVMI) were compared. HOMA-β% and HOMA-IR were calculated to evaluate glucose metabolism. The results showed that there was no significant difference regarding BMI, waist-to-hip ratio, and blood pressure between the two groups. The blood potassium level was significantly lower in PA patients than those in EH patients. The abnormal glucose tolerance and the incidence of diabetes in the PA group were not significantly different from those in EH group, but the insulin secretion levels at 0 min and 30 min were significantly weaker than those in the EH group, and the HOMA-β% was also lower in the PA group than those in the EH group. Left ventricular structural abnormalities in PA patients were more severe than those in EH patients. Subtype analysis indicated that patient with aldosterone-producing adenoma (APA) has more serious hypokalemia and lower levels of HOMA-β% and HOMA-IR comparing to those in the idiopathic adrenal hyperplasia (IHA) patient. These findings demonstrated that PA patients showed more impaired insulin secretion function and more severe left ventricular structural damage compared with EH patients. [ABSTRACT FROM AUTHOR]

Objective. Interleukin- (IL-) 34 is a new type of cytokine with neuroprotective effects discovered in recent years. However, the relationship between IL-34 and vascular dementia (VaD) has not yet been elucidated. The purpose of this study is to determine whether IL-34 is involved in cognitive impairment of VaD. Methods. From January 2017 to December 2020, 84 VaD patients and 60 healthy controls who attended Qingpu Branch of Zhongshan Hospital were prospectively included in the study. Once included in the study, demographic features of all research subjects are collected. They include age, gender, education, white blood cells (WBC), neutrophil, lymphocyte, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglycerides (TG), and total cholesterol (TC). Meanwhile, the Montreal Cognitive Assessment (MoCA) scale was used to assess the cognitive function of participants. The serum IL-34 level was determined by enzyme-linked immunosorbent assay (ELISA). Results. There was no significant difference between the demographic features of VaD patients and healthy controls (p > 0.05). However, the serum IL-34 levels of VaD patients and healthy controls are 27.6 ± 3.9 pg / ml and 41.8 ± 6.0 pg / ml , respectively, and there is a significant statistical difference between them (p < 0.001). The results of bivariate correlation analysis showed that serum IL-34 levels were significantly positively correlated with MoCA scores (r = 0.371 , p = 0.023). Further regression analysis showed that IL-34 was still correlated with MoCA after adjusting for demographic features (β = 0.276 , p = 0038). Conclusions. Serum IL-34 levels in VaD patients were significantly reduced, which may be an independent predictor of cognitive impairment in VaD patients. [ABSTRACT FROM AUTHOR]

Causes of autism spectrum disorder (ASD) have not been fully understood. Previous studies have linked environmental factors with ASD. However, evidence for the greenness-ASD association is limited, especially in China. To fill this gap, we conducted a matched case-control study to examine the association between greenness and ASD in China. Participants in this study were 84,934 children aged 3−12 years in Shanghai, China, selected using a multi-stage cluster sampling method. ASD cases were firstly screened by questionnaires completed by both children's parents and teachers, and were then confirmed by clinical examinations. Further, 10 healthy controls were randomly selected to match each ASD case by age and sex. The final analyses included 146 ASD cases and 1460 healthy controls. Participants' exposure to greenness before and after birth was assessed by normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) from NASA's Earth Observing System according to their residential locations. We used conditional logistic regression to examine the ASD-greenness association. Per interquartile range (IQR) increase in EVI 500m and NDVI 500m during the year before birth were associated with lower risks of ASD with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of 0.96 (95%CI: 0.946, 0.975, IQR = 0.074) and 0.937 (95%CI: 0.915, 0.959, IQR = 0.101). Exposure to greenness during the first 3 years after birth was also significantly associated with lower risk of ASD [IQR ORs for EVI 500m and NDVI 500m were 0.935 (95%CI: 0.91, 0.962, IQR = 0.06) and 0.897 (95%CI: 0.861, 0.935, IQR = 0.09), respectively]. Air pollution showed mediation effects on thegreenness-ASD association. Greenness was observed to have stronger beneficial effects on children without historical diseases and term birth. More greenness exposure before and after birth were significantly associated with lower risks of ASD in children. Our results highlight the importance of greenness in urban planning. [Display omitted] • More greenness was associated with lower risks of autism spectrum disorder (ASD). • IQR OR for NDVI 500m before birth associated with ASD were 0.935 (95%CI: 0.91, 0.962). • IQR OR for NDVI 500m after birth associated with ASD were 0.897 (95%CI: 0.861, 0.935). • Greenness may have beneficial effects on ASD children by absorbing air pollutants. [ABSTRACT FROM AUTHOR]

Evidence links exposure to maternal sulfur dioxide (SO2) and the risk of limb defects have been inconsistent. To investigate associations between SO2 exposure during preconception and the first trimester and risks of polydactyly and syndactyly. The study population was acquired from the Maternal and Child Health Certificate Registry of Liaoning Province between 2010 to 2015, and consisted of 2605 polydactyly, 595 syndactyly cases, and 7950 controls. Ambient air pollutants levels were retrieved from air quality monitoring stations. We used multivariable logistic regression model to assess the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). We found that exposure to increased SO2 concentrations was associated with polydactyly during both the 3 months preconception (ORQ4 vs. Q1 = 3.76; 95% CI 2.61, 5.42; per 10 μg/m3 increment: OR = 1.07; 95% CI 1.04, 1.10) and the first trimester (ORQ4 vs. Q1 = 2.03; 95% CI 1.41, 2.92; per 10 μg/m3 increment: OR = 1.07; 95% CI 1.03, 1.11). However, we only observed increased risk for syndactyly in the analysis of high vs. low quartiles (three months preconception: ORQ4 vs. Q1 = 3.72; 95% CI 2.05, 6.75; first trimester: ORQ4 vs. Q1 = 1.98; 95% CI 1.11, 3.51). Most results of analyses based on single-month exposure window generally showed similar positive associations. Additionally, these findings were broadly consistent across subgroups and sensitivity analyses. Maternal SO2 exposure increase the risk of polydactyly and syndactyly. [ABSTRACT FROM AUTHOR]

Purpose. To compare ocular anatomy differences of lens subluxation between eyes with or without acute angle closure (AAC). Methods. This is a retrospective and case-control study. Sixty cases with mild lens subluxation were recruited. Among them, 30 eyes with acute angle closure were assigned to the AAC group and 30 eyes without AAC were assigned to the non-AAC group. The anterior segment was quantitatively evaluated by ultrasound biomicroscopy (UBM). The axial length (AL) was measured with IOL Master. All patients underwent lens extraction surgery and were followed up for six months. Results. The history of blunt trauma accounted for 22 (73.3%) cases in the AAC group and 21 (70%) cases in the non-AAC group. Fifteen (50%) patients in the AAC group had iridotomy history, and high intraocular pressure recurred. The UBM analysis showed that the average central chamber depth of the affected eyes in the AAC group was 1.82 mm, which was significantly shallower than that in the fellow eyes (2.58 mm, P < 0.05) or both eyes in the non-AAC group.Both eyes in the AAC group presented a shorter AL and shallower anterior chamber than the eyes in the non-AAC group. Conclusions. An asymmetrical anterior chamber between bilateral eyes is an important feature in lens subluxation-induced AAC. The crowded anterior chamber and shorter AL might be the anatomic basis for the eye with lens subluxation-induced AAC. [ABSTRACT FROM AUTHOR]

To investigate the expression of aquaporin 3 (AQP3) in placenta and fetal membranes and the level of adiponectin (ADP) in the umbilical cord blood of severe preeclampsia and to analyze the relationship between the 2 proteins and severe preeclampsia, 60 pregnant women with severe preeclampsia were recruited as the case group and another group of 60 normal pregnant women in the same gestation period were selected as the control. After parturition, the transcriptional levels of AQP3 mRNA in placenta and fetal membranes were evaluated with RT-PCR. The expressions of AQP3 protein in the placenta and fetal membranes were determined by immunohistochemistry and Western blot. Meanwhile, the expression of ADP in umbilical artery blood was detected by ELISA. The content of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and LDL-C/high-density lipoprotein cholesterol in the case group was significantly higher than that in the control group. Multivariate logistic regression analysis showed that the level of TG was related to the onset of severe preeclampsia (OR 2.589). The relative expression of AQP3 mRNA and expression of AQP3 protein in placenta tissue of the case group were significantly lower than those of the control group, whereas in fetal membranes, they were significantly higher. The results of ELISA showed that the level of ADP in umbilical cord blood of neonates in the case group increased remarkably compared with that of the control group. [ABSTRACT FROM AUTHOR]

Few studies were reported on trace elements' alterations in uremic patients undergoing long-term (>24 months) hemodialysis (HD), especially by using the whole blood as the biological fluid for the measuring purpose. Our objective was to develop an improved micro-sampling inductively coupled plasma-mass spectrometry (ICP-MS) method to determine the levels of Ca, Mg, Cu, Zn, Fe, Mn, Se and Pb in uremic patients receiving long-term HD. A ICP-MS method with a modified whole blood sample preparation procedure with small volumes was established and applied for the simultaneous quantification of the various elements in uremic patients undergoing long-term HD. 124 eligible uremic patients receiving long-term HD (75 males and 49 females) and 77 healthy subjects (54 males and 23 females) were recruited and Ca, Mg, Cu, Zn, Fe, Mn, Se and Pb levels were further determined. Our results revealed that uremic patients with HD had significantly higher blood levels of Ca, Mg, Zn and Pb and lower Cu, Fe, Se and Mn concentrations than healthy controls. In conclusion, a reproducible and reliable ICP-MS method using minimal whole blood sample volume (50 μL) with a simple dilution-based preparation procedure was successfully improved, validated and applied. Uremic patients undergoing long-term HD might be at increased risk of some essential trace elements deficiency (especially for Cu, Fe and Se) or toxic trace element excess (Pb) in respect to healthy subjects. Monitoring of blood levels and supplementation of some trace elements may be indicated in uremic patients undergoing long-term HD. [ABSTRACT FROM AUTHOR]

Background: Poor socioeconomic and health-related quality of life (HRQOL) outcomes in survivors of childhood cancer can lead to distress and overall negatively impact the lives of these individuals. The current report has highlighted the impact of stroke and stroke recurrence on mortality, psychological HRQOL, and socioeconomic outcomes within the Childhood Cancer Survivor Study (CCSS).Methods: The CCSS is a retrospective cohort study with longitudinal follow-up concerning survivors of pediatric cancer who were diagnosed between 1970 and 1986. Mortality rates per 100 person-years were calculated across 3 periods: 1) prior to stroke; 2) after first stroke and before recurrent stroke; and 3) after recurrent stroke. Socioeconomic outcomes, the standardized Brief Symptoms Inventory-18, the Medical Outcomes Study 36-Item Short Form Health Survey, and the CCSS-Neurocognitive Questionnaire also were assessed.Results: Among 14,358 participants (median age, 39.7 years), 224 had a stroke after their cancer diagnosis (single stroke in 161 patients and recurrent stroke in 63 patients). Based on 2636 deaths, all-cause late mortality rates were 0.70 (95% CI, 0.68-0.73) prior to stroke, 1.03 (95% CI, 0.73-1.46) after the first stroke, and 2.42 (95% CI, 1.48-3.94) after the recurrent stroke. Among 7304 survivors, those with stroke were more likely to live with a caregiver (single stroke odds ratio [OR], 2.3 [95% CI, 1.4-3.8]; and recurrent stroke OR, 5.3 [95% CI, 1.7-16.8]) compared with stroke-free survivors. Stroke negatively impacted task efficiency (single stroke OR, 2.4 [95% CI, 1.4-4.1] and recurrent stroke OR, 3.3 [95% CI, 1.1-10.3]) and memory (single stroke OR, 2.1 [95% CI, 1.2-3.7]; and recurrent stroke OR, 3.5 [95% CI, 1.1-10.5]).Conclusions: Stroke and stroke recurrence are associated with increased mortality and negatively impact HRQOL measures in survivors of pediatric cancer. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbances are frequently reported in patients with major depressive disorder. We aimed to investigate the effects of vortioxetine on sleep quality and association between changes in sleep and treatment response.Methods: This study is a post-hoc analysis of a clinical trial that sought to evaluate the sensitivity to cognitive change of THINC-integrated tool in patients with major depressive disorder. In total, 92 patients (aged 18 to 65) meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for moderate or severe major depressive disorder and 54 healthy controls were included. All patients received open-label vortioxetine (10-20 mg/day, flexibly dosed) for 8 weeks. Herein, the primary outcomes of interest were changes in sleep, as measured by the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index, between weeks 0, 2, and 8. The association between changes in sleep and depressive symptom severity was secondarily assessed.Results: We observed that sleep, as indicated by scores of Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index, was significantly poorer in patients with major depressive disorder compared to healthy controls at weeks 0, 2, and 8 (p < 0.05). Among patients with major depressive disorder, we observed significant improvements on the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index between weeks 0 and 8 (p < 0.05). We observed a significant association between improvements on the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Insomnia Severity Index and improvement of depressive symptoms.Conclusion: Improvement of depressive symptoms in major depressive disorder patients treated with vortioxetine was associated with significant improvements in sleep. Furthermore, improvements in sleep were predictive of antidepressant response and were linearly correlated with improvement in overall depressive symptom severity. [ABSTRACT FROM AUTHOR]

Objectives: To explore the sensitivity of potential DTI-based biomarkers in detecting microstructural changes for whole-brain white matter in early stage amyotrophic lateral sclerosis (ALS), analyze the relationship between the DTI indices and disease status, and further clarify potential brain regions for disease monitoring and clinical assessment.Methods: Thirty-three non-demented ALS patients and 32 age- and gender-matched subjects participated in this study. DTI data were acquired via 3.0T MRI scanner. Maps of diffusion-related indices including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were obtained. Tract-based spatial statistics (TBSS) were used to investigate whole-brain white matter changes of each index. Correlation analyses between both brain-wide and volume-of-interest (VOI)-wide white matter alterations and clinical factors including ALSFRS-R scores, disease duration, and progression rate were performed.Results: Compared to healthy subjects, ALS patients showed significantly increased RD, MD and reduced FA, mainly along the corticospinal tract (CST) and the body of corpus callosum (CC). Increases in RD were broader than decreases in FA, in CST of both hemispheres. Meanwhile, involvement of several extra-motor regions was also revealed by RD. Significant positive correlation between ALSFRS-R scores and FA, negative correlation between ALSFRS-R and RD were found in left CST.Conclusions: RD may be the most sensitive biomarker for the detection of early demyelination of white matter. Both RD and FA may serve as objective biomarkers for disease severity assessment. CST may be the most affected brain region in non-demented ALS.Key Points: • Changes in RD were broader than those in FA in bilateral CST. • Involvement of extra-motor regions was uncovered by RD. • FA and RD in CST were related to ALSFRS-R scores. [ABSTRACT FROM AUTHOR]

Objective: Aspirin has been shown to prevent preeclampsia. But the mechanisms remain unclear despite that improved placental circulation is considered as an underlying contributor. Our aim was to examine the hypoxia-related morphological and histopathological placental measures in relation to aspirin use during pregnancy.Study Design: We used the Collaborative Perinatal Project (CPP) data, which is a cohort study conducted in the U.S. from 1959 to 1976. A total of 23, 604 women who had information on placental pathology and aspirin intake during pregnancy were included in the analysis. Among them, 1474 women had a history of hypertension or preeclampsia/eclampsia and were classified as a high-risk population; the rest were considered as a low-risk population. 47 placenta measures considered to be relevant to hypoxia were selected to build a composite hypoxia- related placenta index. The generalized linear mixed model was used to fit the relationship between aspirin and placental pathology.Main Outcome Measures: Hypoxia-related placental pathology.Results: Aspirin use during pregnancy was associated with a reduced risk of hypoxia-related placental pathology in the high-risk population [the adjusted odds ratio and 95% confidence interval in the 1st, 2nd, and 3rd trimesters: 0.55 (0.31, 1.00), 0.76 (0.49, 1.17), and 0.53 (0.29, 0.94), respectively]. Longer duration of aspirin use in pregnancy tended to have a lower risk of hypoxia-related placental pathologies in the high-risk population.Conclusions: Aspirin use during pregnancy reduced risks of hypoxia-related placental pathologies in the high-risk women for preeclampsia. The duration of aspirin use determined its effects. [ABSTRACT FROM AUTHOR]

Background: A series of epidemiological studies were conducted to investigate the association between transforming growth factor alpha (TGFA) polymorphism and nonsyndromic cleft lip and/or palate (CL/P) risk, but the findings remain conflicting. The present meta-analysis summarizes the association between the TGFA Taq I polymorphisms and nonsyndromic CL/P risk. Methods: We searched PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature databases from their inception to May 1, 2015. Fixed-effects or random-effects models were used to calculate the pooled odds ratio for two genetic comparisons (heterozygous mutation versus wild type, homozygous mutation versus wild type). All of the statistical tests were conducted by STATA 10.0 (StataCorp, College Station, TX). Results: A total of 26 case-control studies were identified for this meta-analysis. There was evidence of a significant association between the TGFA Taq I polymorphism and nonsyndromic CL/P risk in the overall population. The TGFA polymorphism was associated with nonsyndromic CL/P susceptibility in Asian populations under any of genetic models. However, in subgroup analysis, we did not find a significant association of TGFA gene polymorphisms with a reduced cancer risk in White and other populations and (recessive model, odds ratio = 2.37, 95% confidence intervals = 0.92-6.07; odds ratio = 3.45, 95% confidence intervals = 1.07-11.09, respectively). Conclusion: Our study indicates that the TGFA gene polymorphism might be associated with nonsyndromic CL/P susceptibility. However, these findings still need to be confirmed by single, large, well-designed prospective studies. [ABSTRACT FROM AUTHOR]

In this study, 30 case of patients with full-term premature membrane rupture and another 30 cases of full-term delivered subject without premature rupture of membranes (PROM) were selected to explore the relationship between premature membrane rupture with matrix metalloproteinase 9 (MMP-9) and its substrate level. Results showed the plasma zinc, MMP-9 in serum and amniotic fluid increased in patients with PROM; their type IV collagen in serum and foetal membrane decreased. Increased Zinc ion concentration results in increased concentration of MMP-9, a zinc-dependent enzyme; the degradation of type IV collagen by MMP-9 might be the potential mechanism of premature rupture of membranes in full-term pregnant women. [ABSTRACT FROM PUBLISHER]

Background: Environmental factors may play important roles in asthma, but findings have been inconsistent.Objective: The goal of this study was to determine the associations between early life exposures, environmental factors, and asthma in urban and rural children in southeast China.Methods: A screening questionnaire survey was conducted in 7,164 children from urban Guangzhou and 6,087 from rural Conghua. In the second stage, subsamples of 854 children (419 from Guangzhou, 435 from Conghua) were recruited for a case-control study that included a detailed questionnaire enquiring on family history, early life environmental exposures, dietary habits, and laboratory tests (including histamine airway provocation testing, skin prick tests, and serum antibody analyses). House dust samples from 76 Guangzhou families and 80 Conghua families were obtained to analyze levels of endotoxins, house dust mites, and cockroach allergens.Results: According to the screening survey, the prevalence of physician-diagnosed asthma was lower in children from Conghua (3.4%) than in those from Guangzhou (6.9%) (P < .001). A lower percentage of asthma was reported in rural subjects compared with urban subjects (2.8% vs. 29.4%; P < .001) in the case-control study. Atopy (OR, 1.91 [95% CI, 1.58-2.29]), parental atopy (OR, 2.49 [95% CI, 1.55-4.01]), hospitalization before 3 years of age (OR, 2.54 [95% CI, 1.37-4.70]), high consumption of milk products (OR, 1.68 [95% CI, 1.03-2.73]), and dust Dermatophagoides farinae group 1 allergen (OR, 1.71 [95% CI, 1.34-2.19]) were positively associated with asthma. Living in a crop-farming family at < 1 year of age (OR, 0.15 [95% CI, 0.08-0.32]) and dust endotoxin levels (OR, 0.69 [95% CI, 0.50-0.95]) were negatively associated with asthma.Conclusions: Rural children from an agricultural background exhibited a reduced risk of asthma. Early life exposure to crop farming and high environmental endotoxin levels might protect the children from asthma in southern China. [ABSTRACT FROM AUTHOR]

The physical status of humans can be estimated by observing the appearance of the tongue coating, known as tongue diagnosis. The goals of this study were to reveal the relationship between tongue coating appearance and the oral microbiota in patients with gastric cancer and to open a novel research direction supporting tongue diagnosis. We used a tongue manifestation acquisition instrument to analyse the thickness of the tongue coating of patients with gastric cancer and that of healthy controls, and high-throughput sequencing was used to describe the microbial community of the tongue coating by sequencing the V2-V4 region of the 16S rDNA. The tongue coatings of 74 patients with gastric cancer were significantly thicker than those of 72 healthy controls (343.11 ± 198.22 versus 98.42 ± 48.25, P < 0.001); 51.35% of the patients were assessed as having thick tongue coatings, whereas all healthy controls were assessed as having thin tongue coatings. Thick tongue coatings presented lower microbial community diversity than thin tongue coatings. The tongue coating bacterial community is associated with the appearance of the tongue coating. The tongue coating may be a potential source for diagnosing gastric cancer, but its sensitivity needs to be further improved. [ABSTRACT FROM AUTHOR]

Background: Endometrial cancer is the most common malignancy of the female genital tract worldwide, and endometrial endometrioid adenocarcinoma (EEC) is the major histological type of endometrial cancer. There is a great need for better markers with high sensitivity and specificity to permit early diagnosis and proper management of EEC. The aim of our study is to identify a miRNA classifier within plasma as a noninvasive biomarker for EEC diagnosis. Methods: This study was a retrospective case-control analysis which contained two independent cohorts including 93 participants. First, we screened 375 miRNAs in 29 plasma samples. 9 of the miRNAs were selected to be evaluated their expression by quantitative reverse-transcriptase polymerase chain reaction. A stepwise logistic regression model was then used to establish a new classifier in the validation cohort. Area under the receiver operating characteristic curve was used to evaluate the diagnostic accuracy. Co-expression analysis was used to verify the independence of results. Results: miR-15b, -27a, and -223 were found to be differentially expressed in the EEC plasma between the two cohorts and had few connections with other miRNAs. The areas under the curve (AUC) were 0.768, 0.813, and 0.768 for miR-15b, -27a, and 223, respectively. miR-27a and CA125 can be combined as a potential non-invasive biomarker for detecting EEC, with the AUC of 0.894. Conclusion: Our study demonstrated three miRNAs, including miR-15b, -27a, and -233 have a good clinical value in EEC diagnosis. The classifier, including miR-27a and CA125, demonstrated a high accuracy in the diagnosis of EEC and might serve as a novel non-invasive biomarker in the future. [ABSTRACT FROM AUTHOR]

The authors report the results of a hospital-based case-control study of all patients diagnosed with chronic myelomonocytic leukemia (CMML) (n = 36) from 28 participating hospitals over a 4-year period. Diagnoses were made by a single laboratory using 2001 World Health Organization (WHO) criteria. Subjects were matched to 2 control patients and interviewed concerning previous diseases, work histories, and exposures to potential etiologic agents. Peripheral blood and bone marrow findings revealed clinical features of both myelodysplastic syndromes (MDSs) and myeloproliferative neoplasms (MPNs), consistent with hematopoietic disease category of MDS/MPN. The frequency of clonal cytogenetic abnormalities in all CMML cases was 31%, with no consistent pattern identified. A select number of risk factors associated with occupational exposure, nonoccupational exposure, and prior medical or family history of disease were extracted from the questionnaire. The results were compared between the case and control subjects. A total of 5 study subjects (2 CMML cases and 3 control subjects) were determined to have had some benzene exposure. In addition, none of the highlighted risk factors associated with nonoccupational exposure to etiologic agents was significantly different among the study subjects. These results do not support an increased risk for developing CMML associated with historical exposures to benzene. [ABSTRACT FROM AUTHOR]

Genetic epidemiologists are increasingly interested in family studies using the casecontrol family study design, and this has motivated several recent developments in related statistical methodology. By summarising and extending some of these developments, this paper proposes an estimating-equation-based framework for analysing family data collected from case-control studies, motivated by the likelihood approach proposed by Whittemore (1995). The proposed estimating equation approach requires modelling assumptions about means, correlation coefficients and, at most, trivariate correlation coefficients, and it can be used for analysing family data with arbitrary pedigree structures, which would be prohibitive with the likelihood-based approach. Further, this new approach utilises all available data from case and control probands and from their relatives in assessing association between disease outcome and covariates, and data from relatives in evaluating aggregation of disease phenotypes within families, thus enhancing its efficiency. The approach is illustrated by analysing data collected from case-control studies on ovarian and colorectal cancers. [ABSTRACT FROM AUTHOR]

Background: Many novel diagnostic biomarkers have been developed for gastric cancer (GC) recently. We chose two methods with high diagnostic value, the detection of serum microRNAs and metabolomics based on gas chromatography/mass spectrometry (GC/MS), and aimed to establish appropriate models.Methods: We reviewed the diagnostic accuracies of all microRNAs identified by previous diagnostic tests. Then appropriate microRNAs and their combinations were validated the diagnostic value. We included 80 patients with GC and 82 healthy controls (HCs) and detected the expression of the microRNAs. GC/MS analysis was conducted, and we used three multivariate statistical analyses to establish diagnostic models. The concentrations of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were detected for comparison with the novel models.Results: Sixty-seven published studies and 70 microRNAs were finally included in the systematic review. MiR-18a, miR-19a, miR-21, miR-92a, miR-199a and miR-421 were chosen to further validate their diagnostic efficiencies. Five of those microRNAs in GC patients had significantly different expression. The combination of miR-19a and miR-92a had the highest area under the curve (AUC) at 0.850 with a sensitivity of 91.3% and a specificity of 61.0%. The GC/MS analysis performed an excellent diagnostic value and the AUC reached 1.0.Conclusion: There is a good potential for microRNAs and GC/MS analysis as new diagnostic methods in view of their high diagnostic value compared with traditional biomarkers. [ABSTRACT FROM AUTHOR]

There is no epidemiological evidence on the effects of maternal exposure to ambient particulate matter 10 μm or less in diameter (PM 10) and anencephaly risk in offspring. We conducted a population-based case-control study in Liaoning Province, China. The case group consisted of 663 cases with anencephaly and the control group consisted of 7950 healthy infants from the Maternal and Child Health Certificate Registry of Liaoning Province that were born between 2010 and 2015. Daily PM 10 concentrations were obtained from 77 monitoring stations located within the study area. A multivariable logistic regression model was established to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Maternal PM 10 exposure was significantly associated with an increased risk of anencephaly at three months before conception (highest versus lowest tertile: OR = 1.74, 95% CI: 1.29–2.34; per 10 μg/m3 increment: OR = 1.13, 95% CI: 1.06–1.20) and three months after conception (highest versus lowest tertile: OR = 1.93, 95% CI: 1.44–2.60; per 10 μg/m3 increment: OR = 1.01, 95% CI: 0.95–1.08). The evaluation of shorter exposure windows revealed similar associations for PM 10 exposure from the third month before pregnancy to the third month after pregnancy. Maternal PM 10 exposure is positively associated with anencephaly risk during the critical period of neural system development. • There is no epidemiological evidence of maternal exposure to PM 10 and anencephaly risk. • Maternal exposure to PM 10 before and after pregnancy increases anencephaly risk. • Environmental health policies and actions should be adopted to reduce PM 10 emissions. [ABSTRACT FROM AUTHOR]

The number of studies on air pollution with birth defects as the primary outcome has increased dramatically over the past two decades, but the potential role of specific air pollutants in congenital limb anomalies remains unclear. To evaluate associations between preconception and first-trimester PM 10 exposure and polydactyly and syndactyly in a population-based case-control study. Polydactyly cases (n = 2605), syndactyly cases (n = 595), and controls without any birth defects (n = 7950) born between 2010 and 2015 were selected from the Maternal and Child Health Certificate Registry of Liaoning Province. The monthly mean PM 10 concentrations were obtained from 75 air monitoring stations, and the exposure assessment was based on the mean concentration of all stations in mother's residential city. A multivariable logistic regression model was constructed to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). PM 10 exposure was positively associated with the risks of polydactyly (preconception: aOR T3 vs. T1 = 1.95, 95% CI 1.56–2.45, aOR = 1.06, 95% CI 1.01–1.10 [per 10-μg/m3 increment]; first-trimester: aOR T3 vs. T1 = 2.51, 95% CI 2.00–3.15) and syndactyly (preconception: aOR T3 vs. T1 = 2.86, 95% CI 1.98–4.13, aOR = 1.11, 95% CI 1.03–1.20 [per 10-μg/m3 increment]; first-trimester: aOR T3 vs. T1 = 3.10, 95% CI 2.11–4.56). Analyses based on single month exposure windows basically showed similar positive associations. Additionally, these findings were robust in sensitivity analyses and broadly consistent across subgroups. Our study suggest that preconception and first-trimester PM 10 exposures are related to increased risks of polydactyly and syndactyly. • This is the largest population-based case-control study investigat associations between PM 10 and polydactyly/syndactyly. • Preconception and first-trimester PM 10 exposure may increase risks of polydactyly/syndactyly in offspring. • Gravidae should be encouraged to take protective measures against air pollution as early as possible. [ABSTRACT FROM AUTHOR]

Background: The potential association between maternal exposure to ambient PM10 and offspring neural tube defects (NTDs) is a contentious issue. This study aims to evaluate the aforementioned association at a provincial level in China.Methods: A total of 2736 cases and 7950 randomly selected healthy infants included in the Maternal and Child Health Certificate Registry of Liaoning Province and delivered between 2010 and 2015 were recruited. Daily PM10 concentrations were obtained from all available monitoring stations located within the study area. A multivariable logistic regression model was established to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs).Results: PM10 exposure was significantly associated with the risk of NTDs during the three months preconception (per 10 μg/m3 increment: OR = 1.10, 95% CI 1.07-1.14; per standard deviation [27 μg/m3] increment: OR = 1.29, 95% CI 1.18-1.41; highest tertile: OR = 1.61, 95% CI 1.37-1.91) and the first trimester (highest tertile: OR = 1.57, 95% CI: 1.31-1.87). When focusing on shorter exposure windows, similar associations were observed for PM10 exposure from the third month before pregnancy to the third month after pregnancy. Sensitivity analyses using propensity score matching yielded consistent findings.Conclusions: Maternal exposure to PM10 is positively associated with NTDs during the critical period of fetal neural tube development. However, due to the limitation of the exposure assessment as well as potential residual confounding, further research is warranted to confirm our findings. [ABSTRACT FROM AUTHOR]