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This cohort study sought to investigate the effects of phthalates exposure during pregnancy on offspring asthma and its association with placental stress and inflammatory factor mRNA expression levels. A total of 3474 pregnant women from the China Ma'anshan birth cohort participated in this study. Seven phthalate metabolites were detected in urine samples during pregnancy by solid phase extraction-high-performance liquid chromatography tandem mass spectrometry. Placenta stress and inflammation mRNA expression were assessed by real-time quantitative polymerase chain reaction (RT-qPCR). Early pregnancy may be the critical period when phthalates exposure increases the risk of asthma in infants and young children, and there is a certain gender difference in the risk of asthma in infants and young children. Moreover, through the placenta stress and inflammatory factor associated with infant asthma found anti-inflammatory factor of interleukin-10 (IL-10) mRNA expression will reduce the risk of 36-month-old male infant asthma. The expression of interleukin-4(IL-4) and macrophage (M2) biomarker cluster of differentiation 206(CD206) mRNA reduced the risk of asthma in 18-month-old female infants. Placental stress and inflammatory response were analyzed using mediating effects. Tumor necrosis factor-α (TNFα) showed a complete mediating effect between mono-benzyl phthalate (MBzP) exposure in early pregnancy and asthma in 12-month-old males, and IL-10 also showed a complete mediating effect between mono-n-butyl phthalate (MBP) exposure in early and late pregnancy and asthma in 36-month-old males. In summary, exposure to phthalates during pregnancy may contribute to the development of asthma in infants, which may be associated with placental stress and inflammation.

Backgroud We have recently reported that maternal prenatal pregnancy-related anxiety predicts preschoolers’ emotional and behavioral development in a gender-dependent manner. This study aims to test for this gender-specific effect in a different cohort and investigate whether the gender difference was specific to placental methylation of genes regulating glucocorticoids. Methods A total of 2405 mother–child pairs from the Ma’anshan Birth Cohort Study were included in present study. The maternal pregnancy-related anxiety symptoms were evaluated with the Pregnancy-Related Anxiety Questionnaire in the third trimester of pregnancy. Child neurobehavior was assessed with the Strengths and Difficulties Questionnaire at 4 years old. Placental methylation of FKBP5, NR3C1 and HSD11B2 genes was quantified using the MethylTarget approach in 439 pregnant women. After exploratory factor analysis, the associations between methylation factor scores and pregnancy-related anxiety and child neurobehavior were examined using logistic regression analysis. Results After controlling for confounding factors, pregnancy-related anxiety in the third trimester of pregnancy increased the risk of hyperactivity only in boys and emotional symptoms only in girls. Decreased scores of the factor characterized by FKBP5 methylation were associated with maternal pregnancy-related anxiety only in boys. Furthermore, increased scores of the factors characterized by NR3C1 and HSD11B2 methylation were associated with hyperactivity (NR3C1: adjusted OR = 1.80, 95%CI = 1.15–2.83) and emotional symptoms (HSD11B2: adjusted OR = 0.53, 95%CI = 0.29–0.97; NR3C1: adjusted OR = 1.64, 95%CI = 1.03–2.59) only in boys. However, the scores of the factor characterized by FKBP5, NR3C1 and HSD11B2 did not mediate the relationship between maternal pregnancy-related anxiety and preschoolers’ emotional symptoms and hyperactivity. Conclusions Our results suggested that pregnancy-related anxiety in the third trimester of pregnancy predicted preschoolers’ emotional symptoms and hyperactivity in a gender-dependent manner. Although we did not find the mediation role of the placental methylation of genes regulating glucocorticoids, we found it was associated with both maternal pregnancy-related anxiety and preschoolers’ emotional symptoms and hyperactivity in a gender-dependent manner.

Previous epidemiologic research has shown that phthalate exposure in pregnant women is related to birth outcomes in a sex-specific manner. These outcomes may be mediated by placental inflammation, which is the proposed biological mechanism. This is the first study to address the relationship between phthalate exposure and gene expression in placental inflammation in a sex-specific manner. We performed quantitative PCR to measure placental inflammatory mRNAs (CRP, TNF-α, IL-1β, IL-6, IL-10, MCP-1, IL-8, CD68, and CD206) in 2469 placentae that were sampled at birth. We estimated the associations between mRNA and urinary phthalate monoesters using multiple linear regression models. Mono-n-butyl phthalate (MBP) was correlated with higher IL-1β, IL-6, and CRP expression in placentae of male fetuses and with higher IL-6, CRP, MCP-1, IL-8, IL-10, and CD68 expression in placentae of female fetuses. Mono benzyl phthalate (MBzP) increased the expression of TNF-α, MCP-1, and CD68 only in placentae of male fetuses. Mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) was negatively correlated with CRP, MCP-1, and CD68 in placentae of female fetuses. Maternal phthalate exposure was associated with inflammatory variations in placental tissues. The associations were stronger in placentae of male than of female fetuses. Compared with the other metabolites, MBP plays a strong role in these associations. The placenta is worth being further investigated as a potential mediator of maternal exposure-induced disease risk in children.

Prenatal phthalate exposure has been associated with placental inflammatory factors and infant allergic rhinitis (AR). However, the results are inconclusive. We designed a population-based cohort study to examine the effects of placental inflammatory biomarkers on the sex-dependent associations between maternal phthalate exposure and infant AR.A total of 2,348 pregnant women from Ma'anshan, Anhui Province, China, who were screened before antenatal visits and met the inclusion criteria, were included in the present study. We assessed AR in their offspring aged 36 months with a questionnaire. Quantitative PCR was performed to measure placental inflammatory factor mRNAs. The independent samplesChildhood AR may be related to education and family monthly income (The associations of maternal MEHHP and MEOHP levels with fetal AR in males were significant. Placental HO-1 was a fractional mediator in the associations between MEHHP and AR. Thus, the placenta should be further investigated as a potential mediator of maternal exposure-induced disease risk in children.

Few studies have investigated the relationships between gestational phthalate exposure and maternal circulating vitamin D. In the Ma'anshan birth cohort, 3265 pregnant women were included. Each woman provided up to three urine and serum samples for measurement of phthalates and 25(OH)D and calcium, respectively. Linear mixed models were performed to analyse the association between phthalate metabolites and 25(OH)D and calcium. Stratified analyses of the relationship between phthalates and 25(OH)D by urine collection season were conducted. Finally, the post hoc lag effect of phthalate exposure on 25(OH)D was determined if longitudinal associations were significant. Some phthalate metabolites were associated with increased 25(OH)D but with decreased calcium. Furthermore, the relationship of phthalate exposure with 25(OH)D varied with urine collection season. Phthalate metabolites collected in summer and autumn were associated with an increase in 25(OH)D, while monobenzyl phthalate collected in winter and spring was inversely associated with 25(OH)D. Finally, high-molecular-weight phthalates had lag associations with 25(OH)D with a 1-trimester lag period. Low-molecular-weight phthalates exhibited lag associations with 25(OH)D with a 2-trimester lag period. In conclusion, the positive cross-sectional correlation between phthalate metabolites and 25(OH)D was partly affected by urine collection season. This study suggested that gestational phthalate exposure would have a lag association with maternal 25(OH)D levels.

Although several studies indicate that exposure to polybrominated diphenyl ethers (PBDEs) and metals may influence thyroid function, the evidence is limited and inconsistent in general population. The current study was conducted to determine the levels of plasma PBDEs and urinary metals and evaluate the associations of co-exposure to both with thyroid hormones (THs) among rural adult residents along the Yangtze River, China. A total of 329 subjects were included in current analyses, and 8 PBDEs congeners and 14 urinary metals were measured to reflect the levels of environmental exposure. Multiple linear regression models were used to evaluate the association between PBDEs, metals and THs levels. Bayesian Kernel Machine Regression (BKMR) was used to examine PBDEs and metals mixtures in relation to THs. The geometric mean (GM) and 95% confidence interval (CI) of total measured PBDEs was 65.10 (59.96, 70.68) ng/g lipid weights (lw). BDE-209 was the most abundant congener, with a GM (95% CI) of 47.91 (42.95, 53.26) ng/g lw, accounting for 73.6% of the total PBDEs. Free thyroxine (FT4) was significantly negatively associated with BDE-28, 47, 99, 100, 154, and 183, and urinary strontium [β (95% CI): -0.04 (-0.07, -0.02)], but positively associated with selenium [β (95% CI): 0.04 (0.02, 0.06)]. Free triiodothyronine (FT3) was negatively associated with BDE-28 [β (95% CI): -0.03 (-0.05, -0.01)] and urinary arsenic [β (95% CI): -0.01 (-0.02, -0.001)]. The current study did not observe a statistically significant association of thyroid-stimulating hormone (TSH) with PBDEs and urinary metals. BKMR analyses showed similar trends when these chemicals were taken into consideration simultaneously. We found no significant interaction in the association between individual chemical at the 25th versus 75th percentiles and THs estimates, comparing the results when other chemicals were set at their 10th, 50th, and 90th percentile levels. Further study is required to confirm these findings and determine potential mechanisms.

The aim of this study was to explore the impact of prenatal Al and Mg on placental oxidative stress and inflammatory mRNA expression. A total of 2519 pregnant women from the China Ma'anshan birth cohort participated in this study. Al and Mg levels were measured by inductively coupled plasma mass spectrometry (ICP-MS). Placental stress and inflammatory mRNA expression were assessed by RT-PCR. The median Al levels in the first and second trimesters of pregnancy and in cord blood were higher than the corresponding median Mg levels. Predictors of lower Al and Mg levels included Han ethnicity and high education according to a mixed linear model. Multiple linear regression analysis revealed that Al and Al/Mg levels had a positive association with inflammatory mRNA expression and placental oxidative stress in the second trimester of pregnancy. A negative association existed between Al and Al/Mg levels and inflammatory mRNA expression and placenta oxidative stress in the cord blood, with the exception of IL-1β expression. In conclusion, prenatal Al and Mg status was associated with placental oxidative stress and inflammatory mRNA expression. More preclinical studies are needed to confirm the relevant mechanism.

Thyroid cancer (TC) is threefold more common in women than men. Reproductive and menstrual factors may be related to the onset of papillary thyroid cancer (PTC). This study aims to determine the association of reproductive and menstrual factors with PTC in Chinese females.A total of 335 histologically confirmed cases of PTC were recruited in this case-control study. The controls were matched for age with a deviation of ± 2 years, which conducted from September 2016 to February 2019. Logistic regression models were applied to identify the association of reproductive and menstrual factors with PTC.After adjustment by some variables, early menarche age (OR ≤ 13 years vs. 13years = 2.40, 95 % CI 1.12-5.13) and shorter lifetime breastfeeding (OR6 months vs. ≥ 6 months = 1.99, 95 % CI 1.11-3.55) significantly increased the risk of PTC, whereas younger age at first pregnancy had a protective effect against PTC (OR ≤ 24years vs. 24 years = 0.66, 95 % CI 0.44-0.98). There was a positive correlation between premenopausal and PTC in the lower age group (OREarly menarche age, abortion, shorter breastfeeding duration and premenopausal may be related to the occurrence of PTC. Early age at first pregnancy and larger number of full-time pregnancies were possible to decrease the risk of PTC.

Limited evidence revealed conflicting results on relationship between phthalate exposure and clinical pregnancy loss (gestational weeks >6). A prospective cohort study in Chinese pregnant women (n = 3220) was conducted to investigate the association between urinary phthalate metabolites and clinical pregnancy loss (gestational weeks 6 to 27; n = 109). Morning urine samples during gestational weeks 5 to 14 (mean 10.42) were collected to measure monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP). The concentrations of low- and high-molecular weight phthalate metabolites (ΣLMWP 250 Da) were calculated. Adjusted logistic regression models showed increased risks of clinical pregnancy loss in women with higher creatinine- normalized concentrations of MEP, MBP, MEOHP, MEHHP, ΣLMWP and ΣHMWP. Stratified analysis by gestational weeks (10 weeks) of miscarriage indicated positive associations of MEP, MEOHP, MEHHP and ΣHMWP with embryonic loss (during gestational weeks 6 to 10). The only association of foetal loss (during gestational weeks 11 to 27) was observed with MEHHP. Our findings suggested that Chinese women who were exposed to phthalates during early pregnancy had an increased risk of clinical pregnancy loss, especially embryonic loss.

BACKGROUND Maternal selenium (Se) deficiency is associated with some adverse pregnant outcomes. However, it remains controversial whether maternal Se deficiency during gestation enhances the risks for low-birth-weight (LBW) and small-for-gestational-age (SGA) newborns. METHODS For our cohort study, total 3133 mother-and-infant pairs were selected. Maternal serum Se concentration was detected by graphite furnace atomic absorption spectrometry. According to international references for maternal serum Se concentration, subjects were divided into Se deficiency (

Problematic mobile phone use (PMPU) is defined as an inability to regulate one’s use of the mobile phone, including excessive use, gradual increase in use to get the gratification, interference with school and other personal activities, and the need to avoid emotional alterations when mobile phone use is impeded. The potential health risks of PMPU have attracted increasing research attention. This study investigated the proportion of PMPU and the interactive effect of PMPU and depressive symptoms with alcohol use among college students in Anhui Province, China. A cross-sectional study was conducted among 2,376 college students between May and June 2012. PMPU, depressive symptoms and alcohol use were measured by self-reported validated instruments. Multivariable logistic regression models were used to examine the independent and interactive effects of PMPU and depressive symptoms with alcohol use. Results revealed the proportion of PMPU was 27.9 %, while the prevalence of depressive symptoms and alcohol use was 18.9 and 37.5 %, respectively. PMPU was significantly associated with alcohol use independently (OR = 1.30, 95 % CI = 1.04–1.61), and there was no significant increase with alcohol use in students with depressive symptoms (OR = 1.18, 95 % CI = 0.93–1.50). There was a multiplicative interaction between PMPU and depressive symptoms with alcohol use (OR = 1.46, 95 % CI = 1.04–2.03). We conclude that there is a significant relationship between PMPU and alcohol use, and a significant multiplicative interactive effect of PMPU and depressive symptoms with alcohol use among college students, in Anhui, China. These findings may have important implications for designing and implementing mental health programs at universities.

Many modes of stress (i.e. life events, catastrophic events) during pregnancy have been found to increase the risk of externalizing behaviors, and probably in a sex-specific way. Maternal immune activation may be the sex-difference mechanism, but direct evidence that assess three factors in conjunction -- maternal stress, maternal immune activation, and offspring neurodevelopment --from human beings is lacking. This prospective study followed 2926 pregnant women from early pregnancy to 36 months after delivery. Pregnancy-related anxiety symptoms assessment was completed three times using the Pregnancy-Related Anxiety Questionnaire; child attention deficit hyperactivity disorder (ADHD) symptoms were assessed by the parent version of the Conners' Hyperactivity Index. More importantly, nine inflammatory cytokines were detected in placental tissues for the sex-difference mechanism investigation. Our results showed that after controlling for confounding factors, pregnancy-related anxiety during at least two trimesters of pregnancy increased the risk of ADHD for boys (adjusted odds ratio (aOR) = 3.37, 95 % confidence interval (95 % CI) = 1.78-6.38), but not for girls (aOR = 1.02, 95 %CI = 0.44-2.38), which confirmed previous findings. Besides, the structural equation models revealed that placental C-reactive protein (CRP) mRNA expression significantly mediated the association between pregnancy-related anxiety and ADHD for boys (indirect effect: β = 0.025, P = 0.022), but not for girls (indirect effect: β = 0.005, P = 0.589). This prospective study suggested that frequent pregnancy-related anxiety during pregnancy and its induced-placental inflammation partially contributed to the sex-bias of ADHD symptoms.

This study enrolled 3266 pregnant women, to explore the relationship of prenatal phthalate exposure with the risk of preterm birth and gestational age. All participants filled questionnaires and provided with up to three urine samples during three trimesters. Seven phthalate metabolites in urines were measured. The incidences of very preterm, late preterm, early-term, late-term and postterm births were 0.58%, 3.52%, 24.22%, 10.53%, and 0.34%, respectively. Non-linear relationships were shown between phthalate metabolites and gestational age. Except for monomethyl phthalate (OR = 1.65, 95%CI = 1.17–2.34), the average concentrations of phthalate metabolites were associated with a slightly and insignificantly increased risk of overall preterm birth ( 0.05) or a non-linear manner (p-value

Phthalate has been widely used as a type of plasticiser in various consuming products in daily life. Recent studies have suggested that prenatal phthalate exposure may have adverse effects on fetal development. We aimed to identify the effects of in utero phthalate exposure on birth weight (BW). We evaluated a birth cohort comprising 3474 pregnant women and their single infants; 3103, 2975 and 2838 urine samples were collected in the first, second and third trimesters, respectively. Phthalate metabolites included monomethyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEHHP), and mono-(2-ethyl-5-hydroxylhexyl) phthalate (MEOHP), which were analysed in the urine by using high performance liquid chromatography-tandem mass spectrometry. Mixed linear model was used in the statistical analysis. Generally, MMP and MEP exposure during pregnancy was associated with decreased birth weight of infants (MMP, β=-12.192, p=0.009; MEP, β=-11.876, p=0.014). Hierarchical analysis found that MMP and MEOHP exposure was associated with decreased infants' birth weight only in low birth weight groups (MMP, β=-42.538, p=0.005; MEOHP, β=-63.224, p=0.008); MEHP and MEHHP exposure was associated with decreased infants' birth weight in both low birth weight group (MEHP, β=-42.348, p=0.035; MEHHP, β=-50.485, p=0.006) and high birth weight group (MEHP, β=-16.580, p=0.034; MEHHP, β=-18.009, p=0.040), MBP and MEHP exposure were associated with increased infants' birth weight in male NBW group (MBP, β=10.438, p=0.039; MEHP, β=13.223, p=0.017). Moreover, the effect has sex difference. The reduction of birth weight associated with MEHP and MEOHP exposure was stronger in male infants, while MMP and MEP exposure was more significant in female infants.

Appropriate selection and measurement of lead biomarkers of exposure are critically important for health care management purposes, public health decision making, and primary prevention synthesis. Lead is one of the neurotoxicants that seems to be involved in the etiology of psychologies. Biomarkers are generally classified into three groups: biomarkers of exposure, effect, and susceptibility.The main body compartments that store lead are the blood, soft tissues, and bone; the half-life of lead in these tissues is measured in weeks for blood, months for soft tissues, and years for bone. Within the brain, lead-induced damage in the prefrontal cerebral cortex, hippocampus, and cerebellum can lead to a variety of neurological disorders, such as brain damage, mental retardation, behavioral problems, nerve damage, and possibly Alzheimer's disease, Parkinsons disease, and schizophrenia. This paper presents an overview of biomarkers of lead exposure and discusses the neurotoxic effects of lead with regard to children and adults.

Objective To evaluate levels of lead (Pb) and cadmium (Cd) in the breast milk in the second postpartum month, to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic parameters, and to explore whether these levels affect the infants' physical status or the mothers' psychological status (postpartum depression). Methods A cross-sectional study was conducted between November 2009 and December 2010. Altogether 170 healthy mothers were enrolled from Nanjing Maternity and Child Health Care Hospital. The inclusion criteria were: voluntary to participate in this study, healthy, with no chronic disease, breastfeeding in the second postpartum month, living in a suburban but not non-industrial area of Nanjing, and not occupationally exposed to toxic metals. All the mothers completed a questionnaire and were evaluated based on the Edinburgh Postpartum Depression Scale (EPDS) to identify the risk of postpartum depression. Pb and Cd levels in breast milk were determined by inductively coupled plasma mass spectroscopy. The infants of these mothers were examined for their z scores of weight for age, length for age, head circumference for age, and body mass index for age. Results The median breast milk levels of Pb and Cd were 40.6 μg/L and 0.67 μg/L, respectively. In 164 (96.5%) of the 170 samples, Pb levels were higher than the limit reported by the World Health Organization (> 5 μg/L). Breast milk Cd level was > 1 μg/L in 54 (31.8%) mothers. The mothers with a history of anemia had a higher breast milk Pb level than those without a history of anemia (41.1 μg/L vs. 37.9 μg/L, P = 0.050). The median breast milk Cd level in those who were active and passive smokers during pregnancy was significantly higher than that in non-smokers (0.88 μg/L vs. 0.00 μg/L, P = 0.025). The breast milk Cd level in the mothers not taking iron and vitamin supplements for 2 months postpartum was higher than in those taking the supplements (iron supplement: 0.74 μg/L vs. 0.00 μg/L, P = 0.025; vitamin supplement: 0.78 μg/L vs. 0.00 μg/L, P = 0.005). Breast milk Cd level at the second postpartum month was negatively correlated with the z scores of head circumference (r = − 0.248, P = 0.042) and weight for age at birth (r = − 0.241, P = 0.024) in girls. No correlation was found between the breast milk Pb/Cd levels and the EPDS scores. Conclusion Considering the high levels of Pb and Cd in breast milk in this study, breast milk monitoring programs are necessary.

Objective: The aim of the study was to assess anxiety and depression in women with history of spontaneous abortion or induced abortion during a subsequent pregnancy. Methods: The data were consecutively obtained from seven maternal and child health (MCH) Centers in the Anhui Province of China. The sociodemographic characteristics of the women, the number of previous pregnancies, number of living children, and gestational age of the current pregnancy were ascertained at the time of the interview. Results: The pregnant women who were in the first trimester of their pregnancy reported significantly higher scores than those in the second trimester both on SAS (Zung’s Self-Rating Anxiety Scale) and CES-D (The Center for Epidemiologic Studies-Depression Scale) (SAS score means: 32.11 vs 31.68, P=0.000; CES-D score means: 4.59 vs 4.06, P=0.012). The women with a history of induced abortions were significantly more likely to report more “cases” of depression (OR = 1.543, 95% CI = 1.055- 254) and more “cases” of anxiety (OR = 2.142, 95% CI = 1.294-3.561) during the first trimester than those with no history of abortion. Controlling for confounding variables yielded similar results. However, “cases” of depression and “cases” of anxiety were equally common in women with history of spontaneous abortions and in those with no abortion history. Conclusions: These results suggest women who have experienced a previous induced abortion have omnipresent anxiety and depression symptoms during a subsequent pregnancy, especially during the first trimester.

Some studies suggested that adequate vitamin D might reduce inflammation in adults. However, little is known about this association in early life. We aimed to determine the relationship between cord blood 25-hydroxyvitamin D (25(OH)D) and C-reactive protein (CRP) in neonates. Cord blood levels of 25(OH)D and CRP were measured in 1491 neonates in Hefei, China. Potential confounders including maternal sociodemographic characteristics, perinatal health status, lifestyle, and birth outcomes were prospectively collected. The average values of cord blood 25(OH)D and CRP were 39.43 nmol/L (SD = 20.35) and 6.71 mg/L (SD = 3.07), respectively. Stratified by 25(OH)D levels, per 10 nmol/L increase in 25(OH)D, CRP decreased by 1.42 mg/L (95% CI: 0.90, 1.95) among neonates with 25(OH)D &lt, 25.0 nmol/L, and decreased by 0.49 mg/L (95% CI: 0.17, 0.80) among neonates with 25(OH)D between 25.0 nmol/L and 49.9 nmol/L, after adjusting for potential confounders. However, no significant association between 25(OH)D and CRP was observed among neonates with 25(OH)D ≥50 nmol/L. Cord blood 25(OH)D and CRP levels showed a significant seasonal trend with lower 25(OH)D and higher CRP during winter-spring than summer-autumn. Stratified by season, a significant linear association of 25(OH)D with CRP was observed in neonates born in winter-spring (adjusted β = −0.11, 95% CI: −0.13, −0.10), but not summer-autumn. Among neonates born in winter-spring, neonates with 25(OH)D &lt, 25 nmol/L had higher risk of CRP ≥10 mg/L (adjusted OR = 3.06, 95% CI: 2.00, 4.69), compared to neonates with 25(OH)D ≥25 nmol/L. Neonates with vitamin D deficiency had higher risk of exposure to elevated inflammation at birth.

Summary Background. Systemic lupus erytematosus (SLE) is characterized by the presence of various autoantibodies and the deposition of immune complexes which are cleared by Fcγ receptors. Objectives. Family-based association analysis was performed to investigate whether the FCGR3A-72S/R and FCGR3A-270T/R polymorphisms are risk factors for SLE in a Chinese population. Methods. In total, 119 patients with SLE from 95 nuclear families, aged 14–78 years, who met the American College of Rheumatology 1997 criteria were recruited, as were 316 family members of these patients. We studied two single-nucleotide polymorphisms (SNPs) encoding nonsynonymous substitution in the FCGR3A gene with respect to genetic susceptibility to SLE in a collection of 435 subjects from 95 nuclear families. We performed the genotyping using PCR restriction fragment length polymorphism. Results. Our results showed that FCGR3A-72R/S have an excess of transmission of the R allele from heterozygous parents to affected offspring (transmission disequilibrium test χ2 = 9.30, P = 0.0032). Univariate (single-marker) family-based association tests demonstrated that a variant allele at SNP rs403016 of the FCGR3A gene was significantly associated with genetic susceptibility to SLE (exon 3, Z = 2.5444, P = 0.01097) in an additive model. The R and S allele frequencies were 39.4% and 60.6%, respectively. The frequencies of FCGR3A 72R/R, R/S and SS genotypes were 9.1%, 60.6% and 30.3%, respectively. However, the FCGR3A-270T/S SNP was not found in this Chinese population. Conclusion. This study suggests a linkage disequilibrium of the FCGR3A-72R/S SNP with SLE, and supports the notion that a novel polymorphism of the FCGR3A-72R/S SNP is associated with genetic susceptibility to SLE in Chinese populations.

The aims of the present study are to evaluate the difference of the levels of soluble Fas (sFas) antigen between patients with systemic lupus erythematosus (SLE) and healthy controls and to explore whether sFas has a role in either the disease activity or the organ damage in SLE. Serum levels of sFas were measured in 40 Chinese patients with SLE and 15 age-, gender-, and race-matched healthy controls using double antibody ELISA. SLEDAI scores for disease activity were determined. Data of organ and tissue damage was obtained from clinical records. Serum sFas levels were significantly increased in both more active (mean=8043.8 pg/ml, P

To explore the epidemiological characteristics and gender difference of depressive symptoms among Chinese children and adolescents.Based on the cluster sampling method, 50 boys and 50 girls from each 9.0-18.9 year-olds in both urban and rural areas, were recruited from each research center. Children's Depression Inventory(CDI)was administered to all the participating students from grade 4 to 12 while physical examination indices including pubic hair were provided to both boys and girls. Development of breast in girls and genital development in boys were also measured.The overall prevalence on depressive symptoms was 14.81% for the Chinese adolescents. Boys reported more depressive symptoms (15.35%) than that of girls (14.43%). Prevalence related to depressive symptoms among children and adolescents from rural areas (16.41%)was higher than that of the urban areas(13.23%). Prevalence of depression was higher in boys than in girls in both 10-year-old and 11-year-old groups (χ(2) = 11.625, P0.005;χ(2) = 5.807, P0.005). In the 17 year-old group, prevalence of depression (21.5%)was seen higher in girls than in boys (17.26%) (χ (2) = 6.192, P0.005). Only in the Tanner stage II , the gender difference of depression showed statistically significant (χ(2) = 6.593, P0.005), with boys as 18.4% and girls as 15.8% .The gender differences of depression appeared in both special age groups and developmental stages in Chinese children that called for further longitudinal study to understand the nature of these findings.

Prenatal lead and cadmium exposure will not only influence the mother' organ systems, but also will provide an environment that may influence the fetus and neonate in a harmful way.In the present study, we detected the blood lead levels (BLLS) and cadmium levels for the duration of pregnancy and 6-12 weeks after delivery and to analyze the influencing factors of BLLs in healthy pregnant women.A cohort study survey was carried out. We recruited 174 healthy pregnant women without pregnancy or obstetric complications or abnormal pregnancy outcomes as the gravida group, and 120 healthy non-pregnant women as the control group.The lead concentrations in the three pregnancy trimesters and in the postpartum period were: (5.98 ± 2.43), (5.54 ± 2.01), (5.59 ± 1.97), and (6.76 ± 1.74) µg/dl; and (6.75 ± 2.13) µg/dl in the control group. The cadmium concentrations in the three pregnancy trimesters and postpartum period were 1.61 ± 0.45, 1.63 ± 0.46, 1.64 ± 0.49, and 1.67 ± 0.57. We found that the BLLs in the gravida group were lower than in the control group during all three trimesters. Occupations, supplement nutritional elements (dietary supplements and nutritional (food) elements), and the time of house painting could affect BLLs in pregnant women. Lead-related occupations, using cosmetics, and living in a house painted more recently than one year previously are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors.These findings may help people, especially pregnant women, to reduce lead exposure via supplements of calcium, iron, zinc, and milk or avoiding contacting risk factors.

AIM: To compare the effects of propranolol (PR) to that of PR plus isosorbide-5-mononitrate (ISMN) on variceal pressure in patients with schistosomiasis. METHODS: Forty-eight patients with schistosomiasis who had no previous variceal bleeding were treated with PR alone or PR plus ISMN. Seven patients refused variceal pressure manometry (3 receiving PR and 4 receiving PR plus ISMN). One patient withdrew from the trial due to headache after taking ISMN. At the time of termination, twenty patients were randomly assigned to treatment with PR plus ISMN or PR alone. The dose of PR was adjusted until the resting heart rate had been reduced by 25% or was less than 55 bpm. In the PR plus ISMN group, after PR was titrated to the same target, the dose of ISMN was increased up to 20 mg orally twice a day. Variceal pressure was measured using a noninvasive endoscopic balloon technique at the end of the 6-mo treatment period. RESULTS: In 40 patients (20 in the PR group and 20 in the PR plus ISMN group), variceal pressure was measured before treatment and at the end of the 6-mo treatment period. PR or PR plus ISMN treatment caused a significant reduction in variceal pressure (PR group: from 24.15 ± 6.05 mmHg to 22.68 ± 5.70 mmHg, P = 0.001; PR plus ISMN group: from 25.69 ± 5.26 mmHg to 20.48 ± 5.43 mmHg; P < 0.001). The percentage decrease in variceal pressure was significant after PR plus ISMN compared with that after PR alone (15.93% ± 8.37% vs 6.05% ± 3.67%, P = 0.01). One patient in the PR plus ISMN group and two patients in the PR group had variceal bleeding during follow-up. There were no significant differences between the two groups regarding the incidence of variceal bleeding. In the PR plus ISMN group, three patients had headache and hypotension. The headache was mild and transient and promptly disappeared after continuation of the relevant drug in two patients. Only one patient withdrew from the trial due to severe and lasting headache after taking ISMN. No side effects occurred in the PR group. CONCLUSION: PR plus ISMN therapy may be an alternative treatment for patients with schistosomiasis who have a high risk of bleeding.

Objective To investigate the blood lead levels (BLLs) in the duration of pregnancy and 6–12 weeks after delivery, and analyze the influencing factors of BLLs in healthy pregnant women. Methods Pregnant women were recruited from September 2009 to February 2010 at the prenatal clinic in Nanjing Maternity and Child Health Care Hospital. Altogether 174 healthy pregnant women without pregnant or obstetric complications or abnormal pregnancy outcomes were enrolled as the gravida group, and 120 healthy non-pregnant women as the control group. BLLs during pregnancy were determined by flame atomic absorption spectroscopy. Results BLLs in all the three pregnancy trimesters and postpartum were 59.8±24.3, 55.4±20.1, 55.9±19.7, and 67.6±17.4μg/L, respectively, and the mean BLL in control group was 67.5±21.3μg/L. BLLs during all the three trimesters were lower in the gravida group than in the control group ( P =0.043, 0.021, and 0.028). Furthermore, occupations, nutrients supplementation, and time of house/apartment painted were associated with BLLs in pregnant women. Lead-related occupations, cosmetics use, and living in a house painted less than 1 year before are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors. Conclusion Supplementing calcium, iron, zinc, and milk, or avoiding contact with risk factors may help people, especially pregnant women, to reduce lead exposure.

To investigate the correlations of hepatitis B virus markers and hepatitis B virus -DNA vectors in blood between women in perinatal period and cord blood, and to assess the risk of HBV infections status in pregnant women to intrauterine fetal infective.We selected 612 pregnant women who decided to delivery in hospital, in compliance with the principles of informed consent. According the difference of hepatitis virus serological markers existing in pregnant women, samples were divided into six groups. We used enzyme-linked immunosorbent assay to detect hepatitis virus serological markers, existing in serum of mother and cord blood. Real-time fluorescence quantitative PCR was supplied to test HBV-DNA load levels in these two kinds of biological specimen.In group A, hepatitis B virus "big 3 positives" or 1,3 positive 149 lying-in woman examples, two positive rates of HBV-DNA about pregnant women and cord blood are 99.33% and 32.21%; in group B, positive rates of HBV-DNA in two kinds of specimen are 20.00% and 3.08%; in group C and D, two positive rates are and the average contents of HBV-DNA, the results as mentioned in each group respectively are 65.52%, 12.07% and 13.56%, 1.69% respectively. Control group is group E, 86 lying-in woman examples and the detecting results orderly are 1.16%, 0. There was a significant difference in positive rate of HBV-DNA in cord blood between group A and group B subgroups (chi2 = 54.09, P0.01). There is significant positive correlation between HBV-DNA vectors existing in mother's serum and the positive rate of HBV-DNA in cord blood. Hepatitis B virus the mother blood " big 3 positives " is the umbilicus blood HBV-DNA 6345 times that carries quantity in average.(1) During the perinatal period, along with the HBV-DNA load levels arising of pregnant women, the risk of HBV infections status in pregnant women to intrauterine fetal infective increased. (2) Suggested to develop the compound pattern human hepatitis B immunoglobulin: Increase the composition of efficient price HBeAb-can be combinated HBeAg, HBsAb can be combinated HBsAg, strengthen the hinderance and break hepatitis B virus disseminate. (3) Our government should strengthen the propaganda of hepatitis B virus education. Establish and perfect to surround and produce the system of health protection.

To explore the physical and mental health status on the 'left behind' students in Anhui province and the related influential factors.Stratified cluster sampling method was used to investigate the 682 out of 3421 students from 7 middle schools in both south and north Anhui province, using multidimensional sub-health questionnaire of adolescents (MSQA) and mental health test (MHT), for assessment of the general condition, physical and mental health status.14.22% of the 'left behind' students were in sub-health condition compared to 11.28% among the normal students, and the mental sub-health status represented 13.64% for the former and 10.84% for the latter. In addition, the 'left behind' students appeared less content with their life than those of staying with their parents (P0.05). MHT scores in the subjects were positively correlated with the scores on MSQA and showed significant difference (P0.01).from the multiple linear regression analysis showed that the mental health condition among the left behind students was in linear regression relationship with the decreased physical activity (β = 1.456, P = 0.001), emotional problems (β = 1.096, P = 0.000) and problems of social adaptation (β = 1.011, P = 0.006). The status of physical sub-health in the Anhui province showed that there was no significant difference in each of the study group (P0.05).Decreased physical activity and emotion aporia as well as difficult social adaptation were major factors leading to degenerated mental health levels in the 'left-behind' adolescents. The findings suggested that the mental health status could be improved in this population through better management on their body-health condition.

To investigate the prevalence of common psychosomatic symptoms among Chinese adolescents and the influence on 6 months later suicide and self-injurious behavior.Based on the cluster sampling method, the participants who were recruited from 8 cities from 3 areas in China, including Eastern areas (Beijing, Shaoxing and Guangzhou), Middle areas (Ezhou, Harbin and Taiyuan) and Western areas (Guiyang and Chongqing), were administered by multidimensional sub-health questionnaire of adolescents (MSQA) in March 2008. Demographics, life style, psychosomatic symptoms, suicide and self-injurious behavior were also assessed. A total of 17 622 questionnaires were valid at baseline. Six months later, 14 407 questionnaires were eligible for two waves investigation. Analysis of Pearson chi-square and logistic model regression analysis were employed to compare the incidence of psychosomatic symptoms, suicide and self-injurious behaviors among different areas and to explore the possible risk factors of those symptoms and behaviors.At baseline, rates of total common physiological and psychological symptoms were 24.1% (4255/17622) and 30.9% (5447/17622), respectively, with the highest being eating and drinking too much (6.4%, 1130/17622) and hardly feel ease to learn at home (11.8%, 2087/17 622). In males, the rate of common psychological symptoms (30.7%, 2637/8599) was higher than physiological symptoms (24.0%, 2061/8599) (P0.05); in females, the rate of common psychological symptoms (31.1%, 2810/9023) was higher than physiological symptoms (24.3%, 2194/9023) (P0.05). The rate of the common psychosomatic symptoms in senior high school students (46.8%, 2905/6208) were significantly higher than those in middle high school students (37.3%, 2337/6262) and college students (33.2%, 1711/5152) (all P values0.05). Students from Western areas had the highest incidences of the common physiological and psychological symptoms (30.2%, 1471/4871; 40.6%, 1979/4871), higher than students from Middle areas (22.4%, 1443/6453; 27.0%, 1743/6453) and Eastern areas (21.3%, 1341/6298; 27.4%, 1725/6298) (all P values0. 05). Results from multiple logistic regression showed that physical symptomsor = 2 at baseline were shared risk factors for suicidal ideation (RR = 1.44, 95% CI:1.16 - 1.79), attempted suicide (RR = 1.79, 95% CI: 1.22 - 2.61) and self-injurious behaviors (RR = 1.39, 95% CI: 1.17 - 1.66) 6 months later. Psychopathological symptomsor = 4 at baseline was the shared risk factors for suicide ideation (RR = 1.74, 95% CI: 1.39 -2.17), attempted suicide (RR = 2.08, 95%CI: 1.39 - 3.11) and self-injurious (RR = 1.90, 95%CI: 1.59 - 2.28) 6 months later.It is common in Chinese adolescents who have multiple psychosomatic symptoms simultaneously. What's important is that those common psychosomatic symptoms are shared risk factors of later suicidal and self-injurious behaviors.

To explore the relationship between body mass index (BMI) and physical fitness index (PFI) among children and adolescents.The study sample included 8941 students aged 7 to 18 years in Anhui who attended the Physical Fitness and Health Surveillance program of Chinese School Students, in 2010. Within each sex- and age-specific group, students were classified into five BMI categories which were: very low, BMI5th percentile; low, BMI≥5th but15th percentiles; normal, BMI≥15th but85th percentiles; high, BMI≥85th but95th percentiles; and very high, BMI≥95th percentiles. Z-scores based on urban-rural, sex- and age-specific means and standard deviations were calculated, and the sum of Z-scores for the fitness tests was used as a PFI. Differences in PFI between BMI categories were compared with ANOVA. Sex- and grade-specific regressions of PFI on BMI were done by using a linear model.For 8941 students, the PFIs on very low, low, normal, high and very high group were -1.77, -0.91, 0.32, -0.17 and -0.54, respectively, and showed an inverted U shape. The normal BMI group students presented the highest PFI. Data from Linear regression analysis revealed that PFI was significantly positively correlated with BMI, while negatively associated with BMI square, which indicated that PFI was the quadratic function of BMI. When BMI was increasing, PFI showed a parabolic curvilinear.Relationships between BMI and PFI were parabolic curvilinear among the children and adolescents aged 7 to 18 in Anhui province.

To find out whether the effects of childhood physical abuse on internet addiction disorder in adolescence could be mediated by self-esteem.3798 high school students selected from 76 classes in Grade One and Grade Two, were asked to fill in the anonymous questionnaire, which including the demographic characteristics of students, Young's Internet Addiction Scale, Parent-Child Conflict Tactics Scales and Rosenberg's Self-Esteem Scale.Childhood physical abuse could directly predict less self-esteem and internet addiction disorder (r = -0.108, P0.01, r = 0.057, P0.01) and had significant indirect effects on internet addiction disorder which could be mediated through self-esteem (a = -0.703, standardized b = -0.104, z = 5.052, P0.001). Self-esteem had mediated 22.5% of the childhood physical abuse cases on their internet addiction disorders during the period of adolescence.Self-esteem could partially mediate the relationship between childhood physical abuse and internet addiction disorder. The mediating roles of self-esteem suggested that salient leverage points could make a change through empowerment training, self-esteem group training on self-esteem enhancement in the stage of adolescence.

To investigate the association between psychological sub-healthy status and risks on injuries and related predictors among adolescents in China, in order to develop reasonable intervention programs.Adolescents were selected from middle schools and colleges in eight cities. Baseline status on sub-healthy that related to psycho-pathology was measured using the Multidimensional Sub-health Questionnaire of Adolescents (MSQA). Data on Self- or unintentional injuries were collected using a standardized injury surveillance questionnaire every 3 months, for three times (T0, T1, T2 and T3).A total of 12 113 students completed the study. Prevalence rates related to self-injury among boys and girls were 19.4% and 19.9%, respectively. The rates of having more than 4 types of self-injuries in boys and girls were 4.7% and 4.2%, respectively. Boys had a significantly higher unintentional injury rate than that of girls (62.2% vs. 57.3%). The differences in the rates of having more than 4 types of unintentional injury between boys (3.8%) and girls (3.4%) were also statistically significant. Rates on self- and unintentional-injuries increased in T1, T2 and T3 when the psychological symptoms had an increase. Data from Multiple regression analysis demonstrated that the baseline psychological sub-healthy status was a predictive factor for higher risk of self- and unintentional-injuries at each of the follow-up waves.Sub-healthy status of psycho-pathology was associated with an increased risk on self- and unintentional injuries among adolescents. Integrative psycho-pathological and behavioral intervention programs might help in reducing the risk of injuries among the Chinese adolescents.

To examine the association between self-assessed somatotypes and depression related symptoms.The study sample included 5555 students aged 9 to 18 years who had attended the Physical Fitness and Health Surveillance of Chinese School Students (2010) in Chizhou city, Anhui province. Association between self-assessed somatotypes, body mass index (BMI) and depression symptom were examined.There was a slight consistency between self-assessed somatotypes and BMI in both boys and girls (Kappa = 0.217, P = 0.000; Kappa = 0.203, P = 0.000). Significant difference in the prevalence of depression was found among weight misperception groups in both genders (χ(2) = 145.223, P = 0.000). The prevalence of underestimation of somatotypes was significantly higher in boys than in girls, while the result was reversive on the prevalence of overestimation. Additionally, the prevalence of depression was higher in girls than in boys (χ(2) = 5.199, P = 0.023). Through logistic regression, data showed that self-assessed somatotypes and miscalculated groups were significantly associated with depressive symptoms. Compared to the group that self-assessment as being normal, those students when self-assessed as being slim, overweight or obesity were more likely to be depressive, with odds ratio (ORs) as 1.255 (95%CI: 1.066 - 1.478), 1.538 (95%CI: 1.275 - 1.856) and 1.713 (95%CI: 1.035 - 2.834), respectively. Overestimated and underestimated somatotypes appeared to be risk factors causing symptoms of depression (OR = 1.705, 95%CI: 1.382 - 2.105; OR = 1.241, 95%CI: 1.059 - 1.454).Slight consistency was found between self-assessed somatotypes and BMI, while the misjudged somatotypes were the risk factor related to depressive symptoms. It was suggested that life skills education should be carried out as preventive intervention approach, to improve the physical and mental health well-being of children and adolescents.

Objective: The incidence of idiopathic precocious puberty (IPP) might have an increasing trend. But the causes and risk factors of IPP are unknown. The objective of our study is to evaluate the effects of growth environments and two environmental endocrine disruptors (EDCs), zearalenone (ZEA), and 1,1-dichloro-2,2,bisethylene (p,p 0 -DDE), on patients with IPP. Design: Case–control study. Methods: The study consisted of 78 IPP patients at diagnosis and 100 control children matched for age and sex. A questionnaire was designed to collect data on growth environments, and serum ZEA and p,p 0 -DDE were tested in all subjects. We analyzed data on growth environments, two EDCs, and biological interaction between growth environments and EDCs. Results: In growth environments, small for gestational age, maternal physical disease during pregnancy, early maternal menarche, early puberty of same-degree relatives, and father’s absence in 4- to 6-year olds were risk factors for children with IPP (P!0.05). Serum ZEA concentration, ZEA, and p,p 0 -DDEpositive rates in the IPP group were significantly higher than those in the control group (P!0.05). There was a biological interaction between growth environments and ZEA (relative excess risk due to interactionZ34.562, attributable proportion due to interaction Z0.745, synergy index Z4.193). Conclusions: Results suggest possible effects of growth environments and two EDCs on the development of IPP. In addition, growth environments and ZEA have biological interaction that might increase the risk of developing IPP.

To investigate the prevalence of love affairs and intimate partner violence, and to explore the relationship between intimate partner violence and other mental health and risk behavior in college students.Three universities were selected using cluster sampling method in Hefei and Wuhu. Totally, 2575 college students completed an anonymous questionnaire. Intimate partner violence, depression, satisfaction of school life, self-esteem, suicidal psychology and behavior were evaluated to estimate the relationship between intimate partner violence and mental health/risk behavior.There were 46.9% students reported that they had intimate partner currently or in the past. The rate of having intimate partner in male students was higher than that in female students (χ(2) = 44.13, P0.001). And the rates were higher in sophomores and juniors than in freshmen (χ(2) = 161.84, P0.05). There were 21.1% students had sexual behavior with their intimate partners. But only 21.8% (34/156) intimate partners reported that they used condom every time. There were 11.5% (18/156) intimate partners reported that they never took any contraception. There were 18.6% (29/156) students reported that they were pregnant or led to their girlfriend becoming pregnant, but only less than 50.0% adolescents induced abortion in a legal hospitals. The rates of being the victim of physical assault, emotional abuse, sexual coercion, the total intimate partner violence were 18.0%, 33.6%, 5.1%, 37.1%. The rates of being the victim of physical assault, emotional abuse, total intimate partner violence in male adolescents were higher than those in female adolescents, but the rate of sexual coercion was on the contrary (χ(2) = 70.21, 13.25, 14.04, 5.77, P0.05). Among the intimate partners who had suffered from intimate partner, 74.2% (345/446) students had underwent more than 3 times, and 47.1% had underwent more than 2 types of intimate partner violence. The score of depression was highest in the victims of intimate partner violence, but the scores of self-esteem and school life satisfaction were on the contrary (F = 4.00, 16.39, 8.76, P0.05). The rates of suicidal ideation, suicidal plan, suicidal preparative and attempted suicide were highest in the victims of intimate partner violence (χ(2) = 13.80, 9.72, 8.52, 11.96, P0.05).The rate of having sexual behavior with their intimate partners was high in college students, but their self-protection awareness was insufficient. In the present study, a high prevalence of intimate partner violence among university students was observed, and highlighted a need for attention to the other mental health and risk behavior in adolescents with intimate partner violence.

To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas.975 elderly over 60 years from 41 counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc.In the last year, rates of common physical abuse, serious physical abuse, emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it. Low ability in managing daily activity of living was the risk factor causing serious physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly.High prevalence on abuse and negligence against the elderly was seen in the rural areas of China. Different forms on elderly abuse and negligence were affected by different factors that called for more attention to be paid to those elderly with lower ability in managing their daily life.

To investigate the episodes and influencing factors on self-harm and to explore the relationship between self-harm episodes and suicidal psychology and behaviors in college students.Four universities were selected using cluster sampling method in Anqing city and Chaohu city. Totally, 2713 college students completed this survey. Data were analyzed by Pearson Chi-square and logistic regression.In the last six months, rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-injury without visible tissue damage, self-harmful behaviors with latency damage, other self-harmful behaviors with menticide were 1.9%, 5.5%, 15.3%, 21.2% and 17.0% respectively. The total rate of self-harm was 31.3%. 73.1% of the students with self harmful experiences had the above mentioned behaviors more than 3 times in the last six months. The top 3 reasons for taking self-harm actions were: having learning problems (43.1%), failed love affairs (25.0%) and having conflicts with others (23.9%). There were different influencing factors among different kinds of self-harm episodes. Depression was the risk factor of self-harm. The higher score of having high self-esteem was the protective factor of all kinds of self-harm actions except highly lethal ones. Higher score of difficulties in identifying feelings was one of the risk factors. The rates of suicidal psychology and behaviors in students with self-harm were significantly higher than those in students without those behaviors. Result from linear χ(2) test indicated that the graveness of tissue damage of self-harm was higher along with the rates of suicidal psychology and behaviors (P0.01).Among 2713 college students, about 1/3 adolescents having experienced self-harm in the last 6 months, many with repeated ones. Depression and difficulties in identifying feelings were the two risk factors while self-esteem was the protective factor related to most of the self-harm cases.

To examine the association between internet addiction and suicidal behaviors in adolescence and to explore whether the association could be partly or fully accounted by depression or/and behaviors related to the impulsivity.A total of 3507 urban adolescent students in Hefei were administered to complete the questionnaire concerning interact addiction disorder (IAD), suicidal behaviors during the 12 months preceding the survey, behaviors related to the impulsivity, Center for Epidemiologic Studies Depression Scale and early childhood adversities, respectively. Hierarchical logistic regressions were used to evaluate the associations and possible roles of depression and behaviors related to the impulsivity between internet addition and suicidal behaviors after adjustment for confounding factors.Of the 3507 participants, 5.2% were diagnosed as IAD, 27.4% reported suicidal ideation during the 12 months preceding the survey, with another 9.5% had a plan and 2.6% had an attempt. Internet addition was associated with suicidal ideation (OR = 1.79, 95%CI: 1.32 - 2.44), plan (OR = 2.32, 95%CI: 1.57 - 3.42), and attempt (OR = 2.08, 95%CI: 1.03 - 4.22). After adjustment for potential confounding factors, the association between internet addition and attempt was insignificant. When depression and behaviors related to the impulsivity were entered into Hierarchical regression respectively, the associations between internet addition, suicidal ideation and plan were substantially reduced. While internet addition was enter into Hierarchical regression, the associations between depression, behaviors related to the impulsivity, suicidal ideation and plan were not reduced.Adolescent internet addition seems to be associated with suicidal ideation and plan, and the association is possibly mediated by depression and behaviors related to the impulsivity.

To study the effect of intrahepatic cholestasis of pregnancy (ICP) on the functions of the hypothalamic-pituitary-adrenocortical (HPA) axis and adrenal cortex in normal neonates.Demographic characteristics, prenatal anxiety and depression, and perceived stress during delivery were investigated in 32 ICP women and 32 controls. The cord blood levels of cortisal, adrenocorticotropic hormone (ACTH), and dehydroepiandrosterone sulfate (DHEAS) were measured by the radioimmunity technique in normal neonates immediately after birth.The scores of prenatal anxiety and depression in ICP women were significantly higher than those in controls (p0.05 and p0.01, respectively). There were no significant differences in the perceived stress during delivery between the two groups. The cord blood levels of cortisol and ACTH in neonates from ICP women were significantly lower (p0.01), while the DHEAS level was significantly higher (p0.01) than in neonates from controls. The DHEAS/ACTH ratio was significantly higher (p0.01), while the cortisol/DHEAS ratio was significantly lower in the ICP group (p0.01) than in the control group. The glycocholic acid level in ICP women was positively correlated with the DHEAS level in neonatal cord blood (r=0.47, p0.01).There may be a dissociation between cortisol and DHEAS in neonates with normal birth outcome from ICP women. ICP may result in a decreased responsiveness of HPA axis and an increased secretion of DHEAS by adrenal cortex in these neonates. This suggests that there might be dysfunction of the fetal zones of the adrenal cortex.

To examine life satisfaction as a moderator or mediator of accommodation category and loneliness for elementary and middle school students in rural areas so as to provide evidence for psychological health intervention among said students.All participants were asked to complete an anonymous questionnaire battery which including an 18-item General Health Questionnaire, Children's Loneliness Scale and Multidimensional Students' Life Satisfaction.The average score of loneliness scale (35.0 +/- 9.5) among boarding-school students was significantly higher than those students living at home (33.1 +/- 10.1) (P0.01). The average scores on school-satisfaction (33.5 +/- 6.3), friend-satisfaction (42.1 +/- 6.2) and self-satisfaction (32.4 +/- 5.0) of boarding-school students were significantly higher than those students living at home (35.9 +/- 6.6, 42.9 +/- 6.6, 32.9 +/- 5.3) (P0.05). The association between accommodation category and loneliness was fully mediated by school-satisfaction (the standardized coefficients of loneliness was reduced from 0.043 (P0.05) to 0.021 (P0.05) and partly mediated by self-satisfaction and friend-satisfaction. Data through Moderation analyses indicated that self-satisfaction, school-satisfaction and friend-satisfaction did not serve as moderators.Accommodation category, life satisfaction seemed to be good predictors on loneliness among elementary and middle school students and the fully mediated effect of school-satisfaction between accommodation category and loneliness was significant, suggesting that intervention of loneliness should focus on these variables.

To study the relationship between emotional, physical abuse and internet addiction disorder (IAD) among middle school students, in order to lay foundation for the development of prevention and control programs on IAD.Students selected from 76 classes in Grade One and Grade Two, filled out the anonymous questionnaire, which including demographic characteristics of students, Young's Internet Addiction Scale, Parent-Child Conflict Tactics Scales, etc. Non-conditional multivariate logistic regression model was employed to explore the relationship between child abuse and IAD. Independent variable was child abuse while dependent variable was IAD. Covariant variables would include demographic characteristics, as sex, age, style of household, et al.Among 3798 students, the overall prevalence of emotional abuse was 81.1%, with 55.1% of them reported having experienced physical abuse. Among 3507 internet users, 5.2% was diagnosed as IAD. Results from the non-conditional multivariate logistic regression model showed that odds ratio of severe physical abuse and moderate physical abuse were 3.02 (1.63-5.58) and 4.00 (2.01-7.93).Moderate physical abuse and severe physical abuse were possible risk factors of IAD.

To investigate the status and influencing factors on knowledge, attitude and practice (KAP) about AIDS among the migrant workers in railway construction sites and to provide evidence for strategy development and measures on AIDS related health education and behavioral intervention.943 migrant workers in railway construction sites were surveyed. Univariate analysis, multivariate Logistic regression and correlation analysis were used to explore their influencing factors.The migrant workers in railway construction sites had poor AIDS knowledge as a whole. People with high educational level and income had higher AIDS correlative knowledge than other groups. Only 37.5% (275) of 734 migrant workers who had heard about AIDS felt pity for people with HIV/AIDS. There were 39.6%, 7.3% and 6.9% of 943 migrant workers did not object to "pre-marital sex", "prostitution" or "wenching". There were 90 (9.5%) migrant workers admitted having non-marital sex for the last three months but 22 (28.6%) admitted never using condoms,and only 8 (10.4%) had used each time. It appeared that the higher educational level and scores about AIDS knowledge one had,the higher the rate of using a condom. Both longer time interval away from their families and working time were, the lower they would usage a condom.Migrant workers in construction sites were potential high risk population for HIV/AIDS. AIDS health education and behavioral intervention should be carried out

Ephelides are one of the most common lesions of skin pigmentation mainly on sun-exposed skin. Although they are benign pigmented spots, ephelides cause an increasing concern because of the wide-spreading cosmetic attention of society and possible association with skin cancer. However, there have been few reports on the prevalence of ephelides. The objective of this study was to estimate the prevalence of ephelides and the possible role of genetic factors in the pathogenesis of ephelides in the Han Chinese adolescents. Assessment of the skin was conducted in college students of the Anhui Medical University in China. Information on common skin conditions including ephelides were collected from 9697 Han Chinese college students. A total of 1,841 ephelides cases and 582 normal controls were identified and they, along with their first-degree relatives, provided information on ephelides conditions. The odds ratio was used to estimate the relative risk of ephelides between the first-degree relatives of cases and controls. The overall prevalence of ephelides was estimated to be 19.0% in college students. Ephelides are more common in female students (26.1%) than in males (12.1%; chi(2) = 06.7, P < 0.05). The mean ages of onset for males and females were 12.42 years (+/-4.61) and 12.88 years (+/-3.90; t = 2.11, P < 0.05), respectively. Positive family history was observed in 932 of the 1,841(50.6%) patients. The severity of ephelides in females of light skin was found to be significantly higher than that in males with skin of similar color (U = 3.904, P < 0.001). The risk of having ephelides among first-degree relatives of cases was significantly higher than that for the relatives of normal controls (odds ratio 5.75, 95% confidence interval (CI): 4.61-7.18, P < 0.001). Our study provided the first information on the prevalence of ephelides in Chinese adolescents and suggests that familial factors are important in determining individual susceptibility to ephelides.

To investigate the association between the exons 2 to 4 of the MICA gene and ankylosing spondylitis (AS).By PCR-SSOP, DNA samples from 56 AS patients and 112 random healthy individuals, as normal control were genotyped to analyse the polymorphism in exons 2, 3, 4 of the MICA alleles.MICA*008 was dominant in MICA allele,accounted for 32.14% and 30.36% in AS patients and normal controls respectively. The frequency of MICA*007 was significantly increased in AS patients, when compared with normal controls (chi-square=10.18, P0.05, RR=2.50). No difference was found in the other MICA alleles. The haplotype analysis revealed that there were the strong linkage disequilibrium between MICA and HLA-B of AS patients, and normal controls. There was a difference in MICA*007-B27 between two groups (chi-square=18.46, P0.05, RR=7.47). Both HLA-B27 and MICA*007 were strongly associated with AS. Stratified analysis showed that HLA-B27 was significantly relative to AS,while it was not found between MICA*007 and AS.The increased frequency of MICA alleles may be due to its strong linkage disequilibrium with HLA-B27.

To explore the impact of environmental factors, daily lifestyle, psycho-social factors and the interactions between environmental factors and chemokines genes on systemic lupus erythematosus (SLE).Case-control study was carried out and environmental factors for SLE were analyzed by univariate and multivariate unconditional logistic regression. Interactions between environmental factors and chemokines polymorphism contributing to systemic lupus erythematosus were also analyzed by logistic regression model.There were nineteen factors associated with SLE when univariate unconditional logistic regression was used. However, when multivariate unconditional logistic regression was used, only five factors showed having impacts on the disease, in which drinking well water (OR=0.099) was protective factor for SLE, and multiple drug allergy (OR=8.174), over-exposure to sunshine (OR=18.339), taking antibiotics (OR=9.630) and oral contraceptives were risk factors for SLE. When unconditional logistic regression model was used, results showed that there was interaction between eating irritable food and -2518MCP-1G/G genotype (OR=4.387). No interaction between environmental factors was found that contributing to SLE in this study.Many environmental factors were related to SLE, and there was an interaction between -2518MCP-1G/G genotype and eating irritable food.