OBJECTIVEOur objective is to build a model that explains the association between the exposure to trace elements in the soil and the risk of neural tube defects.

METHODSWe built a function with different parameters to describe the effects of trace elements on neural tube defects. The association between neural tube defects and trace element levels was transformed into an optimization problem using the maximum likelihood method.

RESULTSTin, lead, nickel, iron, copper, and aluminum had typical layered effects (dosage effects) on the prevalence of neural tube defects. Arsenic, selenium, zinc, strontium, and vanadium had no effect, and molybdenum had one threshold value that affected the prevalence of birth defects.

CONCLUSIONAs an exploratory research work, our model can be used to determine the direction of the effect of the trace element content of cultivated soil on the risk of neural tube defects, which shows the clues by the dosage effect of their toxicological characteristics. Based on our findings, future biogeochemical research should focus on the direct effects of trace elements on human health.

China ; epidemiology ; Dose-Response Relationship, Drug ; Environmental Exposure ; Female ; Humans ; Metals ; chemistry ; toxicity ; Models, Biological ; Neural Tube Defects ; chemically induced ; epidemiology ; Pregnancy ; Prevalence ; Soil Pollutants ; chemistry ; toxicity ; Trace Elements ; chemistry ; toxicity

Objective: To explore the spatial distribution of low birth weight (LBW) and the potential environmental risk factors and provide the evidence for the prevention and intervention of LBW. Methods: Data were from a surveillance system for newly born population and adverse pregnancy outcome between 2007 and 2012 in Pingding county, Shanxi province. The data from 313 villages were analyzed. Spatial hierarchical Bayesian model was used to adjust the risk of LBW at village level, Moran’s I and Getis-Ord Gi* were used to analyze the difference in distribution of LBW risk area. Spatial negative binomial model was used to evaluate the association between the risk of LBW and chemical fertilizer application. Results: A total of 18 749 new births were recorded between 2007 and 2012, including 911 LBW cases, the total incidence of LBW was 4.86%. The result of the spatial hierarchical Bayesian model showed that high-risk area of LBW was in the southeast of Pingding and low-risk area was in the middle west of Pingding. The result of Moran’s I showed that there was a clustering pattern of LBW risk, and Getis-Ord Gi* found a high risk (hot spot) area in the south area. Moreover, the findings of association analysis showed that the risk of LBW increased with the increased chemical fertilizer application at village level. Conclusions There were area specific differences in the risk of LBW, and dose-response relationship between chemical fertilizer application and the risk of LBW. Our findings suggest that maternal exposure to chemical fertilizer during pregnancy might be a potential risk factor for LBW in rural area.

Objective:To explore the effects of self-made Huoxue Xiaozhong Xunxi Decoction combined with functional exercise on postoperative swelling of affected limbs, bone metabolism and recovery of knee function in patients with traumatic fracture of tibial plateau (FTP).Methods:Randomized controlled trial. totally 80 patients after FTP surgery in the Qidong Hospital of Traditional Chinese Medicine were enrolled and divided into two groups by random number table method from January 2018 to January 2022, with 40 cases in each group. After surgery, control group was treated with functional exercise, while observation group was additionally treated with self-made Huoxue Xiaozhong Xunxi Decoction. All were treated continuously for 8 weeks. The perioperative indexes (operation time, incision length, intraoperative blood loss, postoperative drainage volume, leaving bed time) in the two groups were recorded. The postoperative swelling and pain of affected limbs were observed, and detumescence time, pain relief time, fracture healing time and complete weight-bearing time were recorded. The knee function was evaluated by Hospital for Special Surgery (HSS). The level of serum bone morphogenetic protein-2 (BMP-2) was detected by ELISA, and total n-terminal propeptide of typeⅠprecollagen (t-PINP) and β-crossLaps (β-CTX) were detected by full-automatic immunoluminescence analyzer. The occurrence of postoperative complications in the two groups was recorded.Results:There was no significant difference in operation time, incision length, intraoperative blood loss, postoperative drainage volume or leaving bed time between the two groups ( P>0.05). The total effective rate of the observation group was 97.5% (39/40), while the control group was 80.0% (32/40), with statistical significance ( χ2=6.14, P=0.013). The detumescence time, pain relief time, fracture healing time and complete weight-bearing time were earlier in the observation group than control group ( P<0.01). After 10 d of treatment, VAS score and swelling degree in observation group were lower than those in the control group ( t=7.05, 3.81, P<0.01). After 8 weeks of treatment, levels of serum BMP-2 [(625.16±67.43) μg/L vs. (542.35±53.27) μg/L, t=6.10], t-PINP [(54.16±7.29) μg/L vs. (50.34±6.12) μg/L, t=2.54] and β-CTX [(1.26±0.38) μg/L vs. (1.04±0.23) μg/L, t=3.13] in observation group were higher than those in the control group ( P<0.05). During treatment, the incidence of complications in the observation group was 2.5% (1/40) and the control group was 7.5% (3/40), without statistical significance ( χ2=1.05, P=0.305). Conclusion:Self-made Huoxue Xiaozhong Xunxi Decoction combined with functional exercise is beneficial to improve pain and swelling of affected limbs and bone metabolism, and promote the recovery of knee function in patients after FTP surgery.

The study was aimed to investigate the extensive amplification and the cytotoxicity of dendritic cells (DC) derived from chronic myeloid leukemia cells. DC were cultured in two steps: firstly, extensive amplification in primary culture of CD34(+) or mononuclear cells isolated from CML patients' bone marrow and peripheral blood with rhFlt3-L and rhTPO for 7 days; secondly, inducing culture of DC with rhGM-CSF, rhTNF and rhIL-4 for 14 days. A system inducing DC directly were established for comparison. DC were identified by immunophenotype with flow cytometry, chromosome analysis by displaying G banding and electric microscopy analysis. The function of stimulating T cells proliferation and cytotoxicity of CML cells were confirmed through MTT assay. The results showed that after first extensive amplification in primary culture with rhFlt3-L and rhTPO for 7 days, CD34(+) cells had a total cell number with (77 +/- 5) fold expansion, and DC were (39 +/- 8)% of total cell respectively after induction culture of DC with rhGM-CSF, rhTNF and rhIL-4 for 14 days. Both the amplification of cell number and yield of DC were higher than the system without extensively culture (P < 0.01). Such DC could stimulate T cells to proliferate and kill leukemia cells finally. In conclusion, two-step culture method can obviously improve the cell number of DC required, that is better than inducing them directly. DC derived from CML cells induce the generation of anti-leukemia immunization.
Adolescent ; Adult ; Aged ; Antigens, CD34 ; immunology ; Cell Proliferation ; Cells, Cultured ; Child ; Cytotoxicity, Immunologic ; Dendritic Cells ; immunology ; pathology ; Female ; Flow Cytometry ; Humans ; Immunophenotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; immunology ; pathology ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; immunology

Objective To investigate the curative effect and mechanism of α lipoic acid combined with epalrestat and methylcobalamin in patients with type 2 diabetes mellitus (T2DM) complicated with pe-ripheral neuropathy ( DPN) . Methods A total of 160 cases of patients with DPN were randomly divided into the control group ( treated with methylcobalamin and epalrestat) and the observation group ( treated with methylcobalamin, epalrestat and α lipoic acid) , and all patients were treated for 4 weeks. The therapeutic effect, nerve conduction velocity, oxidative stress index and related proteins expression in serum were ob-served in two groups. Results The effective rate of treatment in the observation group was higher than that in the control group (87. 50％ vs 75. 0％) (χ2 = 4. 103,P<0. 05). After treatment, the sensory nerve conduction velocity ( SNCV) and motor nerve conduction velocity ( MNCV) of median nerve and common peroneal nerve were significantly better in the observation group than the control group ( P<0. 05 ) . After treatment, the level of superoxide dismutase ( SOD) was significantly higher in the observation group than the control group, while the level of malondialdehyde ( MDA ) was significantly lower the control group (P<0. 05). After treatment, the level of Bcl-2 protein was significantly higher in observation group than the control group, while the levels of Bax and Caspase-3 proteins were significantly lower than the control group (P<0. 05). Conclusions The application ofαlipoic acid combined to epalrestat and methylcobal-amin in the treatment of DPN can significantly improve the sensory and motor nerve conduction.

Objective: To translate and culturally adapt the Penn Acoustic Neuroma Quality of Life (PANQOL) scale into Chinese, and introduce the first specific evaluation tool for the quality of life of acoustic neuroma patients. Methods: Based on strict scale introduction requirements (scale preparation, translation, cultural adaptation and performance evaluation), elaborate on the multistep translation model (forward translation, synthesis, back translation, back translation review, comprehensive coordination) and cultural adaptation process (expert committee, preliminary experiment) to the preliminary experiments PANQOL scale in Chinese version. A preliminary survey and cognitive interview were conducted on 30 patients with acoustic neuroma, and the scale was further revised to establish the Chinese version of PANQOL scale. Results: The translation validity index of each item (I-TVI) in the Chinese version of the PANQOL scale was 96%-100%, and the translation validity index at the scale level (S-TVI) was 100%, reaching the translation standard. The PANQOL scale of 30 patients in the preliminary experiment was generally divided into 73.75 ± 12.12. Conclusions The multistep translation and cultural adaptation of PANQOL scale is a complex and time consuming process. Strict implementation of this process can ensure the quality of the scale introduction. The performance of the Chinese version of PANQOL scale needs to be studied and evaluated by expanding the sample size latterly.