Background Organic phosphate flame retardants are emerging environmental pollutants. While there have been multiple toxicities reported following organic phosphate flame retardants exposure, few studies focus on their potential developmental toxicities. It is necessary to elucidate these developmental toxicological effects and underlying mechanisms to improve risk assessments and better protect sensitive populations. Objective To evaluate potential developmental toxicities in early chicken embryos following exposure to triphenyl phosphate (TPhP) or cresyl diphenyl phosphate (CDP), to reveal TPhP and CDP’s capabilities to activate peroxisome proliferator-activated receptor γ (PPARγ) in vivo in an established chicken embryo gene reporter system, and to investigate the roles of PPARγ in TPhP/CDP-induced developmental toxicities with lentivirus-mediated in vivo gene silencing. Methods Firstly, diverse doses of TPhP and CDP were injected into the air sacs of fertilized eggs to assess the development of chicken embryos after 6 d of incubation, and an optimal dose was chosen for subsequent experiments. Subsequently, the report gene system was employed to evaluate the intraembryonic activation of PPARγ by TPhP and CDP. Eventually, PPARγ was silenced using lentivirus, and the embryos were co-treated with TPhP and CDP to further disclose the roles of PPARγ in the observed developmental toxicity. Results Following developmental exposure to TPhP or CDP, significantly lower chicken embryo weights (normalized with egg weights) were observed in the 6 d embryos (10, 30 mg·kg⁻¹ TPhP and 3, 10, 30 mg·kg⁻¹ CDP), indicating that both chemicals have general developmental toxicities and CDP is more potent. Additionally, exposure to CDP also resulted in remarkably increased sagittal brain area (normalized to embryo weights) and decreased sagittal eye area (normalized to embryo weights) (P<0.05), suggesting that CDP has specific developmental neurotoxicity and ocular toxicity. The PPARγ reporter gene experiment results revealed that rosiglitazone (positive control), TPhP, and CDP all significantly activated PPARγ relative to control (P<0.05). The potency order was rosiglitazone > CDP > TPhP. The lentivirus microinjection successfully achieved in vivo silencing of PPARγ in developing chicken embryos, and the estimated silencing efficacy was approximately 55% according to the real-time quantitative polymerase chain reaction (qRT-PCR) results. The in vivo silencing of PPARγ effectively alleviated TPhP or CDP-induced decrease of embryo weights (P<0.05), as well as CDP-induced increase of brain areas and decrease of eye areas (P<0.05). Conclusions Both TPhP and CDP can induce general developmental toxicities in early chicken embryos, and CDP is more potent than TPhP. Meanwhile, CDP can induce specific enlarged brain area and decreased eye area. The observed toxicities are associated with in vivo activation of PPARγ.

Objective:To investigate the risk factors of pancreatic fistula after radical resection of gastric cancer, and to establish a risk prediction scoring model for pancreatic fistula.Methods:The clinico-pathological data of 312 patients with gastric cancer admitted to the Fourth Hospital of Hebei Medical University from January 2019 to January 2020 were retrospectively analyzed. Multiple factor logistic regression model was used to analyze the risk factors of pancreatic fistula after radical resection of gastric cancer, and a risk prediction scoring model based on the risk factors was established. Hosmer-Lemeshow test was used to detect the goodness of fit of regression equation, and receiver operating characteristics (ROC) curve was used to evaluate the distinction degree of regression equation.Results:Among 312 patients with gastric cancer, 27 cases (8.65%) had pancreatic fistula after radical resection of gastric cancer. Multiple factor logistic regression analysis showed that male patients ( OR = 5.312, 95% CI 1.532-18.420, P = 0.008), age ≥ 60 years old ( OR = 4.928, 95% CI 1.493-16.250, P = 0.009), preoperative diabetes mellitus ( OR = 3.062, 95% CI 1.091-8.589, P = 0.034), lesion location in the gastric body-gastric antrum ( OR = 3.121, 95% CI 1.052-9.251, P = 0.040), intraoperative omental bursa resection ( OR = 6.209, 95% CI 2.084-18.478, P = 0.001), intraoperative lymph node dissection at D2+ station ( OR = 3.114, 95% CI 1.044-9.281, P = 0.042), intraoperative combined organ resection ( OR = 5.063, 95% CI 1.473-17.400, P = 0.010), preoperative TNM stage Ⅲ ( OR = 4.973, 95% CI 1.189-20.792, P = 0.028) were independent risk factors for pancreatic fistula after radical resection of gastric cancer. A risk prediction equation of pancreatic fistula after radical resection of patients with gastric cancer was established: P = -8.619+1.670X 1+1.595X 2+1.119X 3+1.138X 4+1.826X 5+1.136X 6+1.622X 7+1.604X 8; factor X was set as a binomial assignment (0 or 1); X1-X8 were listed as follows respectively: gender (the male was 1), age (≥60 years old was 1), preoperative diabetes history (yes was 1), lesion location (gastric body-gastric antrum was 1), intraoperative resection of omental bursa or not (yes was 1), intraoperative lymph node dissection at D2+ station or not (yes was 1), intraoperative combined organ resection or not (yes was 1), preoperative TNM stage (stage Ⅲ was 1). The goodness of fit of regression equation was high ( P = 0.395). The area under the curve of ROC by using risk prediction scoring model to judge pancreatic fistula was 0.916 (95% CI 0.872-0.960, P<0.01). The probability of pancreatic fistula in patients with score ≥ 5 was 40.90%, and the probability of pancreatic fistula in patients with score < 5 was 3.35%. Conclusions:The occurrence of pancreatic fistula after radical resection of gastric cancer is closely related to a variety of risk factors. By establishing a risk prediction scoring model for pancreatic fistula after radical resection of gastric cancer, it is helpful to effectively identify patients with high risk of pancreatic fistula after radical surgery during the perioperative period.

Purpose: This study attempted to detect the changes of cervical cancer screening rate and willingness among female migrants, and the associated socio-demographic factors in Shenzhen city. Materials and Methods: Two citywide surveys were conducted using a multistage random cluster sampling method in 2011 and 2014, respectively. Data on demographic characteristics, screening participation, and willingness to screen were collected. Logistic regression models were applied to detect possible associated socio-demographic characteristics, and their variations with survey years. Results: In total, 12,017 female migrants were enrolled, with a mean age (standard deviation) of 36.73 (6.55) years. From 2011 to 2014, the screening rate increased (25.8% vs. 35.1%, p < 0.001), while the willingness to screen remained stable (82.2% vs. 82.8%, p=0.46). Overall, socio-demographic characteristics of female migrants, including age, marital status, education, monthly income, employment, and medical insurance, were found to be positively associated with screening participation. Similar impacts in relation to willingness were observed except for age. However, these associations varied with survey years, mainly in the contributions of education and monthly income to screening participation, as well as age, monthly income, and medical insurance to willingness of being screened. Conclusion Identifying changes of associated socio-demographic factors precisely is warranted of necessity, which provides novel clues to adjust targeted actions regularly in promoting cervical cancer screening participation among female migrants in Shenzhen.

Objective To explore the correlation between social support and pregnancy depression in Shenzhen. Methods From August 2018 and June 2020, a structured questionnaire survey was conducted among pregnant women who underwent pregnancy examination in a 3A-grade maternal & child health care hospital. A total of 1 396 questionnaires with complete information were collected. Chi-square test and Wilcoxon rank sum test were used to analyze the baseline characteristics. The odds ratio (OR) and 95% CI confidence interval between social support and pregnancy depression were estimated using logistics regression model. Subgroup analysis was also conducted. Results There were statistically significant differences in education level, medical insurance rate, household registration, family monthly income, proportion of multiparas, proportion of husbands being the only child, pregnancy stress and social support between the depression group and non-depression group. After multi-factors adjustment, the OR (95% CI) of the total social support score was 0.97(95%CI 0.95-0.99), the OR (95% CI) of the objective support dimension was 0.90(95% CI 0.87-0.94), and the P value of the interaction term multiplied by pregnancy term was less than 0.05. According to the stratified analysis of pregnancy, the total score of social support was significantly correlated with the depression status only in the third trimester, with an OR (95% CI) of 0.97 (95% CI 0.94-0.99). The objective support dimension was significantly correlated with depression status in the first and third trimesters, and the OR (95% CI) was 0.78 (95% CI 0.61-0.99) and 0.89 (95% CI 0.84-0.94), respectively. The OR of support utilization score in the third trimester was 0.91 (95% CI 0.83-0.99). Conclusion Social support was negatively correlated with depression during pregnancy and was particularly important in the third trimester. Various dimensions of social support were differentially correlated with pregnancy depression in each trimester. The objective support dimension was particularly important in the first and third trimesters.

Purpose: A cross-sectional survey was conducted to evaluate the differences on awareness and attitude towards human papillomavirus (HPV) and its vaccine between local and migrant residents who participated in cervical cancer screening in Shenzhen, China. Materials and Methods: A total of 9,855 females sampled from healthcare institutions in 20 street blocks through the Cervical Cancer Prevention Network were surveyed in this study by a self-administered questionnaire. Multivariate logistic regression was conducted to explore the role of the hukou and resident status in the willingness to receive HPV vaccination. Results: Local residents had a relatively higher awareness of HPV (62.0% vs. 35.6% vs. 29.9%, p < 0.001) and its vaccine (35.3% vs. 15.4% vs. 14.8%, p < 0.001), as well as a higher willingness to receive HPV vaccination (68.5% vs. 62.5% vs. 56.2%, p < 0.001) than non-permanent residents and floating population. Except for age, education level, marital status, monthly income, having daughter(s), and heard of HPV and its vaccine, the hukou and resident status significantly associated with the willingness to receive HPV vaccination (local residents vs. floating population: odds ratio, 1.216; 95% confidence interval, 1.057 to 1.398). None significant difference on the associated factors was found between local residents and internal migrants (p for interactions > 0.05). Conclusion Inequalities in awareness and attitude towards HPV and its vaccine existed between local and migrant residents in Shenzhen. The hukou and resident status did impact on the willingness to receive HPV vaccination, therefore, it is critical to implement effective health education campaigns on HPV and its vaccine among internal migrants.

Objective To establish a suitable model for predicting the success of trial of labor after cesarean section (TOLAC) during the pregnancy at term.Methods Data for all deliveries at term with one cesarean delivery history in Shenzhen Maternity and Child healthcare hospital during 1 January 2012 to 31 December 2014 were reviewed.Variables associated with VBAC were identified and used to build a model to predict the outcome of TOLAC with multivariable logistic regression.Godness of fit and accuracy of the model were evaluated by ROC.Results A total of 531 women met inclusion criteria and underwent TOLAC.Of the women who underwent trial of labor, 448 (84.4％) had a successful VBAC, 83 failed, and 2 (0.38％) had uterine rupture.Multivariable logistic regression analysis showed that previous cesarean section (CS) time interval, neonatal birth weight (BW) and premature rupture of membranes (PROM) were independent factors affecting TOLAC outcome, and their Odds Ratios were 2.79, 1.002 and 0.244, respectively.The Logistic regression model was expressed as follows:P =1/[1 + exp (2.4 × neonatal BW + 1.03 × previous CS time interval-1.41 × PROM-10.24)].The Hosmer-lemeshow test showed that the model fitted well (x2 =123.45, P =0.996), and the prediction accuracy of the model was 86.77％.The model performed well with an AUC of 0.794 (P =0.000).Conclusions A predictive model, which contains three variables (previous CS time interval, neonatal BW and PROM), has been developed and its prediction efficiency and accuracy are satisfactory.The larger birth weight, the longer time interval from previous CS, and the absence of PROM are more likely to be failed in TOLAC.

Objective: To analyze the distribution and associated factors of high-risk genotypes of HPV in cervical infection among women in Shenzhen. Methods: The information on sociodemographic characteristics and HPV genotypes of HPV-positive women who participated cervical screening test from January 2014 to December 2016 was downloaded from Shenzhen Maternity and Child Healthcare Management Information System. According to the pathogenicity, the high-risk HPV genotypes were divided into 15 types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68; and there were 6 low-risk genotypes including HPV 6, 11, 42, 43, 44, and 81. Chi-square tests were applied to compare the proportions of high-risk HPV infection among women who had different sociodemographic characteristics. A non-conditional logistic regression model was used to analyze the associated factors for high-risk HPV infection. Results: In total, all HIV positives received HPV genotyping, with an average age of (38.08±9.38) years old. There were 9 979 (93.9%) high-risk and 645 (6.1%) low-risk HPV infections. The proportions of HPV infections for high-risk type in each year were 91.5%, 93.8%, and 95.6%, increasing with the screening years (χ²=54.79, P<0.001). Multivariate logistic regression analysis showed that compared with women younger than 25 years old, women in other age groups (at age 26 to 30 years, 31 to 35 years, 36 to 40 years, 41 to 45 years, and 50 years or older) had increased risks of high-risk HPV infection, with OR (95%CI) of 1.67 (1.20-2.31), 1.49 (1.09-2.03), 1.71 (1.23-2.37), 1.65 (1.19-2.31), and 1.84 (1.26-2.67), respectively; compared with the married, single women had a decreased risk of high-risk HPV infection (OR (95%CI): 0.71 (0.50-1.00)); women received HPV testing in 2015 and 2016 showed higher risk of high-risk HPV infection than those in 2014 (OR (95%CI): 1.43 (1.17-1.74) and 2.03 (1.68-2.46)). The 5 most common HPV genotypes were HPV52 (25.1%, 2 670 cases), followed by HPV16 (19.2%, 2 041 cases), HPV58 (13.3%, 1 413 cases), HPV18 (9.9%, 1 048 cases), and HPV51 (9.3%, 993 cases). Conclusion Age, marital status, and screening year were associated with high-risk HPV infections. Besides HPV16 and HPV18, the prevention and control on HPV infections for HPV52, HPV58, and HPV51 should be prioritized in Shenzhen area.

Objective: To analyze the epidemiological genotype features of human papillomavirus (HPV) in cervical infection and their risks for cervical precancers among women in Shenzhen area. Methods: A total of 2 717 individuals ranging in age from 30~59 years were recruited in 18 community health centers of Shenzhen city from March 1 to June 15, 2015 by a cluster sampling method. The results of genotype of HPV, liquid-based cytology (LBC), colposcopy and pathology were analyzed. The clinical sensitivity and specificity as well as positive (PPV) and negative (NPV) predictive values of the combination of different HPV genotype in screening the cervical intraepithelial neoplasia (CIN) 2 and above were estimated. Results: The HPV infection rate in Shenzhen area was 15.9% (432/2 717). The most common HPV genotype was HPV52 (22.9%), followed by HPV16 (12.7%), HPV53 (10.0%), HPV51 (8.6%) and HPV58 (8.1%). Compared with HPV16/18 genotyping, HPV33/16 genotyping had a higher sensitivity (57.1% vs. 42.9%, P<0.05) and an analogous specificity (87.3% vs. 86.9%, P>0.05) in predicting CIN2+ . The sensitivity of combination of HPV33/16 genotyping and low grade squamous intraepithelial lesion (LSIL) positive tested by LBC in predicting CIN2+ was 75.0%, significantly higher than 64.3% of atypical squamous cells of undetermined significance (ASC-US) positive tested by LBC alone (P<0.05). The specificities of these two methods mentioned above in predicting CIN2+ were 83.5% and 89.2%, respectively, without statistical difference (P>0.05). Conclusions Women infected by HPV have distinct risks for CIN2+ according to different high-risk HPV genotypes. The top five risks were HPV 33, 16, 58, 56, and 68. HPV-positive women triaged by LBC LSIL+ combined with HPV33/16 genotyping may be a potential strategy for cervical cancer screening in developed urban area.

Objective To assess the epidemiology and clinical correlates of acute kidney injury(AKI)on patients in department of dermatology. Methods A total of 4710 patients hospitalized in dermatology department with at least two creatinine tests within 7 days were selected as research objects.AKI was defined and staged accord-ing to Kidney Disease Improving Global Outcomes criteria. Results The incidence of AKI was 6.3%. AKI inci-dences of psoriasis with systemic reaction(14.8%),erythroderma(12.8%),drug eruption(12.6%)and systemic lupus erythematosus (12.5%) were significant higher than the total incidence. In multivariate logistic regression model,these 4 skin diseases were independent risk factor of AKI incidence. The OR(95% confidencel interval) was 2.970(2.047~4.310),1.932(1.005~3.717),2.446(1.752~3.415)and 2.254(1.287~3.946). The in-hospital mortality was much higher in patients with AKI than those without(3.1% vs 0.1%,P < 0.001). And the AKI was related to in-hospital death after adjusted by age and comorbidities(Odds ratio 24.630,95%confidencel interval 7.385~82.149 ). Conclusion AKI is common in patients hospitalized in department of dermatology and is associated with patiensts′medical burden ,which shoule be noticed.

This study examined the effect of silencing LRIG3 expression on the proliferation and apoptosis of bladder cancer T24 cells and explored the role of LRIG3 in the tumorigenesis of bladder cancer. Bladder cancer T24 cells were routinely cultured and pSilencer plasmids were employed to construct LRIG3 eukaryotic expression vector of LRIG3-siRNA, i.e., pSilencer-LRIG3-siRNA. After confirmation, the vector was transfected into HEK293 cells to make a replication-deficient adenovirus, pAd-LRIG3-siRNA, which was then introduced into bladder cancer T24 cells. RT-PCR, Western-blotting were performed to detect the levels of LRIG3 mRNA and proteins. Cells number was determined by using MTT test. Hoechst33258 staining, transmission microscopy, flow cytometery were conducted to examine the cell apoptosis. Three groups included a blank control group, a negative control group (containing non-interfering plasmids) and a pAd-LRIG3-siRNA group. Our results showed that the recombinant pAd-LRIG3-siRNA was successfully transfected into the bladder cancer T24 cells. The siRNA formed by the transcription of the recombinant plasmids resulted in significantly reduced expressions of LRIG3 gene and protein and significantly decreased cell proliferation and growth in the pAd-LRIG3-siRNA group as compared with the control group (P<0.01). The siRNA also caused apoptotic changes of some cells, with the apoptosis rate being (17.69±0.75)%, which was significantly different from that of the control group (P<0.01). It was concluded that recombinant pAd-LRIG3-siRNA plasmids could effectively decrease the expression of LRIG3 mRNA and proteins and, to some extent, inhibit the proliferation and promote the apoptosis of bladder cancer T24 cells. Silencing LRIG3 gene might be a novel alternative for the treatment of bladder cancer.