1.Health risk assessment of inhalation exposure to metallic elements in PM2.5 in four cities of the Pearl River Delta in 2022
Jiwei NIU ; Suli HUANG ; Xiaoheng LI ; Zhen ZHANG ; Jiajia JI ; Ning LIU
Shanghai Journal of Preventive Medicine 2024;36(4):393-398
		                        		
		                        			
		                        			ObjectiveTo understand the characteristics of PM2.5 pollution in the air of Pearl River Delta city in Guangdong Province under the COVID-19 epidemic and the health risks of inhaling elements in PM2.5. MethodsIn 2022, 10 PM2.5 monitoring points were set up in 10 districts in Guangzhou, Shenzhen, Foshan and Zhuhai, and air samples were collected for 7 consecutive days every month to analyze the concentration of PM2.5 and the 12 elements in PM2.5. The classic "four-step" method was used to evaluate the carcinogenic risk and chronic non-carcinogenic risk of the elements in air PM2.5 on health. The age-sensitive characteristics of metal elements were combined in the carcinogenic risk assessment, and age-sensitive factors were introduced to analyze the impact of air pollution on population health. ResultsA total of818 samples were collected. and the average annual PM2.5 concentration in the four cities of the Pearl River Delta was 30.17 (1.00-166.00, s=21.06) μg·m-3, which was lower than the concentration limit of the secondary standard of the Ambient Air Quality Standard (GB 3095-2012). The difference of PM2.5 concentration in the four cities was statistically significant. The PM2.5 concentrations in Zhuhai and Shenzhen, which were located near the sea, were lower than those in Guangzhou and Foshan. The monthly mean concentration of PM2.5 in the four cities was the lowest at 13.70 (4.00-34.00, s=5.93) μg·m-3 in July and the highest at 57.73 (14.00-146.00, s=27.96) μg·m-3 in January, showing a low concentration from May to October and a high concentration from November to April of the following year. The average daily PM2.5 concentration exceeded the secondary standard for 29 days, mainly distributed in January and November. The average annual mass concentration of elements in PM2.5 in the four cities was Al>Mn>Pb>As>Ni>Cr>Se>Sb>Cd>Tl>Be>Hg. AS and Mn have chronic non-carcinogenic risk in population, while Cr, AS, Cd, Be and Ni have carcinogenic risk in population. ConclusionThe PM2.5 pollution levels of the four cities in the Pearl River Delta are low and variable. Coastal cities are lower than non-coastal cities, which shows the characteristics of first decreasing and then increasing throughout the year. The order of mass concentration of metal elements of PM2.5 in four cities is basically the same except Be and Ni. As and Mn in PM2.5 show a certain degree of chronic non-carcinogenic risk, and As, Cr, Cd, Ni and Be have a certain degree of carcinogenic risk. The four cities need to take effective intervention measures to continue to strengthen the pollution control and health protection of Cr, As, Cd and Mn in the air, and control the health burden caused by air pollution. 
		                        		
		                        		
		                        		
		                        	
2.Relationship between microsatellite instability and Ki-67 and clinicopathologic features and prognosis of colorectal cancer
Chaofan ZHANG ; Zhi QU ; Xiaoheng FENG ; Fangzhen QIAO ; Jingwei WU ; Xinjun WU
International Journal of Surgery 2023;50(9):581-590,F3
		                        		
		                        			
		                        			Objective:To explore the relationship between microsatellite instability (MSI) and Ki-67 expression level and the clinicopathological features of colorectal cancer, and investigate their impact for prognosis, so as to provide reference for prognostic judgment of colorectal cancer.Methods:The data of 183 patients who underwent radical colorectal cancer surgery and were diagnosed pathologically in the Department of General Surgery, the First Affiliated Hospital of Xinxiang Medical University from January 2017 to December 2019 were retrospectively analysed, including 101 males (55.2%)and 82 females(44.8%), ranged from 20 to 86 years and the mean age was(60.27±13.13)years. According to the results of mismatch repair protein immunohistochemical staining, the patients were divided into MSI-H group ( n=32) and MSI-L/MSS group ( n=151). According to the results of Ki-67 antigen immunohistochemical staining, the patients were divided into low Ki-67 expression group (<82.5%, n=136) and high Ki-67 expression group (≥82.5%, n=47) , among which 62 cases (78.5%) with low Ki-67 expression and 17 cases (21.5%) with high Ki-67 expression were in patients with Ⅲ+ Ⅳ stage colorectal cancer. The data of clinicopathological features, disease-free survival, and overall survival were collected and analyzed. The cotegorical variables were presented as n(%), and the comparisons between groups were performed using Chi-square test or Fisher′s exact test. The multivariate Logistic regression model was used to estimate the correlation between microsatellite instability and Ki-67 expression level and clinicopathologic characteristics of colorectal cancer. Kaplan-Meier survival curve and COX proportional hazards regression model were used to analyze the correlation between microsatellite instability and Ki-67 expression level and disease-free survival and overall survival. Results:Single factor analysis showed that the differences in gender ( χ2=4.37, P=0.037), tumor site ( χ2=26.40, P<0.001), tumor maximum diameter ( χ2=11.12, P=0.001) and nerve invasion ( χ2=5.53, P=0.019) between MSI-H group and MSI-L/MSS group were statistically significant. Multivariate Logistic regression model analysis showed that only gender ( OR=3.013, 95% CI: 1.183-7.672, P=0.021), tumor location ( OR=0.167, 95% CI: 0.067-0.419, P<0.001) and nerve invasion ( OR=0.202, 95% CI: 0.042-0.968, P=0.045) were independently correlative factors for MSI status. In Ⅲ+ Ⅳ stage colorectal cancers, the difference in tumor site between low Ki-67 expression group and high Ki-67 expression group was statistically significant( χ2=3.91, P=0.048). Multivariate Cox proportional hazards regression model analysis revealed that high Ki-67 expression ( HR=0.301, 95% CI: 0.118-0.768, P=0.012; HR=0.275, 95% CI: 0.083-0.912, P=0.035) and MSI-H ( HR=0.072, 95% CI: 0.010-0.525, P=0.009; HR=0.122, 95% CI: 0.017-0.900, P=0.039) were independently protective factors for disease-free survival and overall survival. Conclusions:MSI-H colorectal cancer is common in males, right-sided colonic cancers and non-neuroinvasive patients. In stage Ⅲ+ Ⅳ colorectal cancer, the expression level of Ki-67 in right-sided colonic cancer was lower than in left-sided colorectal cancer. Patients with MSI-H and high Ki-67 expressive colorectal cancer had longer disease-free survival, longer overall survival and better prognosis.
		                        		
		                        		
		                        		
		                        	
3.Establishment of a concise health index synthetic evaluation method for adolescents
XU Huiqiong, ZHANG Xinyu, LI Xiaoheng, CHEN Dingyan, ZHANG Xindong, WANG Xi, WAN Yuhui, TAO Fangbiao
Chinese Journal of School Health 2023;44(5):706-710
		                        		
		                        			Objective:
		                        			The aim of this study was to establish a comprehensive concise health index (CHI) for evaluating adolescents, so as to provide a basis for determining the overall health status of adolescents in China.
		                        		
		                        			Methods:
		                        			On the basis of a literature review and consensus among core researchers, adolescent CHI indicators in the following five dimensions were assessed:physical growth, physical fitness, common diseases, mental health and behavioral health. A total of 24 experts used an analysis hierarcgy process (AHP) to calculate the indicators  subjective weights. In addition, from October to December of 2021, two regions, A and B were selected to conduct empirical research, and the CRITIC method was used to calculate the objective weights of the indicators. Finally, the weight coefficients were determined through the AHP-CRITIC combination weight method, and comprehensive evaluation was performed with the TOPSIS method.
		                        		
		                        			Results:
		                        			Across academic period and genders, the combined weighted coefficients of the health indicators were as follows:BMI, 0.081-0.095; waist circumference, 0.070-0.081; relative grip strength, 0.101-0.108; myopia, 0.110-0.128; dental caries, 0.055-0.070; psychological symptoms, 0.240-0.262; physical exercise, 0.085-0.115; screen time, 0.097-0.111; and sleep duration, 0.086-0.103. The health index of middle school students in city A (0.626±0.065) was significantly higher than that in city B(0.613±0.066)( t=6.34, P <0.01).
		                        		
		                        			Conclusion
		                        			The comprehensive adolescent CHI evaluation method has good consistency and application value, and may serve as a reference for adolescent health monitoring.
		                        		
		                        		
		                        		
		                        	
4.Validity and reliability of the Chinese version of Mobile Phone Involvement Questionnaire in college students.
Lianhong LIN ; Xiaoheng XU ; Leqin FANG ; Likai XIE ; Xiaomin LING ; Yanlin CHEN ; Fuying ZHENG ; Yanrou BEI ; Lu ZHANG ; Bin ZHANG
Journal of Southern Medical University 2020;40(5):746-751
		                        		
		                        			OBJECTIVE:
		                        			To test the validity and reliability of the Chinese version of Mobile Phone Involvement Questionnaire (MPIQ) in college students.
		                        		
		                        			METHODS:
		                        			We assessed the degree of phone dependence using the MPIQ among 2122 college students. One month later, 60 students were randomly selected for assessment with the MPIQ, and the ROC curve was generated to evaluate the true positive rate (sensitivity) and false positive rate at different cutoff values to determine the optimal cutoff score of the MPIQ.
		                        		
		                        			RESULTS:
		                        			Among 98.9% of the participants who finished all the items, their MPIQ scores show a positive skew distribution and a one-factor structure. The load scores of the items ranged from 0.54 to 0.77. The Cronbach's α coefficient and the Spearman Brown split reliability were 0.84 and 0.83, respectively, the correlation coefficients between the items and total score ranged from 0.54 to 0.76, and the test-retest reliability was 0.48 ( < 0.001). At the optimal cut-off score of 32, the sensitivity and the specificity of the MPIQ were 0.634 and 0.652, respectively.
		                        		
		                        			CONCLUSIONS
		                        			At the optimal cut-off score of 32, the MPIQ has good validity and reliability for assessing phone dependence among college students.
		                        		
		                        		
		                        		
		                        			Cell Phone
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Reproducibility of Results
		                        			;
		                        		
		                        			Students
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
5.Association of mobile phone overuse with sleep disorder and unhealthy eating behaviors in college students of a medical university in Guangzhou.
Leqin FANG ; Xiaoheng XU ; Xiaomin LIN ; Yanlin CHEN ; Fuying ZHENG ; Yanrou BEI ; Lu ZHANG ; Bin ZHANG
Journal of Southern Medical University 2019;39(12):1500-1505
		                        		
		                        			OBJECTIVE:
		                        			To investigate the association of mobile phone use with sleep disorder and unhealthy eating behavior among college students of a medical university in Guangzhou.
		                        		
		                        			METHODS:
		                        			Mobile Phone Involvement Questionnaire (MPIQ), Pittsburgh Sleep Quality Index (PSQI) and the Three Factor Eating Questionnaire Revised 21 Item (TFEQ-R21) were used to survey 2122 undergraduates of the medical university. One-sample t test, One-way ANOVA and multiple linear regression analysis were used to analyze the data.
		                        		
		                        			RESULTS:
		                        			Age, body mass index (BMI), phone use before sleep, phone use frequency, sleep quality (assessed by total PSQI score) and the dimension scores of TFEQ-R21 for uncontrolled eating, cognitive restraint, and emotional eating were all significantly correlated with the total score of MPIQ ( < 0.05). Phone use before sleep, high frequency of mobile phone use, poor sleep quality and emotional eating were associated with high MPIQ scores, while lower cognitive restraint and emotional eating tendency were correlated with lower scores of MPIQ. Bivariate analysis revealed that age (=0.088, < 0.001), BMI (=0.055, < 0.05), PSQI scores (=0.204, < 0.001), TFEQ-UE scores (=0.199, < 0.001), TFEQ-CR scores (=-0.076, < 0.001), TFEQ-EE scores (=0.170, < 0.001), phone use before sleep (=0.429, < 0.001), and phone use frequency (=0.316, < 0.001) were all significantly correlated with MPIQ scores; multiple linear regression analysis showed that model 4 incorporating the scores of TFEQ-UE, TFEQ-CR, and TFEQ-EE explained up to 21.8% of the main effect (adjusted R= 21.5%).
		                        		
		                        			CONCLUSIONS
		                        			Mobile phone overuse is associated with poor sleep quality and unhealthy eating behaviors, and education and interventions for mobile phone use is essential among college students.
		                        		
		                        		
		                        		
		                        			Cell Phone
		                        			;
		                        		
		                        			Feeding Behavior
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Sleep Wake Disorders
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		                        			Students
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		                        			Universities
		                        			
		                        		
		                        	
6.Combining speech sample and feature bilateral selection algorithm for classification of Parkinson's disease.
Xiaoheng ZHANG ; Lirui WANG ; Yao CAO ; Pin WANG ; Cheng ZHANG ; Liuyang YANG ; Yongming LI ; Yanling ZHANG ; Oumei CHENG
Journal of Biomedical Engineering 2018;34(6):942-948
		                        		
		                        			
		                        			Diagnosis of Parkinson's disease (PD) based on speech data has been proved to be an effective way in recent years. However, current researches just care about the feature extraction and classifier design, and do not consider the instance selection. Former research by authors showed that the instance selection can lead to improvement on classification accuracy. However, no attention is paid on the relationship between speech sample and feature until now. Therefore, a new diagnosis algorithm of PD is proposed in this paper by simultaneously selecting speech sample and feature based on relevant feature weighting algorithm and multiple kernel method, so as to find their synergy effects, thereby improving classification accuracy. Experimental results showed that this proposed algorithm obtained apparent improvement on classification accuracy. It can obtain mean classification accuracy of 82.5%, which was 30.5% higher than the relevant algorithm. Besides, the proposed algorithm detected the synergy effects of speech sample and feature, which is valuable for speech marker extraction.
		                        		
		                        		
		                        		
		                        	
7.A retrospective cohort study on treatment ofTiaogan-Bushen-Xiaoji recipe for the patients with advanced breast cancer
Weiyu ZHANG ; Xiaoheng SHEN ; Lan ZHENG ; Haifeng YING ; Guyin LOU ; Yuanbiao GUO ; Weirong ZHU ; Lingling LYU
International Journal of Traditional Chinese Medicine 2018;40(1):18-21
		                        		
		                        			
		                        			Objective To explore the efficacy ofTiaogan-Bushen-Xiaoji recipe (TGBSXJ Recipe) on overall survival and progression free survival (PFS) in patients with advanced breast cancer.Methods A total of 105 patients with advanced breast cancer, who received the first-line treatment, were divided into two groups, 56 cases in the control group and 49 in the experimental group. The control group received standard therapy according to guidelines, including chemotherapy, targeted therapy, endocrine therapy and treatment of bisphosphonates.The experimental group received the treatment of TGBSXJ Recipe besides the standard therapy. The overall survival (OS), progression-free survival (PFS) and Karnofsky (KPS) of the patients in two groups were observed and compared. The treatment ended with the sighs of the observation ending, the second progress for the disease or death.Results The overall survival of the experimental group was significantly higher than that of the control group [OS: 58.2(50.7-65.8)/monthsvs. 43.8(30.6-51.6)/months,P=0.040]. The PFS of the experimental group was significantly higher than the control group [PFS: 30.7(23.8-37.7)/monthsvs. 15.2(11.3-19.1)/months,P=0.001]. The KPS of the experimental group was significantly higher than the control group (88.6 ± 10.0vs. 80.5 ± 19.0,t=2.654). The PFS of the triple negative breast cancer (TNBC) in the experimental group was significantly higher than control group [(25.1(12.1-38.0)/monthsvs. 9.9(4.7-15.0)/months,P=0.038].Conclusions The TGBSXJ recipe could extend the OS and PFS and improve the life quality of the patients with advanced breast cancer. In this study, no severe adverse effects had been found in the experimental group.
		                        		
		                        		
		                        		
		                        	
8.Relationship between body mass index and the incidence risk and severity of papillary thyroid microcarcinoma
Lin MA ; Qinghe SUN ; Lei ZHANG ; Jinbao YANG ; Yuewu LIU ; Ziwen LIU ; Ge CHEN ; Shuguang CHEN ; Xiaoheng WEN ; Zhonghua SHANG ; Yanlong LI ; Xiaoyi LI
International Journal of Surgery 2018;45(12):800-805
		                        		
		                        			
		                        			Objectives To evaluate the relationship between body mass index (BMI) and the incidence risk of papillary thyroid microcarcinoma (PTMC).Methods This retrospective study included 1210 PTMC patients who underwent surgery between November 2013 and October 2014 in Peking Union Medical College Hospital,China Academy of Medical Science.A population-based 1∶1 matched case-control study was conducted,and each PTMC patients was matched with one who received thyroid function and ultrasonic to confirm that there was no disease in the thyroid.The clinical profiles of these patients were collected.According to Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults,all subjects were divided into three groups:underweight (BMI ≤ 18.5 kg/m2),normal(18.5 kg/m2 < BMI ≤ 23.9 kg/m2),overweight (24.0 kg/m2 < BMI < 27.9 kg/m2) and obese group(BMI≥28.0 kg/m2).The relationship between BMI and PTMC incidence risk was analyzed by casecontrol study.Univariate and multivariate logistic regression analysis was applied to analyze the relationship between BMI and PTMC severity.Results The BMI of PTMC patients was significant higher than in normal control [(24.30 ±3.33) kg/m2 vs (23.31 ± 3.50) kg/m2,P < 0.0001].Compared with BMI normal group,the incidence risk of PTMC in underweight group was significantly lower (OR =0.449,95 % CI:0.270-0.747),which is higher in overweight and obese group (OR =1.559,95% CI:1.261-1.928;OR =2.059,95% CI:1.501-2.823).Histopathological review of 1210 PTMC patients with surgical resection revealed.The proportions of underweight,normal,overweight and obese group of the patients with extrathyroid extension (3.1%,48.0%,36.7%,12.2%) have significant differences with those in the patients whose tumor are limited to the thyroid (0.7%,45.2%,36.0%,18.1%) (P =0.0090).The proportions of 4 group of the patients with multiple lesions (3.2%,49.0%,35.6%,12.2%) were significantly differences to those in the patients with single lesion (0.8%,43.3%,38.7%,17.2%) (P =0.0050).Multivariate analysis showed that underweight is a protective factor of extrathyroidal extension (OR =0.219,95 % CI:0.051-0.932;OR =0.279,95 % CI:0.085-0.935) and mulifocality,and obese is an independent risk factors(OR =1.556,95%CI:1.047-2.312;OR =1.764,95%CI:1.204-2.584).Conclusions This study identified that the incidence risk of PTMC is positive related with BMI.In PTMC patients,obesity increases the risk of mulifocality and extrathyroidal extension.Attention should be paid to the effect of obesity on the incidence risk of PTMC and the diagnosis and treatment in clinical practice.
		                        		
		                        		
		                        		
		                        	
9.Abnormal bone mineral density in health checkup population with subclinical thyroid dysfunction
Xiaoheng WEN ; Biao ZHANG ; Yan JIANG ; Cuiping LI ; Huijun WANG
Chinese Journal of Health Management 2017;11(4):314-318
		                        		
		                        			
		                        			Objective To investigate the relationship between abnormal bone mineral density (BMD) and subclinical thyroid dysfunction. Methods Thyroid function, biochemical indicators of bone metabolism and BMD were reviewed retrospectively in the subjects who received health checkups from July 1, 2009 to January 31, 2017 in the Health Check-up Department of Peking Union Medical College Hospital. People who had thyroid dysfunction, recognized risk factors for osteoporosis, and medication history were excluded. A cross-sectional analysis of thyroid status and biochemical indicators of bone metabolism was performed by the standard methods. BMD at the lumbar spine and femoral neck was measured using dual energy X-ray absorptiometry. Results A total of 6884 subjects (3726 women and 3158 men) were enrolled in the study, with an average age of (50.74 ± 10.41) years. They were divided into three groups:subclinical hyperthyroid, subclinical hypothyroid, and euthyroidism. The alkaline phosphatase in subclinical hyperthyroid group was higher than that in the euthyroidism group[ (67.95±20.64)U/L vs. (63.88±18.99)U/L]. Calcium and phosphorus in blood were higher in both subclinical hyperthyroid and subclinical hypothyroid groups. The rate of abnormal BMD in male euthyroidism, subclinical hyperthyroid and subclinical hypothyroid groups were 36.10%(1049/2906), 29.27%(12/41) and 27.01%(57/211), respectively. The rate of abnormal BMD showed no difference between subclinical hyperthyroid group and euthyroidism group (P>0.05). The rate of abnormal BMD was lower in subclinical hypothyroid group than in euthyroidism group (χ2=7.0901, P<0.01), especially in the males aged 40-49 years (χ2=10.4618, P<0.01). The rate of abnormal BMD in female euthyroidism, subclinical hyperthyroid and subclinical hypothyroid groups was 38.81%(1286/3314), 45.83% (33/72) and 40.88% (139/340), respectively. The rate of abnormal BMD showed no difference among the three groups (P>0.05). Conclusion There is no significant difference in the rate of abnormal BMD between subclinical thyroid dysfunction group and euthyroidism group, possibly because abnormal serum biochemical indicators preceded the presence of low BMD. More sensitive methods used to determine the status of bone metabolism await to be developed.
		                        		
		                        		
		                        		
		                        	
10.Species identification of freshwater snail Planorbella trivolvis and analysis of its potential distribution
Xiaoheng LI ; Shitong GAO ; Wenbiao GU ; Yi ZHANG ; Yunhai GUO
Chinese Journal of Schistosomiasis Control 2015;(3):268-272
		                        		
		                        			
		                        			Objective To identify the species classification of an ornamental Planorbidae from a flower market in Shanghai and analyze its potential distribution in China. Methods In August 2013,six freshwater snail specimens were collected from the Wanshang flower market. The species was identified by morphology and molecular biology. An ecological niche model was constructed based on the native geographic presence occurrence data,and projected onto the whole of China to predict the poten?tial distribution. Results Their shell external morphology suggested that the specimens belonged to Planorbella trivolvis(Say 1817)of Planorbidae,which is native in North America. The sequence data of a fragment of the mitochondrial cytochrome c oxi?dase subunit I(COI)confirmed its identification. A total of 2 294 georeferenced occurrence points in North America were car?ried out from the Global Biodiversity Information Facility databases and 614 records with coordinates were used to produce a North American native niche model by a maximum entropy method(Maxent). The projection on China results suggested high probabilities of occurrence mostly in Henan Province and its borderland with nearby provinces. Conclusions P. trivolvis is sim?ilarly with Biomphalaria species from shell morphology. It is the first records of the species in China,and the field dispersal is not clear.
		                        		
		                        		
		                        		
		                        	
            

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