1.Association between ambient ozone exposure during pregnancy and risk of preterm birth in Guangdong Province
Peng HU ; Shanshan RAN ; Qingmei LIN ; Yin YANG ; Zilong ZHANG ; Xiaoling GUO ; Yonggui GAO ; Jinde ZHAO ; Hualiang LIN
Journal of Environmental and Occupational Medicine 2025;42(4):379-384
Background Air pollution exposure has a significant impact on maternal and child health. However, the research on the association between ambient ozone (O3) exposure during pregnancy and the risk of premature birth in newborns is limited, and the conclusions are inconsistent. Objective To investigate the association of ambient O3 exposure during pregnancy with the risk of preterm birth in Guangdong Province. Methods Data of pregnant women in Guangzhou from 2013 to 2019 and Foshan from 2018 to 2023 were collected, and O3 concentrations during different trimesters were assessed according to maternal residential addresses. Bilinear interpolation was used to evaluate the concentrations of air pollution. A cohort study design was adopted in our study. Restricted cubic spline curves were used to evaluate the exposure-response relationship between O3 exposure and preterm birth risk and explore potential exposure threshold of O3. Logistic regression models were used to evaluate the association of O3 exposure with preterm birth. Results A total of 702 924 pregnant women were included in this study, of whom 43 051 (6.12%) were preterm. The average O3 exposure concentrations of pregnant women during the first, second, third, and whole trimesters were 95.51, 97.51, 100.60, and 97.87 μg·m−3, respectively. We observed J-shaped associations between O3 exposure and preterm birth risk during the second, third, and whole trimesters of pregnancy using restricted cubic spline curves. This study found that there were threshold concentrations between O3 exposure and preterm birth risk during different gestational periods, and the threshold concentrations in the first, second, third, and whole trimesters were 112.32, 99.83, 111.74, and 112.46 μg·m−3, respectively. During the second, third, and whole trimesters of pregnancy, after adjusting for maternal age, baby sex, pre-pregnancy body mass index, mode of delivery, baby birth weight, gestational diabetes, and gestational hypertension, the odds ratios (OR) of preterm birth were 1.02 (95%CI: 1.01, 1.04), 1.02 (95%CI: 1.00, 1.03), and 1.17 (95%CI: 1.13, 1.21) for each 10 μg·m−3 increase in O3 concentration above the O3 threshold. No significant association was found between O3 exposure and the risk of preterm birth during the first trimester. Conclusion There is a nonlinear association between the risk of preterm birth and O3 exposure during pregnancy, and higher concentrations of O3 exposure during pregnancy are associated with the risk of preterm birth. Above the O3 threshold concentration during pregnancy, especially during the second, third, and whole trimesters, the risk of preterm birth elevates with the increase of O3 exposure concentrations.
2.Applications and advancements of instrumental variable approach in causal inference in environmental epidemiology
Hui SHI ; Guzhengyue ZHENG ; Xing ZHAO ; Shourui HUANG ; Baozhuo AI ; Jialong WU ; Hualiang LIN
Journal of Environmental and Occupational Medicine 2024;41(2):219-225
In environmental epidemiological research, extensive non-random environmental exposures and complex confounding biases pose significant challenges when attempting causal inference. In recent years, the introduction of causal inference methods into observational studies has provided a broader range of statistical tools for causal inference research in environmental epidemiology. The instrumental variable (IV) approach, as a causal inference technique for effectively controlling unmeasured confounding factors, has gradually found application in the field of environmental epidemiological research. This article reviewed the basic principles of IV and summarized the current research progress and limitations of applying IV for causal inference in environmental epidemiology. IV application in the field of environmental epidemiology is still in the initial stage. Rational use of IV and effective integration with other causal inference methods will become the focus of the development of causal inference in environmental epidemiology. The aim of this paper is to provide a methodological reference and basis for future studies involving causal inference to target population health effects of environmental exposures in China.
3.Effect of air pollution, genetic susceptibility on the risk of all-cause mortality and cardiovascular outcomes among atrial fibrillation patients
Junguo ZHANG ; Ge CHEN ; Dashan ZHENG ; Jianheng CHEN ; Chaoling ZHANG ; Shengtao WEI ; Huaicai ZENG ; Hualiang LIN
Chinese Journal of Epidemiology 2024;45(10):1362-1370
Objective:To analyze the association between air pollution, genetic susceptibility, and the risk of all-cause mortality and cardiovascular outcomes in patients with atrial fibrillation (AF).Methods:AF patients aged between 40-69 years old registered in the United Kingdom Biobank from 2006 to 2010 were included. After excluding those lost to follow-up or with incomplete data during follow-up, 5 814 subjects were analyzed. Long-term exposure to air pollution was estimated at the geocoded residential address of each participant. Genetic risk scores for all-cause mortality, cardiovascular disease, heart failure, myocardial infarction, and stroke were constructed separately for each object to assess the corresponding genetic susceptibility. The Cox proportional hazards model was used to analyze the association between air pollution, genetic susceptibility, and the risk of all-cause mortality and cardiovascular outcomes in AF patients.Results:During a median follow-up of 12.4 years, there were 929 of all-cause mortality (15.98%) and 1 772 of cardiovascular events (30.48%). Multivariable-adjusted analyses revealed that higher exposure to PM 2.5, PM 10, NO x, and NO 2 was associated with an increased risk of cardiovascular disease mortality, heart failure, myocardial infarction, and stroke, with hazard ratios ( HRs) ranging from 1.26 to 1.48. Specifically, for each interquartile range ( IQR) increase in PM 2.5 exposure, the HRs for the outcomes mentioned above were 1.33 (95% CI: 1.14-1.54), 1.42 (95% CI: 1.31-1.54), 1.46 (95% CI: 1.30-1.64), and 1.43 (95% CI: 1.27-1.61), respectively. Both NO x and NO 2 exposures were associated with a 9% increased risk of all-cause mortality per IQR increment, with corresponding HRs of 1.09 (95% CI: 1.02-1.17) and 1.09 (95% CI: 1.01-1.17), respectively. Individuals with high genetic susceptibility to AF had a higher risk of myocardial infarction and stroke compared to those with low genetic susceptibility, with corresponding HRs of 1.39 (95% CI: 1.04-1.87) and 1.46 (95% CI: 1.09-1.95), respectively. Compared to AF patients with low air pollution exposure, those with high air pollution exposure have adjusted population attributable fractions of up to 33.57% (95% CI: 17.87%-46.26%) for cardiovascular mortality, 28.61% (95% CI: 20.67%-35.75%) for heart failure, 33.35% (95% CI: 20.97%-43.79%) for myocardial infarction, and 42.29% (95% CI: 30.05%-52.71%) for stroke. Furthermore, there was an additive interaction between PM 2.5, NO x, and NO 2 exposure and high genetic susceptibility on the incidence of myocardial infarction. An additive interaction was also observed between NO x, NO 2 exposure, and high genetic susceptibility on the incidence of heart failure (all P<0.05). Conclusions:Both air pollution and genetic susceptibility increase the risk of all-cause mortality and cardiovascular outcomes in AF patients.
4.Association, differences, and applications of three commonly used statistical indicators: risk ratio, hazard ratio, and odds ratio
Dashan ZHENG ; Junguo ZHANG ; Wanqi WEN ; Hualiang LIN
Chinese Journal of Preventive Medicine 2024;58(5):706-710
Relative Risk ( RR), Hazard Ratio ( HR), and Odds Ratio ( OR) are commonly used statistical measures in the field of public health to assess the magnitude of the effect of exposure factors on outcomes. These indicators have different calculation principles and implications in public health. However, a few researchers misused or misinterpreted RR, HR, and OR values when interpreting study results. Therefore, this article explores the relationships and differences among these measures, as well as the correct selection and application of RR, HR, and OR in both cohort study and case-control study.
5.Association, differences, and applications of three commonly used statistical indicators: risk ratio, hazard ratio, and odds ratio
Dashan ZHENG ; Junguo ZHANG ; Wanqi WEN ; Hualiang LIN
Chinese Journal of Preventive Medicine 2024;58(5):706-710
Relative Risk ( RR), Hazard Ratio ( HR), and Odds Ratio ( OR) are commonly used statistical measures in the field of public health to assess the magnitude of the effect of exposure factors on outcomes. These indicators have different calculation principles and implications in public health. However, a few researchers misused or misinterpreted RR, HR, and OR values when interpreting study results. Therefore, this article explores the relationships and differences among these measures, as well as the correct selection and application of RR, HR, and OR in both cohort study and case-control study.
6.Influence of personality traits on mental health and mediating role of work-family support among front-line power grid workers
Xiao ZHOU ; Xiling WU ; Chaolin XIONG ; Hualiang LI ; Aihua LIN
Journal of Environmental and Occupational Medicine 2023;40(3):310-316
Background Front-line power grid workers are required to face a variety of occupational hazards (such as aerial work), which make them susceptible to psychological problems and further reduce their performance efficiency and safety level. Objective To investigate the mental health status of front-line power grid workers and explore the influence of personality traits on mental health and the potential mediating role of work-family support between them. Methods This study was designed as a cross-sectional study. From January to June 2019, a cluster random sampling method was used to select two of the 20 power supply stations owned by a Guangdong power company. A total of 485 front-line power grid workers were included in the study. Sociodemographic characteristics were investigated, and NEO Five-Factor Inventory, Work-Family Support Scale, and Symptom Checklist 90 (SCL-90) were used in the survey. Spearman correlation analysis was conducted to analyze the correlations between measured variables. Structural equation modeling was used to analyze the relationships of personality traits, work-family support, and mental health, and Bootstrap analysis was used to test the mediating effect of work-family support on the relationship of personality traits and mental health. Results The M (P25, P75) of total SCL-90 score was 134.00 (110.00, 167.00), and 139 (28.66%) front-line power grid workers showed positive mental health symptoms. The correlation analysis indicated that among the front-line power grid workers, neuroticism score was negatively correlated with work-family support total score (rs=−0.356, P<0.001), and positively correlated with the total score of SCL-90 (rs=0.557, P<0.001) as well as all the scores of its sub-dimensions (rs=0.436-0.550, P<0.001). Openness score was positively correlated with work-family support total score (rs=0.269, P<0.001), and except for paranoid ideation (P>0.05), openness score was negatively correlated with the scores of all the other sub-dimensions of SCL-90 (rs=−0.091-−0.147, P<0.05). The scores of the other three personality traits (extroversion, agreeableness, and conscientiousness) were positively correlated with work-family support total score (rs=0.331-0.466, P<0.001), and negatively correlated with the total score of SCL-90 as well as the scores of all its sub-dimensions (P<0.001). The modified structural equation modeling indicated that the direct effect of work-family support on mental health symptoms was −0.225 (P<0.001). The direct effects of extraversion and openness on work-family support were 0.241 (P<0.001) and 0.123 (P<0.05), respectively, while the effect on mental health symptoms was not statistically significant. The direct effects of neuroticism on work-family support and mental health symptoms were -0.152 (P<0.01) and 0.467 (P<0.001), respectively. The direct effects of conscientiousness on work-family support and mental health symptoms were not statistically significant (P>0.05). The direct effect of agreeableness on work-family support was not statistically significant (P>0.05), while the direct effect on mental health symptoms was −0.180 (P<0.001). Conclusion The front-line power grid workers show a high score of SCL-90. Workers with higher neuroticism are more vulnerable to mental health symptoms. Work-family support fully mediates the effects of extraversion and openness on mental health symptoms, and partially mediates the effects of neuroticism on mental health symptoms, while does not mediate the effects of agreeableness on mental health symptoms. Sufficient work-family support may improve mental health status.
7.Clinical study on Fuzheng Zhuyu Xiehuo Decoction combine with conventional western medicine therapy in the treatment of acute pancreatitis of intermingled blood stasis-toxin syndrome
Lin XIAO ; Yin XU ; Yangxiang ZHOU ; Hualiang TAN
International Journal of Traditional Chinese Medicine 2022;44(4):375-379
Objective:To explore the efficacy of Fuzheng Zhuyu Xiehuo Decoction for the patients with acute pancreatitis (AP) of intermingled blood stasis-toxin syndrome and its influence on peripheral blood inflammatory factors and microcirculation indicators.Methods:A total of 100 patients with AP, admitted to department of spleen and stomach diseases of the First Affiliated Hospital of Hunan University of Chinese Medicine and department of gastroenterology of the Central Hospital of Shaoyang, who met the inclusion criteria between March 2019 and March 2020, were divided into two groups according to the random number table method, with 50 in each group. The control group was given conventional western medicine, while the observation group was treated with Fuzheng Zhuyu Xiehuo Decoction on the basis of the control group. The TCM syndromes were scored before and after treatment, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) was used to evaluate the severity of the disease, and ELISA was adopted to detect the levels of IL-6, IL-8, TNF-α and thromboxane A2 (TXA2), prostaglandin I 2 (PGI 2) and platelet activating factor (PAF). The abdominal pain, abdominal distension, fever, gastrointestinal function recovery time and hospital stay were observed and the adverse events were recorded. Results:The total effective rate was 96.0% (48/50) in the observation group and that of the control group was 84.0% (42/50) ( χ2=4.00, P=0.045). The scores of abdominal pain, abdominal distension, fever and nausea and vomiting in observation group were significantly lower than those in the control group ( t=7.07, 7.06, 11.47, 10.30, all Ps<0.01), and the recovery times of abdominal pain, abdominal distension, fever and gastrointestinal function and hospital stay in the observation group were significantly shorter than those in the control group ( t=4.52, 4.90, 6.27, 6.55, 7.12, all Ps<0.01). After treatment, the levels of serum IL-6 [(30.15±7.04) μg/L vs. (42.37±8.29) μg/L, t=7.95], IL-8 [(39.36±8.11) μg/L vs. (50.36±10.47) μg/L, t=5.87], TNF-α [(106.28±21.04) μg/L vs. (153.45±30.23) μg/L, t=9.06] in the observation group were significantly lower than those in the control group ( P<0.01). The serum TXA2 [(223.68±40.15) ng/L vs. (257.11±50.32) ng/L, t=3.67] and PAF [(74.86±15.37) ng/L vs. (85.53±15.26) ng/L, t=3.48] in the observation group were significantly lower than those in the control group ( P<0.01) while the level of PGI 2 [(91.43±17.45) ng/L vs. (76.49±15.13) ng/L, t=4.57] in the observation group was significantly higher than those in the control group ( P<0.01). Conclusion:Fuzheng Zhuyu Xiehuo Decoction combined with western medicine can improve clinical symptoms and blood microcirculation status, relieve inflammatory response and enhance clinical efficacy of patients with AP of intermingled blood stasis-toxin syndrome.
8.A potent PGK1 antagonist reveals PGK1 regulates the production of IL-1β and IL-6.
Liping LIAO ; Wenzhen DANG ; Tingting LIN ; Jinghua YU ; Tonghai LIU ; Wen LI ; Senhao XIAO ; Lei FENG ; Jing HUANG ; Rong FU ; Jiacheng LI ; Liping LIU ; Mingchen WANG ; Hongru TAO ; Hualiang JIANG ; Kaixian CHEN ; Xingxing DIAO ; Bing ZHOU ; Xiaoyan SHEN ; Cheng LUO
Acta Pharmaceutica Sinica B 2022;12(11):4180-4192
Glycolytic metabolism enzymes have been implicated in the immunometabolism field through changes in metabolic status. PGK1 is a catalytic enzyme in the glycolytic pathway. Here, we set up a high-throughput screen platform to identify PGK1 inhibitors. DC-PGKI is an ATP-competitive inhibitor of PGK1 with an affinity of K d = 99.08 nmol/L. DC-PGKI stabilizes PGK1 in vitro and in vivo, and suppresses both glycolytic activity and the kinase function of PGK1. In addition, DC-PGKI unveils that PGK1 regulates production of IL-1β and IL-6 in LPS-stimulated macrophages. Mechanistically, inhibition of PGK1 with DC-PGKI results in NRF2 (nuclear factor-erythroid factor 2-related factor 2, NFE2L2) accumulation, then NRF2 translocates to the nucleus and binds to the proximity region of Il-1β and Il-6 genes, and inhibits LPS-induced expression of these genes. DC-PGKI ameliorates colitis in the dextran sulfate sodium (DSS)-induced colitis mouse model. These data support PGK1 as a regulator of macrophages and suggest potential utility of PGK1 inhibitors in the treatment of inflammatory bowel disease.
9.Discovery of a subtype-selective, covalent inhibitor against palmitoylation pocket of TEAD3.
Tian LU ; Yong LI ; Wenchao LU ; Twgm SPITTERS ; Xueyu FANG ; Jun WANG ; Simian CAI ; Jing GAO ; Yanting ZHOU ; Zhe DUAN ; Huan XIONG ; Liping LIU ; Qi LI ; Hualiang JIANG ; Kaixian CHEN ; Hu ZHOU ; Hua LIN ; Huijin FENG ; Bing ZHOU ; Christopher L ANTOS ; Cheng LUO
Acta Pharmaceutica Sinica B 2021;11(10):3206-3219
The TEA domain (TEAD) family proteins (TEAD1‒4) are essential transcription factors that control cell differentiation and organ size in the Hippo pathway. Although the sequences and structures of TEAD family proteins are highly conserved, each TEAD isoform has unique physiological and pathological functions. Therefore, the development and discovery of subtype selective inhibitors for TEAD protein will provide important chemical probes for the TEAD-related function studies in development and diseases. Here, we identified a novel TEAD1/3 covalent inhibitor (DC-TEADin1072) with biochemical IC
10.The impact of ambient temperature exposure on emergency calls-a time series analysis based on data of Xuchang and Zhengzhou
Siqi AI ; Lijie QIN ; Yingjie CUI ; Shiyu ZHANG ; Fei TIAN ; Huan LI ; Yin YANG ; Hualiang LIN
Chinese Journal of Preventive Medicine 2021;55(2):194-199
Objective:To investigate the effect of hourly ambient temperature exposure on emergency calls in Xuchang city and Zhengzhou city.Methods:The hourly meteorological data, air pollution data and emergency calls of Xuchang city and Zhengzhou city were collected from January 1, 2017 to October 31, 2019. A distributed lag non-linear model was used to calculate the excess relative risk ( ERR). The lag effect and cumulative effect of extreme temperature exposure on emergency calls were evaluated. Results:The relationship between hourly temperature exposure and emergency calls was a U-shaped curve. In Xuchang city and Zhengzhou city, both low and high temperatures would increase the number of hourly emergency calls. The earliest effect of low temperature occurred at a lag of 22 h and 52 h, with ERR values (95% CI) about 0.20% (0.00%, 0.39%) and 0.11% (0.00%, 0.22%), respectively. The earliest effect of high temperature occurred at a lag of 0 h with ERR values about 1.59% (1.09%, 2.09%) and 1.45% (1.22%, 1.69%), respectively. High temperature had the greatest impact on the number of emergency calls of cardiovascular disease at a lag of 4-8 h. The cumulative ERR values (95% CI) of the two cities were 8.70% (4.98%, 12.75%) and 3.89% (2.61%, 5.22%), respectively. Conclusion:High temperature exposure could increase the number of emergency calls within a few hours, while the effect of low temperature would not occur until 22 hours later.

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