OBJECTIVE: To investigate the incidence rate and risk factors for metabolic bone disease of prematurity (MBDP) in very low birth weight/extremely low birth weight (VLBW/ELBW) infants. METHODS: The medical data of 61 786 neonates from multiple centers of China between September 1, 2013 and August 31, 2016 were retrospectively investigated, including 504 VLBW/ELBW preterm infants who met the inclusion criteria. Among the 504 infants, 108 infants diagnosed with MBDP were enrolled as the MBDP group and the remaining 396 infants were enrolled as the non-MBDP group. The two groups were compared in terms of general information of mothers and preterm infants, major diseases during hospitalization, nutritional support strategies, and other treatment conditions. The multivariate logistic regression analysis was used to investigate the risk factors for MBDP. RESULTS: The incidence rate of MBDP was 19.4% (88/452) in VLBW preterm infants and 38.5% (20/52) in ELBW preterm infants. The incidence rate of MBDP was 21.7% in preterm infants with a gestational age of < 32 weeks and 45.5% in those with a gestational age of < 28 weeks. The univariate analysis showed that compared with the non-MBDP group, the MBDP group had significantly lower gestational age and birth weight, a significantly longer length of hospital stay, and a significantly higher incidence rate of extrauterine growth retardation ( CONCLUSIONS A lower gestational age, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis may be associated an increased risk of MBDP in VLBW/ELBW preterm infants. It is necessary to strengthen perinatal healthcare, avoid premature delivery, improve the awareness of the prevention and treatment of MBDP among neonatal pediatricians, and adopt positive and reasonable nutrition strategies and comprehensive management measures for preterm infants.
Birth Weight ; Bone Diseases, Metabolic/etiology* ; China/epidemiology* ; Female ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Pregnancy ; Retrospective Studies ; Risk Factors

BACKGROUND: Sleep disorders are common but under-researched symptoms in patients with multiple system atrophy (MSA). We investigated the frequency and factors associated with sleep-related symptoms in patients with MSA and the impact of sleep disturbances on disease severity. METHODS: This cross-sectional study involved 165 patients with MSA. Three sleep-related symptoms, namely Parkinson's disease (PD)-related sleep problems (PD-SP), excessive daytime sleepiness (EDS), and rapid eye movement sleep behavior disorder (RBD), were evaluated using the PD Sleep Scale-2 (PDSS-2), Epworth Sleepiness Scale (ESS), and RBD Screening Questionnaire (RBDSQ), respectively. Disease severity was evaluated using the Unified MSA Rating Scale (UMSARS). RESULTS: The frequency of PD-SP (PDSS-2 score of ≥18), EDS (ESS score of ≥10), and RBD (RBDSQ score of ≥5) in patients with MSA was 18.8%, 27.3%, and 49.7%, respectively. The frequency of coexistence of all three sleep-related symptoms was 7.3%. Compared with the cerebellar subtype of MSA (MSA-C), the parkinsonism subtype of MSA (MSA-P) was associated with a higher frequency of PD-SP and EDS, but not of RBD. Binary logistic regression revealed that the MSA-P subtype, a higher total UMSARS score, and anxiety were associated with PD-SP; that male sex, a higher total UMSARS score, the MSA-P subtype, and fatigue were associated with EDS; and that male sex, a higher total UMSARS score, and autonomic onset were associated with RBD in patients with MSA. Stepwise linear regression showed that the number of sleep-related symptoms (PD-SP, EDS, and RBD), disease duration, depression, fatigue, and total Montreal Cognitive Assessment score were predictors of disease severity in patients with MSA. CONCLUSIONS Sleep-related disorders were associated with both MSA subtypes and the severity of disease in patients with MSA, indicating that sleep disorders may reflect the distribution and degree of dopaminergic/non-dopaminergic neuron degeneration in MSA.
Cross-Sectional Studies ; Humans ; Male ; Multiple System Atrophy ; REM Sleep Behavior Disorder ; Severity of Illness Index ; Sleep

Diagnostic Tests, Routine ; methods ; Humans ; Mycobacterium tuberculosis ; isolation & purification ; Sensitivity and Specificity ; Tuberculosis, Pulmonary ; diagnosis ; microbiology

PURPOSE: Studies suggest that regular use of metformin may decrease cancer mortality. We investigated the association between diabetes medication use and cancer survival. MATERIALS AND METHODS: The current study includes 633 breast, 890 colorectal, 824 lung, and 543 gastric cancer cases identified from participants of two population-based cohort studies in Shanghai. Information on diabetes medication use was obtained by linking to electronic medical records. The associations between diabetes medication use (metformin, sulfonylureas, and insulin) and overall and cancer-specific survival were evaluated using time-dependent Cox proportional hazards models. RESULTS: After adjustment for clinical characteristics and treatment factors, use of metformin was associated with better overall survival among colorectal cancer patients (hazards ratio [HR], 0.55; 95% confidence interval [CI], 0.34 to 0.88) and for all four types of cancer combined (HR, 0.75; 95% CI, 0.57 to 0.98). Ever use of insulin was associated with worse survival for all cancer types combined (HR, 1.89; 95% CI, 1.57 to 2.29) and for the four cancer types individually. Similar associations were seen for diabetic patients. Sulfonylureas use was associated with worse overall survival for breast or gastric cancer (HR, 2.87; 95% CI, 1.22 to 6.80 and HR, 2.05; 95% CI, 1.09 to 3.84, respectively) among diabetic patients. Similar association patterns were observed between diabetes medication use and cancer-specific survival. CONCLUSION: Metformin was associated with improved survival among colorectal cancer cases, while insulin use was associated with worse survival among patients of four major cancers. Further investigation on the topic is needed given the potential translational impact of these findings.
Breast ; Cohort Studies ; Colorectal Neoplasms ; Electronic Health Records ; Humans ; Insulin ; Lung ; Metformin ; Mortality ; Proportional Hazards Models ; Stomach Neoplasms

Objective:To investigate the impact of dexamethasone on the balance of natural regulatory T cells(nTreg) and typeⅠ regulatory T cell(Tr1) in vitro.Methods:Peripheral blood lymphocytes(PBMCs) recruited from healthy donor,divided into dexam-ethasone stimulus group and negative control group.After 3 days treatment,cells were stained.The expression of CD25,CD127, Lymphocyte-activation 3 (LAG-3) and Forkhead box P3 (Foxp3) and frequency of Treg and Tr1 were analyzed by flow cytometry.Results:Compared to the control group,after stimulation with dexamethasone for 3 days,the percentage of CD4+T cells increased in a dose-dependent manner.The expression of CD25 and Foxp3 in CD4+T cells decreased significantly (P=0.006, P<0.000 1),while CD127 and LAG-3 expression increased significantly in CD4+T cells (P<0.000 1,P=0.011).Dexamethasone treatment significantly enhance the frequency of Tr1(P=0.051),reduce the frequency of Treg (P<0.001),and the ratio of Tr1/Treg also increased(P=0.044).Conclusion:Short-term treatment with dexamethasone in vitro change the balance of natural regulatory and type Ⅰ regulatory T cells.

Objective To investigate the association of GNA 11 gene polymorphisms with idiopathic hypoparathyroidism (IHP) and its complications. Methods Two hundred and three patients with IHP and 209 control subjects were recruited at Peking Union Medical College Hospital from December 1987 to December 2015. The GNA11 gene polymorphisms were selected and genotyped by Sequenom MassArray iPLEX system.Results The minor allele T of rs308060 was associated with an increased risk of IHP in the additive [OR = 2.505(1.005-6.245) , P＜0.05; OR=3.269(1.264-8.458), P＜0.05]and recessive model[OR= 2.727(1.105-6.727), P＜0.05]. Although no significant difference was found in the incidence of intracranial calcification and cataract in IHP patients, the haplotype CTCGCT consisting of minor allele T of rs308060 was correlated with their 24 hours urinary calcium levels (β = 0. 186, P＜0.05). Conclusions The minor allele T of rs308060 in GNA11 means high risk of IHP, and is positively correlated with urinary calcium excretion in IHP patients after treatment with oral calcium and vitamin D analogs supplements.

Objective To evaluate the AChE and nAChR in the NMJ and the morphology of the muscle in the bilateral triceps surae after the unilateral shock wave therapy. Method 60 male New Zealand rabbits weighing (2± 0.2) Kg were used in this study. Two thousand shock waves at an energy flux density of 1.5bar and the frequency of 10Hz were applied to their left calf muscles. Divided into six groups, both sides of the triceps muscle of calf were taken out on the day of the shock wave and the1,2,4,6 and 8 weeks after the treatment. HE staining was used to observe the morphological changes of muscle tissue and the average optical density was measured after AChE stain so as to calculate the receptor count after Acetylcholine receptor immunohistochemistry. Result No abnormal morphological abnormalities were observed in all rabbits. In the first five groups, the AChE was significantly higher in the side of the shockwave treatment compairing with the control side (<0.05),slow decrease after 1 week after the treatment. In the first five groups, the nAChR was significantly lower in the side of the shock wave treatment compairing with the control side ( <0.05), and gradually increased to normal after 8 weeks. Conslusion Suitable dose of shock wave will not have a greater impact on morphology of muscle tissue. After the shock wave treatment, the amount and degree of stimulate of muscle cells were decreased, and the production of action potentials was reduced. While the experimental side AchE and AchR in shock wave treatment day to 8 weeks after treatment showed a significant trend to normal, it shows that the effect of shock wave on NMJ is transient and reversible.

We delineated the molecular characteristic of recombinant strain GⅡ.P16/GⅡ.2 of norovirus associated with acute viral gastroenteritis outbreaks in Fujian Province in winter of 2016.Norovirus were detected in specimens of patients collected from the gastroenteritis outbreaks by real time reverse transcription-PCR and reverse transcription-PCR (RT-PCR).The PCR products of the positive samples were purified,and partial RNA dependent RNA polymerase (RdRp) gene and partial capsid gene were sequenced.The sequences were analyzed using bioinformatics software and online database,and phylogenetic tree were also constructed.Norovirus were detected in all 18 stools.Analysis of 9 positive sequences indicated an emergence of norovirus GⅡ.P16/ GⅡ.2 and confirmed being the cause of gastroenteritis outbreaks.All the strains shared homology of 98％ with strains of Kawasaki 194 of Japan detected in 2016 and 97.7％-98.8％ with IPH2161-08VG06 of Belgium detected in 2008,RdRp and capsid separately.These outbreak strains showed some degree of differences from the predominant strain,2012 Sydney GⅡ.4 variant.This is the first time to have found norovirus GⅡ.P16/ GⅡ.2 causing viral gastroenteritis outbreaks in Fujian.More in-depth analysis of the Norovirus GⅡ.P16/ GⅡ.2 could be useful to optimize preventative strategies and develop new and more effective therapeutic measure.

Objective To evaluate the effects of combined lifestyle-related factors and risk of cancer incidence among adult men in urban Shanghai.Methods Information was obtained from 60 817 men in the Shanghai Men' s Health Study (2002-2006) program and 2033 incident cancers who were confirmed at the end of 2009.A healthy lifestyle score (HLS) system was developed,based on five lifestyle-related factors,and participants were scored one point for each of the healthy behaviour:never smoked,alcohol intake less than 1 drink/day,under normal weight range (18.5-27.9 kg/m2),physical activity (≥ 54 Met-hours/week),fruit and vegetable intake ≥451 g/day,the else would score as zero.The total score would range from zero to five.Cox regression model was used to evaluate the associations between combined lifestyle-related factors and the cancer incidence.Results Compared to men having scores as zero or one,the hazard ratios (95％ confidence intervals) for men with two,three,four,five health behaviour scores were 0.77 (95％CI:0.66,0.90),0.67 (95％CI:0.58,0.78),0.56(95％ CI:0.47,0.65),0.51 (95％ CI:0.42,0.62),respectively.The population attributable risks for cancer incidence was 10.4％ for those having scores less than 3 items.Conclusion Never smoked,moderate alcohol intake,maintaining normal weight,being physically fit,and having enough daily fruit and vegetable intake were associated with lower risk of total cancer incidence in men.Our data showed that healthy lifestyle could significantly benefit the public health programs of the population.

ABO blood type has been associated with risk of several malignancies. However, results are not consistent. In this population-based case-control study including 1204 incident endometrial cancer cases and 1212 population controls, we examined the association of self-reported serologic blood type with endometrial cancer risk using a logistic regression model. Women with endometrial cancer were more likely to have blood type A. Compared to women with blood type O, the adjusted odds ratios for endometrial cancer were 1.00 [95% confidence interval (CI), 0.79-1.28] for type B, 1.24 (95% CI, 0.90-1.69) for type AB, and 1.50 (95% CI, 1.19-1.90) for type A. A significant dose-response relationship was observed for cancer risk and level of antigen A (P for trend = 0.0003). The positive association of blood type A with cancer risk was observed regardless of menopausal status, body mass index, oral contraceptive use, or family cancer history. Our results suggest that ABO blood type may be involved in the development of endometrial cancer.
ABO Blood-Group System ; Adult ; Aged ; Body Mass Index ; Case-Control Studies ; China ; epidemiology ; Confidence Intervals ; Contraceptives, Oral ; adverse effects ; Endometrial Neoplasms ; blood ; chemically induced ; etiology ; Female ; Humans ; Logistic Models ; Middle Aged ; Odds Ratio ; Risk Factors