As global greenhouse gases continue rising,the urgency of more ambitious action is clearer than ever before.China is the world’s biggest emitter of greenhouse gases and one of the countries affected most by climate c...As global greenhouse gases continue rising,the urgency of more ambitious action is clearer than ever before.China is the world’s biggest emitter of greenhouse gases and one of the countries affected most by climate change.The evidence about the impacts of climate change on the environment and human health may encourage China to take more decisive action to mitigate greenhouse gas emissions and adapt to climate impacts.展开更多
Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repe...Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted.Biological samples,including morning urine and venous blood,were collected to measure concentrations of 29 typical organic pollutants,including hydroxy polycyclic aromatic hydrocarbons(OH-PAHs),bisphenol A and its substitutes,phthalates and their metabolites,parabens,and five biomarkers of oxidative stress.Health assessments included blood pressure measurements and lung function indicators.Results Urinary concentrations of 2-hydroxyphenanthrene(2-OH-PHE)(β=4.35%[95%confidence interval(CI):0.85%,7.97%]),3-hydroxyphenanthrene(β=3.44%[95%CI:0.19%,6.79%]),and 4-hydroxyphenanthrene(4-OH-PHE)(β=5.78%[95%CI:1.27%,10.5%])were significantly and positively associated with systolic blood pressure.Exposures to 1-hydroxypyrene(1-OH-PYR)(β=3.05%[95%CI:−4.66%,−1.41%]),2-OH-PHE(β=2.68%[95%CI:−4%,−1.34%]),and 4-OH-PHE(β=3%[95%CI:−4.68%,−1.29%])were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity.These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health.Biomarkers of oxidative stress,including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase,mediated the effects of multiple OH-PAHs on blood pressure and lung function.展开更多
Stromal vascular fraction(SVF)is a complex mixture derived from adipose tissue,consisting of a variety of cells.Due to its potential for tissue repair,immunomod-ulation,and support of angiogenesis,SVF represents a pro...Stromal vascular fraction(SVF)is a complex mixture derived from adipose tissue,consisting of a variety of cells.Due to its potential for tissue repair,immunomod-ulation,and support of angiogenesis,SVF represents a promising frontier in regenerative medicine and offers potential therapy for a range of disease condi-tions.In this article,we delve into the mechanisms through which SVF exerts its effects and explore its potential applications in treating both male and female reproductive disorders,including erectile dysfunction,testicular injury,stress urinary incontinence and intrauterine adhesion.展开更多
Background Genitourinary cancers constitute a significant portion of the global cancer burden and have emerged as a prominent cause of cancer-related mortality.However,there remains a paucity of up-to-date statistical...Background Genitourinary cancers constitute a significant portion of the global cancer burden and have emerged as a prominent cause of cancer-related mortality.However,there remains a paucity of up-to-date statistical analyses that meticulously examine the global and national shifts in the epidemiology of genitourinary cancers.Our study aimed to provide a comprehensive understanding of the global distribution and progression of genitourinary cancers through analyses of the recently updated 2021 Global Burden of Disease(GBD)database.Methods This study presented the incidence,mortality,disability-adjusted life years(DALYs),and their respective age-standardized rates for four genitourinary cancers(bladder,kidney,prostate,and testicular cancers)by sex,age,and location from 1990 to 2021.Estimates for these data were presented with their 95%uncertainty intervals(UIs).Estimated annual percentage changes(EAPCs)and Bayesian Age-Period-Cohort(BAPC)models were utilized to further quantify the temporal dynamics of age-standardized rates(ASRs)in genitourinary cancers.Countries and territories were categorized according to socio-demographic index(SDI)quintiles.Results Globally,with the exception of a sustained decline in age-standardized incidence rates(ASIRs)for bladder cancer(EAPC=−0.36%),the ASIRs for kidney,prostate,and testicular cancers demonstrated an upward trend from 1990 to 2021(EAPC=0.53%,0.20%,and 1.43%,respectively).In terms of geographical regions,High-income North America had the highest ASIRs for both bladder(13.98 per 100,000 persons[95%UI,12.96 to 14.61])and prostate(47.02 per 100,000 persons[95%UI,44.47 to 49.04])cancers.Southern Latin America recorded the highest ASIRs for kidney(13.44 per 100,000 persons[95%UI,12.27 to 14.73])and testicular(4.98 per 100,000 persons[95%UI,4.33 to 5.72])cancers.Additionally,Central Europe(1.25%[95%CI,1.12%to 1.38%]),East Asia(2.40%[95%CI,2.21%to 2.59%]),Eastern Europe(3.74%[95%CI,3.55%to 3.92%]),and the Caribbean(5.52%[95%CI,4.32%to 6.74%])exhibited the highest EAPCs for bladder,kidney,prostate,and testicular cancers,respectively.Unlike the ASIRs,age-standardized mortality rates(ASMRs)and age-standardized DALYs rates(ASDRs)showed a downward trend over time in all types of genitourinary cancers.The disease burdens of bladder,kidney,and prostate cancers were primarily distributed among older men,while testicular cancer mainly occurred in young men.Smoking remained the primary risk factor for bladder cancer.Meanwhile,high fasting plasma glucose and high body-mass index exerted increasingly significant impacts on bladder and kidney cancers,respectively,during the study period.Projections to 2050 suggest that the global burdens of genitourinary cancers are expected to decline to varying degrees.However,regional disparities in genitourinary cancer burdens are projected to persist.Conclusions Although the results demonstrate a marginal decline in ASRs caused by genitourinary cancers,they still impose a considerable global burden and result in numerous deaths.Our study obtained and analyzed the latest epidemiological data of genitourinary cancers from the GBD 2021,offering valuable information for national healthcare professionals and policymakers to optimize resource allocation,manage costs more efficiently,and develop practical healthcare policies.展开更多
Objective Exposure to polycyclic aromatic hydrocarbons(PAHs)or metal(loid)s individually has been associated with neural tube defects(NTDs).However,the impacts of PAH and metal(loid)co-exposure and potential interacti...Objective Exposure to polycyclic aromatic hydrocarbons(PAHs)or metal(loid)s individually has been associated with neural tube defects(NTDs).However,the impacts of PAH and metal(loid)co-exposure and potential interaction effects on NTD risk remain unclear.We conducted a case-control study in China among population with a high prevalence of NTDs to investigate the combined effects of PAH and metal(loid)exposures on the risk of NTD.Methods Cases included 80 women who gave birth to offspring with NTDs,whereas controls were 50 women who delivered infants with no congenital malformations.We analyzed the levels of placental PAHs using gas chromatography and mass spectrometry,PAH-DNA adducts with 32P-post-labeling method,and metal(loid)s with an inductively coupled plasma mass spectrometer.Unconditional logistic regression was employed to estimate the associations between individual exposures and NTDs.Least absolute shrinkage and selection operator(LASSO)penalized regression models were used to select a subset of exposures,while additive interaction models were used to identify interaction effects.Results In the single-exposure models,we found that eight PAHs,PAH-DNA adducts,and 28 metal(loid)s were associated with NTDs.Pyrene,selenium,molybdenum,cadmium,uranium,and rubidium were selected through LASSO regression and were statistically associated with NTDs in the multiple-exposure models.Women with high levels of pyrene and molybdenum or pyrene and selenium exhibited significantly increased risk of having offspring with NTDs,indicating that these combinations may have synergistic effects on the risk of NTDs.Conclusion Our findings suggest that individual PAHs and metal(loid)s,as well as their interactions,may be associated with the risk of NTDs,which warrants further investigation.展开更多
The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associ...The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associated with both Cu and PTB.Therefore,we explored the association of blood Cu in the first trimester with the risk of PTB and its subtypes,as well as the potential mediating effect of serum lipid using a nested case-control study.The concentrations of Cu in the serum and blood cells,and serum lipids in the first trimester were measured.The concentration of Cu in whole blood was calculated based on hematocrit.Compared to the lowest tertile of Cu concentrations in the first trimester,the highest tertile of Cu significantly increased the risk of SPB with adjusted odds ratios(AORs)of 2.75(95% confidence interval(CI):1.41-5.34)for serum and 3.75(95% CI:1.21-11.60)for whole blood,and significantly increased the risk of IPB with AORs of 3.25(95%CI:1.06-9.94)for blood cells.According to the mediation analysis,the indirect effect of triglyceride(β=0.016,95%CI:0.0002-0.042)was the only significant effect in the association between Cu and SPB,with the mediating proportion of 9.8%(95%CI:0.2%-33.4%).It suggested that a high level of serum Cu may be associated with an increased risk of SPB with a possible mediator of serum triglyceride,and a high level of blood cell Cu may be associated with an increased risk of IPB.展开更多
Precise formation of complex neural circuits in the spinal cord,achieved through the integration of diverse neuronal populations,is essential for central nervous system function.However,the specialization and migratio...Precise formation of complex neural circuits in the spinal cord,achieved through the integration of diverse neuronal populations,is essential for central nervous system function.However,the specialization and migration of human spinal cord neurons remain poorly understood.In this study,we perform single-cell transcriptome sequencing of human spinal cord from Carnegie Stages(CS)16–21 and mouse spinal cord from embryonic day(E)8.0–11.5,complemented by in situ sequencing of human spinal cord(CS 16–20).Our results reveal the critical role of the precursor state in neuronal differentiation and migration,identifying key transcription factors that regulate these processes across species.Notably,each neuronal lineage expresses unique markers as early as the progenitor stage at the spinal cord midline,and subsequently undergoes a shared transcriptional program during precursor commitment that guides migration.This synchronized migration,validated by spatial transcriptomics,occurs in both dorsal and ventral regions.Our findings offer important insights into the migration patterns and regulatory factors that guide spinal cord neuron subtype specification during embryogenesis.展开更多
BACKGROUND Following cesarean section,a significant number of women encounter moderate to severe pain.Inadequate management of acute pain post-cesarean section can have far-reaching implications,adversely impacting ma...BACKGROUND Following cesarean section,a significant number of women encounter moderate to severe pain.Inadequate management of acute pain post-cesarean section can have far-reaching implications,adversely impacting maternal emotional wellbeing,daily activities,breastfeeding,and neonatal care.It may also impede maternal organ function recovery,leading to escalated opioid usage,heightened risk of postpartum depression,and the development of chronic postoperative pain.Both the Chinese Enhanced Recovery After Surgery(ERAS)guidelines and the American ERAS Society guidelines consistently advocate for the adoption of multimodal analgesia protocols in post-cesarean section pain management.Esketamine,functioning as an antagonist of the N-Methyl-D-Aspartate receptor,has been validated for pain management in surgical patients and has exhibited effectiveness in depression treatment.Research has suggested that incorporating esketamine into postoperative pain management via pain pumps can lead to improvements in short-term depression and pain outcomes.This study aims to assess the efficacy and safety of administering a single dose of esketamine during cesarean section.AIM To investigate the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.METHODS A total of 315 women undergoing elective cesarean section under combined spinal-epidural anesthesia were randomized into three groups:low-dose esketamine(0.15 mg/kg),high-dose esketamine(0.25 mg/kg),and control(saline).Postoperative Visual Analog Scale(VAS)scores were recorded at 6 hours,12 hours,24 hours,and 48 hours.Edinburgh Postnatal Depression Scale(EPDS)scores were noted on 2 days,7 days and 42 days.Ramsay sedation scores were assessed at specified intervals post-injection.Postoperative adverse reactions were also recorded.RESULTS Low-dose group and high-dose group compared to control group,had significantly lower postoperative VAS pain scores at 6 hours 12 hours,and 24 hours(P<0.05),with reduced analgesic usage(P<0.05).EPDS scores and postpartum depression rates were significantly lower on 2 days and 7 days(P<0.05).No significant differences in first exhaust and defecation times were observed(P>0.05),but ambulation times were shorter(P<0.05).Ramsay scores were higher at 5 minutes,15 minutes,and upon room exit(P<0.05).Low-dose group and high-dose group had higher incidences of hallucination,lethargy,and diplopia within 2 hours(P<0.05),and with low-dose group had lower incidences of hallucination,lethargy,and diplopia than high-dose group(P<0.05).CONCLUSION Esketamine enhances analgesia and postpartum recovery;a 0.15 mg/kg dose is optimal for cesarean sections,balancing efficacy with minimized adverse effects.展开更多
DearEditor,Congenital hypogonadotropic hypogonadism(CHH)is a rare genetic disease characterized by gonadotropin-releasing hormone(GnRH)deficiency or insufficiency and normal hypothalamic-pituitary structures,resulting...DearEditor,Congenital hypogonadotropic hypogonadism(CHH)is a rare genetic disease characterized by gonadotropin-releasing hormone(GnRH)deficiency or insufficiency and normal hypothalamic-pituitary structures,resulting in defective sexual maturation or/and infertility.!CHH presents as a variety of nonreproductive phenotypes,such as renal hypoplasia,dental hypoplasia,or oculomotor abnormalities.展开更多
Background Depressive symptoms and cognitive impairment often interact,rendering their associations controversial.To date,their joint trajectories and associations with dementia and death remain underexplored.Aims To ...Background Depressive symptoms and cognitive impairment often interact,rendering their associations controversial.To date,their joint trajectories and associations with dementia and death remain underexplored.Aims To explore the interactions between depressive symptoms and cognitive function,their developmental trajectories and the associations with all-cause dementia,Alzheimer’s disease(AD)and all-cause death in older adults.Methods Data were from the Health and Retirement Study.Depressive symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status,respectively.All-cause dementia and AD were defined by self-reported or proxy-reported physician diagnoses.All-cause death was determined by interviews.The restricted cubic spline,group-based trajectory modelling and subdistribution hazard regression were used.Results Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found,especially in women(p for interaction<0.05).Independent trajectory analysis showed that emerging or high(vs no)depressive trajectories and poor or rapidly decreased cognitive trajectories(vs very good)from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia,AD and all-cause death.15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined,where rapidly decreased cognitive function was more common in those with no depressive symptoms.Compared with older adults with the trajectory of no depressive symptoms and very good cognitive function,those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death,with subdistribution hazard ratios(95%confidence intervals)of 4.47(2.99 to 6.67)and 1.84(1.43 to 2.36),especially in women.Conclusions To effectively mitigate the risk of dementia and death,it is crucial to acknowledge the importance of preventing cognitive decline in older adults without depressive symptoms,particularly in women.展开更多
Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 pat...Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively.Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk.Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.展开更多
The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cy...The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.展开更多
Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and ...Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and to explore the determinants like geographic factor.Methods This study was conducted in women at mid-pregnancy, late-pregnancy and postpartum from southern, central and northern China. Approximately 132 women were included in each stratum by the three phases and regions. Plasma Hcy concentrations were assessed using high-performance liquid chromatography(HPLC), with hyperhomocysteinemia defined as > 10.0 μmol/L. Quantile regression was to estimate medians and interquartile ranges(IQRs), and logistic regression to examine the determinants of hyperhomocysteinemia.Results For 1,190 women included, the median(IQR) Hcy concentration was 5.66(4.62, 7.37) μmol/L.The adjusted median in mid-pregnancy, late-pregnancy and postpartum women was 4.75(4.13, 5.54),5.72(4.81, 6.85) and 7.09(5.65, 8.75) μmol/L, respectively, showing an increasing trend(P < 0.001). This increasing trend persisted across the three regions. Higher Hcy concentrations were observed in women residing in northern region and those with younger age or lower economic status. A total of 106(8.9%)women had hyperhomocysteinemia, with a higher prevalence in those residing in northern region(16.0%), or in postpartum women(16.5%).Conclusion Hcy levels, varying with geographic region, maternal age and economic status, are increased from mid-pregnancy to late-pregnancy and postpartum, indicating a need to monitor Hcy levels in pregnant and postpartum women to control potential risks related to elevated Hcy levels.展开更多
BACKGROUND There are conflicting results on the potential correlation between folic acid and gestational diabetes mellitus(GDM),and the correlation between genetic factors related to folic acid metabolism pathways and...BACKGROUND There are conflicting results on the potential correlation between folic acid and gestational diabetes mellitus(GDM),and the correlation between genetic factors related to folic acid metabolism pathways and GDM remains to be revealed.AIM To examine the association between single-nucleotide polymorphisms(SNPs)of enzyme genes in the folate metabolite pathway as well as that between GDM-related genes and risk for GDM.METHODS A nested case-control study was conducted with GDM cases(n=412)and healthy controls(n=412).DNA was extracted blood samples and SNPs were genotyped using Agena Bioscience’s MassARRAY gene mass spectrometry system.The associations between different SNPs of genes and the risk for GDM were estimated using logistic regression models.The generalized multi-factor dimensionality reduction(GMDR)method was used to analyze gene-gene and gene-environment interactions using the GMDR 0.9 software.RESULTS The variation allele frequency of melatonin receptor 1B(MTNR1B)rs10830963 was higher in the GDM group than in controls(P<0.05).MTNR1B rs10830963 mutant G was associated with risk for GDM[adjusted odds ratio(aOR):1.43;95%confidence interval(95%CI):1.13-1.80]in the additive model.MTNR1B rs10830963 GG+GC was significantly associated with the risk for GDM(aOR:1.65;95%CI:1.23-2.22)in the dominant model.The two-locus model of MTNR1B rs10830963 and CHEMERIN rs4721 was the best model(P<0.05)for gene-gene interactions in the GMDR results.The high-risk rs10830963×rs4721 type of interaction was a risk factor for GDM(aOR:2.09;95%CI:1.49-2.93).CONCLUSION This study does not find an association between SNPs of folate metabolic enzymes and risk for GDM.The G mutant allele of MTNR1B rs10830963 is identified as a risk factor for GDM in the additive model,and there may be gene-gene interactions between MTNR1B rs10830963 and CHEMERIN rs4721.It is conducive to studying the causes of GDM and provides a new perspective for the precise prevention of this disease.展开更多
Background We performed an umbrella review to synthesize evidence on the effects of physical activity(PA)interventions on indicators of physical and psychological health among children and adolescents,including body m...Background We performed an umbrella review to synthesize evidence on the effects of physical activity(PA)interventions on indicators of physical and psychological health among children and adolescents,including body mass index(BMI),blood pressure(BP),depressive symptoms,and cognitive function.Methods PubMed,Embase,Web of Science,and the Cochrane Library were systematically searched from inception through 31 July 2023.We included meta-analyses of randomized controlled trials exploring the effects of PA interventions on BMI,BP,depressive symptoms,or cognitive function in healthy or general children and adolescents.Standard Mean Difference(SMD)was calculated for continuous outcome indicators,while Relative Risk(RR)was calculated for categorical outcome indicators.Results A total of 21 meta-analyses were included.The evidence for the effects of PA interventions on reducing BMI[n=68,368,SMD=-0.04,95%confidence interval(CI)=-0.07 to-0.01,P=0.012,P=46.6%],relieving diastolic BP(n=8204,SMD=-1.16,95%CI=-2.12 to-0.20,P=0.018,P=83.1%),preventing depressive symptoms(n=5146,SMD=-0.21,95%CI=-0.31 to-0.12,P<0.001,P=29.0%),and promoting cognitive function(n=19,955,SMD=0.40,95%CI=0.27-0.54,P<0.001,P?=88.0%)was all weak but significant(class IV evidence).Subgroup analyses demonstrated that school-based and after-school PA interventions,curricular PA interventions,and PA interventions emphasizing enjoyment were more effective in reducing BMI,while curricular PA and sports programs achieved greater executive function.Conclusion PA interventions could weakly reduce BMI,relieve BP,prevent depressive symptoms,and promote cognitive function in general children and adolescents.Targeted interventions on PA should be a priority to promote physical and psychological health for children and adolescents,especially the curricular PA emphasizing enjoyment in the school settings.展开更多
Objective: The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a p...Objective: The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a populationbased cancer registry.Methods: Data on the incidence of cancer from 2000 to 2016 were obtained from the Beijing Cancer Registry.We examined trends in the sex-specific, age-standardized incidence of lung cancer by histological type using a Joinpoint regression model.Results: A total of 117,409 cases of lung cancer were diagnosed from 2000 to 2016. Overall, 73,062(62.23%)patients were males. The most common histological type among both sexes was adenocarcinoma; however, the proportion of adenocarcinoma differed significantly between males and females(45.36% vs. 77.14%, respectively,P<0.0001). The age-standardized incidence of total lung cancer increased from 2000 to 2010 with an annual percent change(APC) of 2.2% [95% confidence interval(95% CI), 1.5% to 2.9%] and stabilized thereafter. Among males, the incidence of total lung cancer peaked in 2008 and then decreased slightly, with an APC of-1.1%(95%CI,-2.1% to-0.1%). Among females, the incidence increased continuously during the study period, with an APC of 1.4%(95% CI, 0.9% to 1.9%). The incidence of squamous cell carcinoma decreased significantly in recent years among both sexes, with APCs of-2.6%(95% CI,-4.5% to-0.6%) from 2007 to 2016 for males and-5.4%(95%CI,-7.2% to-3.6%) from 2004 to 2016 for females. In contrast, the incidence of adenocarcinoma increased continuously throughout the study period, by APCs of 4.0%(95% CI, 2.6% to 5.4%) for males and 6.2%(95% CI,4.8% to 7.6%) for females. The incidence of small cell carcinoma peaked in 2007 and stabilized thereafter among males, whereas it peaked in 2012 and then decreased with an APC of-14.7%(95% CI,-25.3% to-2.6%) among females. The incidence of large cell carcinoma and other specified malignant neoplasm did not change much,whereas the incidence of unspecified type decreased among both sexes during the study period.Conclusions: Although the incidence of squamous cell carcinoma decreased significantly among both sexes in recent years in Beijing, China, adenocarcinoma increased continuously throughout the study period among both sexes. Knowledge of differences in trends is useful for surveillance and control of lung cancer. However, the reason for the increase in adenocarcinoma remains unclear and warrants investigation.展开更多
Neural tube defects(NTDs) are a group of congenital malformations of the central nervous system that are caused by the closure failure of the embryonic neural tube by the 28 th day of conception. Anencephaly and spina...Neural tube defects(NTDs) are a group of congenital malformations of the central nervous system that are caused by the closure failure of the embryonic neural tube by the 28 th day of conception. Anencephaly and spina bifida are the two major subtypes. Fetuses with anencephaly are often stillborn or electively aborted due to prenatal diagnosis, or they die shortly after birth. Most infants with spina bifida are live-born and, with proper surgical treatment, can survive into adulthood. However, these children often have life-long physical disabilities. China has one of the highest prevalence of NTDs in the world. Inadequate dietary folate intake is believed to be the main cause of the cluster. Unlike many other countries that use staple fortification with folic acid as the public health strategy to prevent NTDs, the Chinese government provides all women who have a rural household registration and who plan to become pregnant with folic acid supplements, free of charge, through a nation-wide program started in 2009. Two to three years after the initiation of the program, the folic acid supplementation rate increased to 85% in the areas of the highest NTD prevalence. The mean plasma folate level of women during early and mid-pregnancy doubled the level before the program was introduced. However, most women began taking folic acid supplements when they knew that they were pregnant. This is too late for the protection of the embryonic neural tube. In a postprogram survey of the women who reported folic acid supplementation, less than a quarter of the women began taking supplements prior to pregnancy, indicating that the remaining three quarters of the fetuses remained unprotected during the time of neural tube formation. Therefore, staple food fortification with folic acid should be considered as a priority in the prevention of NTDs.展开更多
Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited...Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited.Aims This cross-sectional study aimed to investigate the correlations between intrafamilial and social ACEs,their associations with depressive symptoms and cognitive impairment and the(education-moderated)mediating role of social ACEs.Methods Data for this cross-sectional study were from the China Health and Retirement Longitudinal Study.Nine intrafamilial(0,1,2,3,and 4 or more)and three social(0,1,and 2 or more)ACEs were identified.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale.Global cognition,including episodic memory and mental intactness,was calculated as z scores.Binary and ordered logistic regressions,generalised linear models with Gaussian family and identity link,and mediation analysis were used.Results 13435 participants aged 59.0(51.0–66.0)were included.Compared with participants with no intrafamilial ACEs,those with 1,2,3,and 4 or more intrafamilial ACEs tended to develop more social ACEs,with odds ratios(ORs)of 1.55(95%confidence interval(CI):1.36 to 1.76),2.36(95%CI:2.08 to 2.68),3.46(95%CI:3.02 to 3.96)and 6.10(95%CI:5.30 to 7.02),respectively.Both intrafamilial and social ACEs were associated with depressive symptoms(OR>3 for four or more intrafamilial ACEs and two or more social ACEs)and global cognition(β=−0.26 for four or more intrafamilial ACEs andβ=−0.29 for two or more social ACEs).Social ACEs mediated the associations of intrafamilial ACEs with depressive symptoms and global cognition by 12.3%and 13.1%,respectively.Furthermore,as education levels increased,the impact of intrafamilial ACEs on depressive symptoms was increasingly mediated through social ACEs,while the mediating role of social ACEs between intrafamilial ACEs and cognitive impairment gradually diminished.Conclusions Improving children’s social environments and elevating general education can prevent later-life depressive symptoms and cognitive impairment attributed to ACEs in China.展开更多
Objective: Adjuvant chemotherapy (AC) after curative resection is known to improve the survival of patients with non-small cell lung cancer (NSCLC); however, few studies have reported the correlation between the time ...Objective: Adjuvant chemotherapy (AC) after curative resection is known to improve the survival of patients with non-small cell lung cancer (NSCLC); however, few studies have reported the correlation between the time to initiation of AC (TTAC) and survival in NSCLC patients. Methods: The clinical data of 925 NSCLC patients who received curative resection and post-operative AC at the Cancer Hospital of Chinese Academy of Medical Sciences between 2003 and 2013 were retrospectively analyzed. TTAC was measured from the date of surgery to the initiation of AC. Disease-free survival (DFS) was defined as the duration from surgery to the time of tumor recurrence or last follow-up evaluation. The optimal cut-off value of TTAC was determined by maximally selected log-rank statistics. The DFS curve was estimated using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to identify risk factors independently associated with DFS. Propensity score matching (PSM) was performed for survival analysis using the match data. Results: The optimal discriminating cut-off value of TTAC was set at d 35 after curative resection based on which the patients were assigned into two groups: group A (<= 35 d) and group B (> 35 d). There was no significant difference in the DFS between the two groups (P=0.246), indicating that the TTAC is not an independent prognostic factor for DFS. A further comparison continued to show no significant difference in the DFS among 258 PSM pairs (P=0.283). Conclusions: There was no significant correlation between the TTAC and DFS in NSCLC patients. Studies with larger samples are needed to further verify this conclusion.展开更多
Acephalic spermatozoa syndrome(ASS)is one of the most severe spermatogenic failures of all infertility in men.The cognition of ASS has experienced a tortuous process.Over the past years,with the in-depth understanding...Acephalic spermatozoa syndrome(ASS)is one of the most severe spermatogenic failures of all infertility in men.The cognition of ASS has experienced a tortuous process.Over the past years,with the in-depth understanding of spermatogenesis and the emergence of new genetic research technologies,the unraveling of the genetic causes of spermatogenic failure has become highly active.From these advances,we established a genetic background and made significant progress in the discovery of the genetic causes of ASS.It is important to identify pathogenic genes and mutations in ASS to determine the biological reasons for the occurrence of the disease as well as provide genetic diagnosis and treatment strategies for patients with this syndrome.In this review,we enumerate various technological developments,which have made a positive contribution to the discovery of candidate genes for ASS from the past to the present.Simultaneously,we summarize the known genetic etiology of this phenotype and the clinical outcomes of treatments in the present.Furthermore,we propose perspectives for further study and application of genetic diagnosis and assisted reproductive treatment in the future.展开更多
基金supported by the National Natural Science Foundation of China(No.82025030,No.72394404)the National Key Research and Development Program of China(No.2022YFC3702700)the National Research Program for Key Issues in Air Pollution Control of China(No.DQGG0401).
文摘As global greenhouse gases continue rising,the urgency of more ambitious action is clearer than ever before.China is the world’s biggest emitter of greenhouse gases and one of the countries affected most by climate change.The evidence about the impacts of climate change on the environment and human health may encourage China to take more decisive action to mitigate greenhouse gas emissions and adapt to climate impacts.
基金supported by the National Key Research&Development Program of the Ministry of Science and Technology of China(2022YFE0134900,2023YFC3708305,2023YFC3708302)Strategy Priority Research Program(Category B)of the Chinese Academy of Sciences(No.XDB0750300)National Natural Science Foundation of China(Grant No.42477455,42077390).
文摘Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted.Biological samples,including morning urine and venous blood,were collected to measure concentrations of 29 typical organic pollutants,including hydroxy polycyclic aromatic hydrocarbons(OH-PAHs),bisphenol A and its substitutes,phthalates and their metabolites,parabens,and five biomarkers of oxidative stress.Health assessments included blood pressure measurements and lung function indicators.Results Urinary concentrations of 2-hydroxyphenanthrene(2-OH-PHE)(β=4.35%[95%confidence interval(CI):0.85%,7.97%]),3-hydroxyphenanthrene(β=3.44%[95%CI:0.19%,6.79%]),and 4-hydroxyphenanthrene(4-OH-PHE)(β=5.78%[95%CI:1.27%,10.5%])were significantly and positively associated with systolic blood pressure.Exposures to 1-hydroxypyrene(1-OH-PYR)(β=3.05%[95%CI:−4.66%,−1.41%]),2-OH-PHE(β=2.68%[95%CI:−4%,−1.34%]),and 4-OH-PHE(β=3%[95%CI:−4.68%,−1.29%])were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity.These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health.Biomarkers of oxidative stress,including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase,mediated the effects of multiple OH-PAHs on blood pressure and lung function.
文摘Stromal vascular fraction(SVF)is a complex mixture derived from adipose tissue,consisting of a variety of cells.Due to its potential for tissue repair,immunomod-ulation,and support of angiogenesis,SVF represents a promising frontier in regenerative medicine and offers potential therapy for a range of disease condi-tions.In this article,we delve into the mechanisms through which SVF exerts its effects and explore its potential applications in treating both male and female reproductive disorders,including erectile dysfunction,testicular injury,stress urinary incontinence and intrauterine adhesion.
基金funded by the National Natural Science Foundation of China(grant numbers:82202877 and 8237110369)the Natural Science Foundation of Guangdong Province of China(grant number:2024A1515010599)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(grant number:XMLX202134).
文摘Background Genitourinary cancers constitute a significant portion of the global cancer burden and have emerged as a prominent cause of cancer-related mortality.However,there remains a paucity of up-to-date statistical analyses that meticulously examine the global and national shifts in the epidemiology of genitourinary cancers.Our study aimed to provide a comprehensive understanding of the global distribution and progression of genitourinary cancers through analyses of the recently updated 2021 Global Burden of Disease(GBD)database.Methods This study presented the incidence,mortality,disability-adjusted life years(DALYs),and their respective age-standardized rates for four genitourinary cancers(bladder,kidney,prostate,and testicular cancers)by sex,age,and location from 1990 to 2021.Estimates for these data were presented with their 95%uncertainty intervals(UIs).Estimated annual percentage changes(EAPCs)and Bayesian Age-Period-Cohort(BAPC)models were utilized to further quantify the temporal dynamics of age-standardized rates(ASRs)in genitourinary cancers.Countries and territories were categorized according to socio-demographic index(SDI)quintiles.Results Globally,with the exception of a sustained decline in age-standardized incidence rates(ASIRs)for bladder cancer(EAPC=−0.36%),the ASIRs for kidney,prostate,and testicular cancers demonstrated an upward trend from 1990 to 2021(EAPC=0.53%,0.20%,and 1.43%,respectively).In terms of geographical regions,High-income North America had the highest ASIRs for both bladder(13.98 per 100,000 persons[95%UI,12.96 to 14.61])and prostate(47.02 per 100,000 persons[95%UI,44.47 to 49.04])cancers.Southern Latin America recorded the highest ASIRs for kidney(13.44 per 100,000 persons[95%UI,12.27 to 14.73])and testicular(4.98 per 100,000 persons[95%UI,4.33 to 5.72])cancers.Additionally,Central Europe(1.25%[95%CI,1.12%to 1.38%]),East Asia(2.40%[95%CI,2.21%to 2.59%]),Eastern Europe(3.74%[95%CI,3.55%to 3.92%]),and the Caribbean(5.52%[95%CI,4.32%to 6.74%])exhibited the highest EAPCs for bladder,kidney,prostate,and testicular cancers,respectively.Unlike the ASIRs,age-standardized mortality rates(ASMRs)and age-standardized DALYs rates(ASDRs)showed a downward trend over time in all types of genitourinary cancers.The disease burdens of bladder,kidney,and prostate cancers were primarily distributed among older men,while testicular cancer mainly occurred in young men.Smoking remained the primary risk factor for bladder cancer.Meanwhile,high fasting plasma glucose and high body-mass index exerted increasingly significant impacts on bladder and kidney cancers,respectively,during the study period.Projections to 2050 suggest that the global burdens of genitourinary cancers are expected to decline to varying degrees.However,regional disparities in genitourinary cancer burdens are projected to persist.Conclusions Although the results demonstrate a marginal decline in ASRs caused by genitourinary cancers,they still impose a considerable global burden and result in numerous deaths.Our study obtained and analyzed the latest epidemiological data of genitourinary cancers from the GBD 2021,offering valuable information for national healthcare professionals and policymakers to optimize resource allocation,manage costs more efficiently,and develop practical healthcare policies.
基金supported by the National Key Research and Development Program,Ministry of Science and Technology of the People's Republic of China(Grant No.2021YFC2701001)the National Natural Science Foundation of China(Grant No.81973056).
文摘Objective Exposure to polycyclic aromatic hydrocarbons(PAHs)or metal(loid)s individually has been associated with neural tube defects(NTDs).However,the impacts of PAH and metal(loid)co-exposure and potential interaction effects on NTD risk remain unclear.We conducted a case-control study in China among population with a high prevalence of NTDs to investigate the combined effects of PAH and metal(loid)exposures on the risk of NTD.Methods Cases included 80 women who gave birth to offspring with NTDs,whereas controls were 50 women who delivered infants with no congenital malformations.We analyzed the levels of placental PAHs using gas chromatography and mass spectrometry,PAH-DNA adducts with 32P-post-labeling method,and metal(loid)s with an inductively coupled plasma mass spectrometer.Unconditional logistic regression was employed to estimate the associations between individual exposures and NTDs.Least absolute shrinkage and selection operator(LASSO)penalized regression models were used to select a subset of exposures,while additive interaction models were used to identify interaction effects.Results In the single-exposure models,we found that eight PAHs,PAH-DNA adducts,and 28 metal(loid)s were associated with NTDs.Pyrene,selenium,molybdenum,cadmium,uranium,and rubidium were selected through LASSO regression and were statistically associated with NTDs in the multiple-exposure models.Women with high levels of pyrene and molybdenum or pyrene and selenium exhibited significantly increased risk of having offspring with NTDs,indicating that these combinations may have synergistic effects on the risk of NTDs.Conclusion Our findings suggest that individual PAHs and metal(loid)s,as well as their interactions,may be associated with the risk of NTDs,which warrants further investigation.
基金supported by Beijing Natural Science Foundation(No.7222248)the National Natural Science Foundation of China(No.81673177).
文摘The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associated with both Cu and PTB.Therefore,we explored the association of blood Cu in the first trimester with the risk of PTB and its subtypes,as well as the potential mediating effect of serum lipid using a nested case-control study.The concentrations of Cu in the serum and blood cells,and serum lipids in the first trimester were measured.The concentration of Cu in whole blood was calculated based on hematocrit.Compared to the lowest tertile of Cu concentrations in the first trimester,the highest tertile of Cu significantly increased the risk of SPB with adjusted odds ratios(AORs)of 2.75(95% confidence interval(CI):1.41-5.34)for serum and 3.75(95% CI:1.21-11.60)for whole blood,and significantly increased the risk of IPB with AORs of 3.25(95%CI:1.06-9.94)for blood cells.According to the mediation analysis,the indirect effect of triglyceride(β=0.016,95%CI:0.0002-0.042)was the only significant effect in the association between Cu and SPB,with the mediating proportion of 9.8%(95%CI:0.2%-33.4%).It suggested that a high level of serum Cu may be associated with an increased risk of SPB with a possible mediator of serum triglyceride,and a high level of blood cell Cu may be associated with an increased risk of IPB.
基金supported by the National Key R&D Program of China (2024YFA1802300 and 2023YFF1204701)the National Natural Science Foundation of China (32225012 and 32200662)+3 种基金Major Project of Guangzhou National Laboratory (GZNL2023A02005)Pearl River Talent Recruitment Program (2021ZT09Y233)Science and Technology Planning Project of Guangdong Province,China(2023B1212060050 and 2023B1212120009)Health@Inno HK Program launched by Innovation Technology Commission of the Hong Kong SAR,P.R. China.
文摘Precise formation of complex neural circuits in the spinal cord,achieved through the integration of diverse neuronal populations,is essential for central nervous system function.However,the specialization and migration of human spinal cord neurons remain poorly understood.In this study,we perform single-cell transcriptome sequencing of human spinal cord from Carnegie Stages(CS)16–21 and mouse spinal cord from embryonic day(E)8.0–11.5,complemented by in situ sequencing of human spinal cord(CS 16–20).Our results reveal the critical role of the precursor state in neuronal differentiation and migration,identifying key transcription factors that regulate these processes across species.Notably,each neuronal lineage expresses unique markers as early as the progenitor stage at the spinal cord midline,and subsequently undergoes a shared transcriptional program during precursor commitment that guides migration.This synchronized migration,validated by spatial transcriptomics,occurs in both dorsal and ventral regions.Our findings offer important insights into the migration patterns and regulatory factors that guide spinal cord neuron subtype specification during embryogenesis.
基金the Project of Science and Technology Bureau of Shijiazhuang,Hebei Province,No.201460823.
文摘BACKGROUND Following cesarean section,a significant number of women encounter moderate to severe pain.Inadequate management of acute pain post-cesarean section can have far-reaching implications,adversely impacting maternal emotional wellbeing,daily activities,breastfeeding,and neonatal care.It may also impede maternal organ function recovery,leading to escalated opioid usage,heightened risk of postpartum depression,and the development of chronic postoperative pain.Both the Chinese Enhanced Recovery After Surgery(ERAS)guidelines and the American ERAS Society guidelines consistently advocate for the adoption of multimodal analgesia protocols in post-cesarean section pain management.Esketamine,functioning as an antagonist of the N-Methyl-D-Aspartate receptor,has been validated for pain management in surgical patients and has exhibited effectiveness in depression treatment.Research has suggested that incorporating esketamine into postoperative pain management via pain pumps can lead to improvements in short-term depression and pain outcomes.This study aims to assess the efficacy and safety of administering a single dose of esketamine during cesarean section.AIM To investigate the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.METHODS A total of 315 women undergoing elective cesarean section under combined spinal-epidural anesthesia were randomized into three groups:low-dose esketamine(0.15 mg/kg),high-dose esketamine(0.25 mg/kg),and control(saline).Postoperative Visual Analog Scale(VAS)scores were recorded at 6 hours,12 hours,24 hours,and 48 hours.Edinburgh Postnatal Depression Scale(EPDS)scores were noted on 2 days,7 days and 42 days.Ramsay sedation scores were assessed at specified intervals post-injection.Postoperative adverse reactions were also recorded.RESULTS Low-dose group and high-dose group compared to control group,had significantly lower postoperative VAS pain scores at 6 hours 12 hours,and 24 hours(P<0.05),with reduced analgesic usage(P<0.05).EPDS scores and postpartum depression rates were significantly lower on 2 days and 7 days(P<0.05).No significant differences in first exhaust and defecation times were observed(P>0.05),but ambulation times were shorter(P<0.05).Ramsay scores were higher at 5 minutes,15 minutes,and upon room exit(P<0.05).Low-dose group and high-dose group had higher incidences of hallucination,lethargy,and diplopia within 2 hours(P<0.05),and with low-dose group had lower incidences of hallucination,lethargy,and diplopia than high-dose group(P<0.05).CONCLUSION Esketamine enhances analgesia and postpartum recovery;a 0.15 mg/kg dose is optimal for cesarean sections,balancing efficacy with minimized adverse effects.
基金This research was supported by the Shengjing Hospital Clinical Research Project(No.M0071)345 Talent Project of Shengjing Hospital(No.M1463)to BCP.
文摘DearEditor,Congenital hypogonadotropic hypogonadism(CHH)is a rare genetic disease characterized by gonadotropin-releasing hormone(GnRH)deficiency or insufficiency and normal hypothalamic-pituitary structures,resulting in defective sexual maturation or/and infertility.!CHH presents as a variety of nonreproductive phenotypes,such as renal hypoplasia,dental hypoplasia,or oculomotor abnormalities.
基金This study is funded by the Major Project of the National Social Science Fund of China(21&ZD187).
文摘Background Depressive symptoms and cognitive impairment often interact,rendering their associations controversial.To date,their joint trajectories and associations with dementia and death remain underexplored.Aims To explore the interactions between depressive symptoms and cognitive function,their developmental trajectories and the associations with all-cause dementia,Alzheimer’s disease(AD)and all-cause death in older adults.Methods Data were from the Health and Retirement Study.Depressive symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status,respectively.All-cause dementia and AD were defined by self-reported or proxy-reported physician diagnoses.All-cause death was determined by interviews.The restricted cubic spline,group-based trajectory modelling and subdistribution hazard regression were used.Results Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found,especially in women(p for interaction<0.05).Independent trajectory analysis showed that emerging or high(vs no)depressive trajectories and poor or rapidly decreased cognitive trajectories(vs very good)from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia,AD and all-cause death.15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined,where rapidly decreased cognitive function was more common in those with no depressive symptoms.Compared with older adults with the trajectory of no depressive symptoms and very good cognitive function,those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death,with subdistribution hazard ratios(95%confidence intervals)of 4.47(2.99 to 6.67)and 1.84(1.43 to 2.36),especially in women.Conclusions To effectively mitigate the risk of dementia and death,it is crucial to acknowledge the importance of preventing cognitive decline in older adults without depressive symptoms,particularly in women.
基金supported by the National Key Research&Development Program of the Ministry of Science and Technology of China[Grant No.2022YFE01349002023YFC3708305]+2 种基金the Strategy Priority Research Program(Category B)of Chinese Academy of Sciences[No.XDB0750300]the Yunnan Major Scientific and Technological Projects[Grant No.202202AG050019]the National Natural Science Foundation of China[Grant No.42077390].
文摘Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively.Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk.Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.
基金Hainan Province Major Science and Technology Plan Projects(No.ZDKJ2021037,ZDKJ2017007)National Natural Science Foundation of China(No.81960283),and Co-funded by the Hainan Provincial Academician Innovation Platform Research Project and the Hainan Provincial Clinical Medicine Center Construction Project。
文摘The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.
文摘Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and to explore the determinants like geographic factor.Methods This study was conducted in women at mid-pregnancy, late-pregnancy and postpartum from southern, central and northern China. Approximately 132 women were included in each stratum by the three phases and regions. Plasma Hcy concentrations were assessed using high-performance liquid chromatography(HPLC), with hyperhomocysteinemia defined as > 10.0 μmol/L. Quantile regression was to estimate medians and interquartile ranges(IQRs), and logistic regression to examine the determinants of hyperhomocysteinemia.Results For 1,190 women included, the median(IQR) Hcy concentration was 5.66(4.62, 7.37) μmol/L.The adjusted median in mid-pregnancy, late-pregnancy and postpartum women was 4.75(4.13, 5.54),5.72(4.81, 6.85) and 7.09(5.65, 8.75) μmol/L, respectively, showing an increasing trend(P < 0.001). This increasing trend persisted across the three regions. Higher Hcy concentrations were observed in women residing in northern region and those with younger age or lower economic status. A total of 106(8.9%)women had hyperhomocysteinemia, with a higher prevalence in those residing in northern region(16.0%), or in postpartum women(16.5%).Conclusion Hcy levels, varying with geographic region, maternal age and economic status, are increased from mid-pregnancy to late-pregnancy and postpartum, indicating a need to monitor Hcy levels in pregnant and postpartum women to control potential risks related to elevated Hcy levels.
基金Supported by the National Key Research and Development Program of China,No.2021YFC2700700 and No.2021YFC2700704Capital’s Funds for Health Improvement and Research(CFH)in People’s Republic of China,No.2020-1-5112.
文摘BACKGROUND There are conflicting results on the potential correlation between folic acid and gestational diabetes mellitus(GDM),and the correlation between genetic factors related to folic acid metabolism pathways and GDM remains to be revealed.AIM To examine the association between single-nucleotide polymorphisms(SNPs)of enzyme genes in the folate metabolite pathway as well as that between GDM-related genes and risk for GDM.METHODS A nested case-control study was conducted with GDM cases(n=412)and healthy controls(n=412).DNA was extracted blood samples and SNPs were genotyped using Agena Bioscience’s MassARRAY gene mass spectrometry system.The associations between different SNPs of genes and the risk for GDM were estimated using logistic regression models.The generalized multi-factor dimensionality reduction(GMDR)method was used to analyze gene-gene and gene-environment interactions using the GMDR 0.9 software.RESULTS The variation allele frequency of melatonin receptor 1B(MTNR1B)rs10830963 was higher in the GDM group than in controls(P<0.05).MTNR1B rs10830963 mutant G was associated with risk for GDM[adjusted odds ratio(aOR):1.43;95%confidence interval(95%CI):1.13-1.80]in the additive model.MTNR1B rs10830963 GG+GC was significantly associated with the risk for GDM(aOR:1.65;95%CI:1.23-2.22)in the dominant model.The two-locus model of MTNR1B rs10830963 and CHEMERIN rs4721 was the best model(P<0.05)for gene-gene interactions in the GMDR results.The high-risk rs10830963×rs4721 type of interaction was a risk factor for GDM(aOR:2.09;95%CI:1.49-2.93).CONCLUSION This study does not find an association between SNPs of folate metabolic enzymes and risk for GDM.The G mutant allele of MTNR1B rs10830963 is identified as a risk factor for GDM in the additive model,and there may be gene-gene interactions between MTNR1B rs10830963 and CHEMERIN rs4721.It is conducive to studying the causes of GDM and provides a new perspective for the precise prevention of this disease.
基金supported by grants from the General Administration of Sport of China,the National Natural Science Foundation of China(grant number 82273654 to YS)Natural Science Foundation of Beijing(grant number 7222247 to YS)Beijing Office for Education Sciences Planning(grant number BBAA22027 to YS).
文摘Background We performed an umbrella review to synthesize evidence on the effects of physical activity(PA)interventions on indicators of physical and psychological health among children and adolescents,including body mass index(BMI),blood pressure(BP),depressive symptoms,and cognitive function.Methods PubMed,Embase,Web of Science,and the Cochrane Library were systematically searched from inception through 31 July 2023.We included meta-analyses of randomized controlled trials exploring the effects of PA interventions on BMI,BP,depressive symptoms,or cognitive function in healthy or general children and adolescents.Standard Mean Difference(SMD)was calculated for continuous outcome indicators,while Relative Risk(RR)was calculated for categorical outcome indicators.Results A total of 21 meta-analyses were included.The evidence for the effects of PA interventions on reducing BMI[n=68,368,SMD=-0.04,95%confidence interval(CI)=-0.07 to-0.01,P=0.012,P=46.6%],relieving diastolic BP(n=8204,SMD=-1.16,95%CI=-2.12 to-0.20,P=0.018,P=83.1%),preventing depressive symptoms(n=5146,SMD=-0.21,95%CI=-0.31 to-0.12,P<0.001,P=29.0%),and promoting cognitive function(n=19,955,SMD=0.40,95%CI=0.27-0.54,P<0.001,P?=88.0%)was all weak but significant(class IV evidence).Subgroup analyses demonstrated that school-based and after-school PA interventions,curricular PA interventions,and PA interventions emphasizing enjoyment were more effective in reducing BMI,while curricular PA and sports programs achieved greater executive function.Conclusion PA interventions could weakly reduce BMI,relieve BP,prevent depressive symptoms,and promote cognitive function in general children and adolescents.Targeted interventions on PA should be a priority to promote physical and psychological health for children and adolescents,especially the curricular PA emphasizing enjoyment in the school settings.
基金supported by the Beijing Young Talent Program (No. 20160000 21469G189)
文摘Objective: The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a populationbased cancer registry.Methods: Data on the incidence of cancer from 2000 to 2016 were obtained from the Beijing Cancer Registry.We examined trends in the sex-specific, age-standardized incidence of lung cancer by histological type using a Joinpoint regression model.Results: A total of 117,409 cases of lung cancer were diagnosed from 2000 to 2016. Overall, 73,062(62.23%)patients were males. The most common histological type among both sexes was adenocarcinoma; however, the proportion of adenocarcinoma differed significantly between males and females(45.36% vs. 77.14%, respectively,P<0.0001). The age-standardized incidence of total lung cancer increased from 2000 to 2010 with an annual percent change(APC) of 2.2% [95% confidence interval(95% CI), 1.5% to 2.9%] and stabilized thereafter. Among males, the incidence of total lung cancer peaked in 2008 and then decreased slightly, with an APC of-1.1%(95%CI,-2.1% to-0.1%). Among females, the incidence increased continuously during the study period, with an APC of 1.4%(95% CI, 0.9% to 1.9%). The incidence of squamous cell carcinoma decreased significantly in recent years among both sexes, with APCs of-2.6%(95% CI,-4.5% to-0.6%) from 2007 to 2016 for males and-5.4%(95%CI,-7.2% to-3.6%) from 2004 to 2016 for females. In contrast, the incidence of adenocarcinoma increased continuously throughout the study period, by APCs of 4.0%(95% CI, 2.6% to 5.4%) for males and 6.2%(95% CI,4.8% to 7.6%) for females. The incidence of small cell carcinoma peaked in 2007 and stabilized thereafter among males, whereas it peaked in 2012 and then decreased with an APC of-14.7%(95% CI,-25.3% to-2.6%) among females. The incidence of large cell carcinoma and other specified malignant neoplasm did not change much,whereas the incidence of unspecified type decreased among both sexes during the study period.Conclusions: Although the incidence of squamous cell carcinoma decreased significantly among both sexes in recent years in Beijing, China, adenocarcinoma increased continuously throughout the study period among both sexes. Knowledge of differences in trends is useful for surveillance and control of lung cancer. However, the reason for the increase in adenocarcinoma remains unclear and warrants investigation.
文摘Neural tube defects(NTDs) are a group of congenital malformations of the central nervous system that are caused by the closure failure of the embryonic neural tube by the 28 th day of conception. Anencephaly and spina bifida are the two major subtypes. Fetuses with anencephaly are often stillborn or electively aborted due to prenatal diagnosis, or they die shortly after birth. Most infants with spina bifida are live-born and, with proper surgical treatment, can survive into adulthood. However, these children often have life-long physical disabilities. China has one of the highest prevalence of NTDs in the world. Inadequate dietary folate intake is believed to be the main cause of the cluster. Unlike many other countries that use staple fortification with folic acid as the public health strategy to prevent NTDs, the Chinese government provides all women who have a rural household registration and who plan to become pregnant with folic acid supplements, free of charge, through a nation-wide program started in 2009. Two to three years after the initiation of the program, the folic acid supplementation rate increased to 85% in the areas of the highest NTD prevalence. The mean plasma folate level of women during early and mid-pregnancy doubled the level before the program was introduced. However, most women began taking folic acid supplements when they knew that they were pregnant. This is too late for the protection of the embryonic neural tube. In a postprogram survey of the women who reported folic acid supplementation, less than a quarter of the women began taking supplements prior to pregnancy, indicating that the remaining three quarters of the fetuses remained unprotected during the time of neural tube formation. Therefore, staple food fortification with folic acid should be considered as a priority in the prevention of NTDs.
基金This study was funded by the Major Project of the National Social Science Fund of China(21ZDA107)the Fundamental Research Funds for the Central Universities(7101303357).
文摘Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited.Aims This cross-sectional study aimed to investigate the correlations between intrafamilial and social ACEs,their associations with depressive symptoms and cognitive impairment and the(education-moderated)mediating role of social ACEs.Methods Data for this cross-sectional study were from the China Health and Retirement Longitudinal Study.Nine intrafamilial(0,1,2,3,and 4 or more)and three social(0,1,and 2 or more)ACEs were identified.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale.Global cognition,including episodic memory and mental intactness,was calculated as z scores.Binary and ordered logistic regressions,generalised linear models with Gaussian family and identity link,and mediation analysis were used.Results 13435 participants aged 59.0(51.0–66.0)were included.Compared with participants with no intrafamilial ACEs,those with 1,2,3,and 4 or more intrafamilial ACEs tended to develop more social ACEs,with odds ratios(ORs)of 1.55(95%confidence interval(CI):1.36 to 1.76),2.36(95%CI:2.08 to 2.68),3.46(95%CI:3.02 to 3.96)and 6.10(95%CI:5.30 to 7.02),respectively.Both intrafamilial and social ACEs were associated with depressive symptoms(OR>3 for four or more intrafamilial ACEs and two or more social ACEs)and global cognition(β=−0.26 for four or more intrafamilial ACEs andβ=−0.29 for two or more social ACEs).Social ACEs mediated the associations of intrafamilial ACEs with depressive symptoms and global cognition by 12.3%and 13.1%,respectively.Furthermore,as education levels increased,the impact of intrafamilial ACEs on depressive symptoms was increasingly mediated through social ACEs,while the mediating role of social ACEs between intrafamilial ACEs and cognitive impairment gradually diminished.Conclusions Improving children’s social environments and elevating general education can prevent later-life depressive symptoms and cognitive impairment attributed to ACEs in China.
文摘Objective: Adjuvant chemotherapy (AC) after curative resection is known to improve the survival of patients with non-small cell lung cancer (NSCLC); however, few studies have reported the correlation between the time to initiation of AC (TTAC) and survival in NSCLC patients. Methods: The clinical data of 925 NSCLC patients who received curative resection and post-operative AC at the Cancer Hospital of Chinese Academy of Medical Sciences between 2003 and 2013 were retrospectively analyzed. TTAC was measured from the date of surgery to the initiation of AC. Disease-free survival (DFS) was defined as the duration from surgery to the time of tumor recurrence or last follow-up evaluation. The optimal cut-off value of TTAC was determined by maximally selected log-rank statistics. The DFS curve was estimated using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to identify risk factors independently associated with DFS. Propensity score matching (PSM) was performed for survival analysis using the match data. Results: The optimal discriminating cut-off value of TTAC was set at d 35 after curative resection based on which the patients were assigned into two groups: group A (<= 35 d) and group B (> 35 d). There was no significant difference in the DFS between the two groups (P=0.246), indicating that the TTAC is not an independent prognostic factor for DFS. A further comparison continued to show no significant difference in the DFS among 258 PSM pairs (P=0.283). Conclusions: There was no significant correlation between the TTAC and DFS in NSCLC patients. Studies with larger samples are needed to further verify this conclusion.
文摘Acephalic spermatozoa syndrome(ASS)is one of the most severe spermatogenic failures of all infertility in men.The cognition of ASS has experienced a tortuous process.Over the past years,with the in-depth understanding of spermatogenesis and the emergence of new genetic research technologies,the unraveling of the genetic causes of spermatogenic failure has become highly active.From these advances,we established a genetic background and made significant progress in the discovery of the genetic causes of ASS.It is important to identify pathogenic genes and mutations in ASS to determine the biological reasons for the occurrence of the disease as well as provide genetic diagnosis and treatment strategies for patients with this syndrome.In this review,we enumerate various technological developments,which have made a positive contribution to the discovery of candidate genes for ASS from the past to the present.Simultaneously,we summarize the known genetic etiology of this phenotype and the clinical outcomes of treatments in the present.Furthermore,we propose perspectives for further study and application of genetic diagnosis and assisted reproductive treatment in the future.
