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Background Chloropropanol esters (MCPDE) have attracted much attention in recent years as a kind of new contaminant found in various refined oils. The pollution of 3-monochloropropane-1,2-diol esters (3-MCPDE) is the most prominent. 3-MCPDE is hydrolyzed in organisms to 3-monochloropropane-1,2-diol which has been shown to have reproductive toxicity, nephrotoxicity, and potential carcinogenicity. Infant formula powders can be polluted by 3-MCPDE when refined edible oils are added during production. Objective To assess the risk of exposure to 3-MCPDE related to the consumption of infant formula powders for children aged 0-3 years in Shanghai market using the food consumption data and the data of 3-MCPDE contamination in these foods. Methods Gas chromatography-mass spectrometry was used to determine 3-MCPDE in 133 samples of infant formula powders in Shanghai. Using a multistage stratified random sampling method, a total of 807 infants and toddlers aged 0-3 years were randomly selected from each district/rural/town in Shanghai, including 208 children aged 0-6 months, 276 children aged 6-12 months, and 323 children aged 12-36 months. The food consumption data was investigated using food frequency questionnaire (FFQ) distributed by combining telephone inquiries and face-to-face interviews among guardians. Population's probability distributions of 3-MCPDE exposure were assessed by @Risk 7.5 software and Monte Carlo simulation algorithm. According to the dietary intake assessment model and the tolerable daily intake (TDI) of 3-MCPDE of 2.00 μg·(kg·d)−1 proposed by the European Food Safety Authority (ESFA), a risk assessment of exposure to 3-MCPDE was conducted for infants and toddlers aged 0 to 3 years old in Shanghai who consumed 3-MCPDE via infant formula powders. Results The average concentration of 3-MCPDE in 133 samples of infant formula powders was 0.115 mg·kg−1 with a positive rate of 100.00%. Among different types of formula powders, infant formula powders for infants of 0-6 months had the highest concentrations of 3-MCPDE and fat [0.136 mg·kg−1 and 25.2 g (per 100 g sample) in average respectively]. There was a positive correlation between fat concentration and 3-MCPDE concentration in the samples (r=0.438, P<0.05). The average consumption of infant formula powders of 807 infants aged 0-3 years was 88.3 g·d−1. Among all investigated age groups, the average consumption of infant formula powders by infants aged 0-6, 6-12, and 12-36 months was 87.7, 98.3, and 80.1 g·d−1 respectively. The dietary exposure to 3-MCPDE from infant formula powders of infants aged 0-3 years averaged 0.83 μg·(kg·d)−1 for general intake level or valued 1.44 μg·(kg·d)−1 using the 95 percentile for high intake level. Exposure decreased with increasing age and was highest in infants 0-6 months of age, whose general and high intake levels were 1.41 and 2.34 μg·(kg·d)−1, respectively. The risk population defined with the exposure higher than the TDI proposed by EFSA were proportioned to be 13.90% and 0.50% in infants aged 0-6 months and 6-12 months respectively, indicating a risk that cannot be ignored, and no risk in infants aged 12-36 months. Conclusion Among the investigated infants aged 0-3 years in Shanghai, those aged 0-6 months are at a high risk of exposure to 3-MCPDE. In view of the sensitivity of infants to pollutant exposure, the risk of exposure to 3-MCPDE should be highly concerned.
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ObjectiveTo construct an evaluation index system for the development of district-level disease prevention and control centers according to the requirements of the modernization of Shanghai’s disease control system and public health work practices， and to comprehensively assess the construction and development of district-level disease prevention and control institutions. MethodsAccording to the national and municipal requirements for the development of disease prevention and control institutions， an index framework was proposed through literature search and expert interviews. 39 representative experts in the field of public health at the national， provincial， and municipal （district） levels were selected to participate in the consultation and construction of the index system. The authority coefficient， the coefficient of variation， etc. were used to carry out quality control and determination of each index on the Delphi method. ResultsThe questionnaire response rate was 100%， the expert authority coefficient was 0.86，the degree of familiarity was 0.79， and the judgment basis was 0.92. The coefficients of variation of the necessary indicators in the index system were all <0.25 in the dimension of importance， and there were statistical differences in the statistical test of Kendall’s W coordination coefficients at all levels and dimensions （all P<0.001）. After multiple rounds of consultation， experts reached a consensus， forming a development evaluation index system of district-level CDCs with 6 first-level indicators， 24 second-level indicators， and 105 third-level indicators （including 63 necessary indicators and 42 recommended indicators）. ConclusionThe evaluation index system of Shanghai district-level CDCs based on the Delphi method has good authority， reliability， sensitivity and operability. This indicator system can effectively support the development of Shanghai district-level CDCs， and can be used for evaluation at multiple levels and in an all-round way in the future. The evaluation results can provide an evidence-based basis for the modernization of the disease prevention and control system and the continuous and dynamic updating of the development goals in the future.
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Background Subways are typical congregate settings and may facilitate aerosol transmission of viruses. However, quantified transmission probability estimates are lacking. Purpose To model spread and diffusion of respiratory aerosols in subways by simulation and calculation of infection probabilities. Methods The internal environment of carriages of Shanghai Metro Line 10 was used to establish a study scene. The movement of tiny particles was simulated using the turbulent model. Trend analysis of infection probabilities and viral quantum doses was conducted in a closed subway carriage scene by a quantum emission-infection probability model. Results Under a typical twelve-vent air conditioning configuration, respiratory droplet aerosols within a subway carriage dispersed rapidly throughout various regions due to airflow, with limited short-term diffusion to other carriages. Concurrently, owing to the uncertainty of airflow patterns, the airflow might circulate and converge within carriages, causing delayed outward dispersion or hindered dispersion of droplet aerosols upon entry into these zones. Passengers boarding the carriage could exacerbate the formation of these zones. When the air conditioning system functioned adequately (air exchange rate=23.21 h−1), the probability of a virus carrier transmitting the virus to other passengers within the same carriage via aerosol transmission was approximately 3.8%. However, in the event of air conditioning system failure (air exchange rate=0.5 h−1), this probability escalated dramatically to 30%. Furthermore, a super-spreader (with virus spreading exceeding 90% of the average) elevated the infection probability to 14.9%. Additionally, due to the complexity of turbulence within the carriage, if local diffusion occurred in 1/2 zones of a carriage, the anticipated infection probability would increase to 8.9%, or during the morning or evening rush hours leading to elevated aerosol concentrations, the infection probability would rise to 4.7%. The subway transmission probability for common coronaviruses diminished to as low as 0.9%. Conclusion Combined computational fluid dynamics and infection probability analysis reveals that in the prevalent twelve-vent air conditioning configurations, despite being a major transportation hub with substantial spatial-temporal overlap, the internal space of subway carriages exhibits a certain level of resistance to virus aerosol transmission owing to built-in ventilation capabilities. However, turbulence and passenger positioning may lead to localized hovering of droplet aerosols, thereby increase the risk of virus transmission. Furthermore, super-spreaders, poor operational status of built-in air conditioning system, and high passenger volume at morning or evening peak hours exert profound effects on virus transmission and infection probability.
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ObjectiveTo provide basic data of daily dietary intake from various food categories as well as in different regions， seasons， genders， and age groups in Shanghai residents aged 15 and over. MethodsMultistage stratified proportional probability sampling （PPS） was used to extract the samples， and food frequency questionnaire （FFQ） was used to investigate the dietary intake of the subjects in four seasons from 2012 to 2013. The weighted statistical analysis of the samples comprehensively considered the sampling design weights， the stratified adjustment weights， and the non-response adjustment weights. ResultsThe total daily dietary intake （excluding drinking water） of residents aged 15 years and above was 1 174.71 g， and the highest three daily dietary intake categories were cereals （252.31 g）， vegetables （205.36 g） and fruits （141.00 g）. The total daily dietary intake of the residents in the urban area， the suburban area and the rural area was 1 209.15 g，1 172.27 g and 948.50 g， respectively， and the total daily dietary intake in the outer suburb area was significantly lower than that in other areas （F=74.12，P<0.001）. The total daily dietary intake in different seasons was 1 232.47 g in spring， 1 166.80 g in summer， 1 241.15 g in autumn and 1 088.83 g in winter， respectively. The total daily dietary intake in winter was lower than that in other seasons （F=15.96，P<0.001）. Fruits and beverages intake showed apparent seasonality. The total daily dietary intake in male and female residents was 1 234.03 g and 1 112.32 g， respectively， and the total daily dietary intake of male was higher than that of female （F=78.59，P<0.001）. The total daily dietary intake of residents in different age groups was 1 218.64 g for 15‒44 years old， 1 141.27 g for 45‒59 years old， and 1 064.54 g for 60 years old and above （F=20.28，P<0.001）. ConclusionThe daily intake of cereals， livestock and poultry meat， aquatic products， eggs and edible oil is relatively balanced， but the daily intake of vegetables， fruits and milk is relatively insufficient for the residents aged 15 years and above in Shanghai. The daily intake of different food types shows distinguishable characteristics in urban and rural areas， seasons， age groups and genders.
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Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.
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The ketogenic diet(KD) treatment program planned for a 2 years old and 5 months boy suffered from severe cerebral complications after ependymoma operation in the Children′s Hospital of Nanjing Medical University at December 2018 was analyzed retrospectively.The patient developed various complications, including cerebral hemorrhage, hydrocephalus and hernia after the operation of ependymoma, with coma, fever and convulsion, and 1 month of anti-infection and antiepileptic treatment was ineffective.After 2 weeks of 4∶1 KD, fever and convulsion were effectively relieved without obvious side effects.One month later, the patient regained consciousness, demonstrating that KD can be applied to treat severe cerebral complications after ependymoma operation.
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Shanghai Diet and Health Survey (SDHS) was designed to prospectively access local residents' food consumption,energy and nutrient intake,related chemical contaminant exposure,and the seasonal change trend to explore the relationship of diet with health.Data from SDHS can be used as fundamental information and scientific evidences for the development of local nutrition and food safety policies.
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Shanghai Diet and Health Survey (SDHS) was designed to prospectively access local residents' food consumption,energy and nutrient intake,related chemical contaminant exposure,and the seasonal change trend to explore the relationship of diet with health.Data from SDHS can be used as fundamental information and scientific evidences for the development of local nutrition and food safety policies.
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Objective To investigate the effect of scalp acupuncture plus real-time cognitive training on cerebral blood flow in Alzheimer disease patients with cognitive disorder.Methods One hundred Alzheimer disease patients with cognitive disorder were randomly allocated to treatment and control groups, 50 cases each. Both groups received treatment for the primary disease. In addition, the treatment group received scalp acupuncture plus real-time cognitive training and the control group took Ginkgo leaf extract tablets. Mean flow velocity (Vm) in the left vertebral artery (LVA), right vertebral artery (RVA) and middle cerebral artery (MCA) were measured using transcranial Doppler in the two groups of patients before and after three months of treatment.Results There were statistically significant pre-/post-treatment differences in LVA, RVA and MCA Vm in the two groups (P<0.01). There were statistically significant post-treatment differences in LVA, RVA and MCA Vm between the treatment and control groups (P<0.05).Conclusions Scalp acupuncture plus real-time cognitive training can improve cerebral circulation and increase cerebral blood flow in Alzheimer disease patients with cognitive disorder.
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Objective To study newborns weight in singleton term births and the associationbetween newborns birth weight and mode of delivery in 3 hospitals.Methods From Jan.2005 to Dec.2009,13 963 singleton term live neonates born in the Department of Obstetrics and Gynecology of Peking University First Hospital(PU group),6519 neonates in Affiliated Hospital of Binzhou Medical College (BMC group,)and 8725 neonates in Miyun Hospital Affiliated to Capital Medical University,Yanjing Medical College(MYC group)were enrolled in this retrospective study.The newborns weight and the rate of macrosomia was calculated and compared.Those newborns from PU group and MYC group were divided into 2288 neonates at macrosomia group and 20 400 neonates at non-macrosomia group,their mode of deliveries were analyzed.Results(1)The mean neonatal birth weight were(3386 ± 414)g at PU group,(3389 ± 446)g at BMC group and(3445 ± 449)g at MYC group.Neonates born weight in MYC was significantly higher than those from in PU group and BMC group(P =0.000).Neonates born weight in BMC showed higher than those in PU group,which did.not reached statistical difference(P =0.638).(2)The incidence of macrosomia were 7.935％(1108/13 963)in PU group,9.802％(639/6519)in BMU group and 13.524％(1180/8725)in MYU group.The incidence of macrosomia in MYC group was higher than those in PU and BMC group,the incidence of macrosomia in BMC group was higher than that in PU group,which reached statistically difference(P =0.000).(3)The proportion of cesarean delivery were 75.306％(1723/ 2288)at macrosomia group,50.765％(10 356/20 400)at non-macrosomia group,which showed statistical difference(P =0.000).Conclusions(1)The difference of newborns birth weight existed in different administrative level hospital.(2)The risk of cesarean delivery due to macrosomia is higher than that of nonmacrosomia.(3)Obstetricians should pay more attention to nutrition in gestation period to lessen the incidence of macrosomia and cesarean section.
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Objective To investigate the trend in birth weight of term infants delivered in Miyun Hospital in recent ten years, and its relationship with cesarean section rate, to provide evidence for health care during pregnancy and lowering the cesarean section rate. MethodsSingleton term live-birth newborns in Beijing Miyun Hospital from January 1, 2000 to December 31, 2009 were admitted into this study.Trends of birth weight, microsomia rate and cesarean section rate were analyzed. Results(1) There were 14 716 singleton term live-birth newborns delivered in the tenyear period, among which 7642 males and 7074 females with the proportion of male and female of 1.08 : 1. One thousand seven hundred and seventy-three (12.0％) microsomia were delivered, and the number of low birth weight infants was 180 (1.2％). (2) The birth weight of term infants was from 1200 g to 5850 g and the average birth weight was (3422±447) g. The average birth weight of each year increased, and the differences among each year showed statistical significance (F= 15. 337,P＜0.01). (3) The percentage of microsomia of each year increased, and the differences among each year also showed statistical significance (x2= 125. 285, P＜0. 01).(4) The cesarean section rate increased from 49.9％ in 2000 to 57.1％ in 2009 with statistical difference (x2 =180. 883, P＜0.01).(5) The cesarean section rate increased with the average birth weight of the singleton live-birth term infants in the 10 years from 52.2 ％ in those ＜2500 g to 85.4 ％ in those 4500 g～, and the differences had statistical significance (x2 =518. 519, P＜0. 01). ConclusionsCesarean section rate had close correlation with birth weight in term birth infants.It is suggested that prenatal care should be strengthened and nutrition guidance during pregnancy should be paid more attention.
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Objective To investigate the relationship between early pregnancy fasting plasma glucose (FPG) and gestational glucose metabolism disorders. Methods Six hundred and fifty-six pregnant women who were singleton, non-diabetes before pregnancy and had FPG examined during 5-13 weeks of pregnancy were admitted into this study from January 1, 2009 to May 31, 2009. All these subjects had routine prenatal examination and finally delivered in the Department of Obstetrics of Peking University First Hospital. The FPG, 50 g glucose challenge test (GCT) after 24 weeks of pregnancy, 75 g oral glucose tolerance test (OGTT), gestational diabetes mellitus (GDM),gestational impaired glucose tolerance (GIGT) were analyzed with receiver operating characteristic (ROC) curve. Results (1) Relationship between FPG and GCT were analyzed with ROC curve.The maximum area under curve was 0. 539 (95% CI: 0. 493-0. 586) and there was no correlation between the FPG and GCT results(P=0. 057). (2) Relationship between early pregnancy FPG and abnormal FPG examined after 24 gestational weeks were also analyzed . The maximum area under curve was 0. 796(95% CI: 0. 672-0. 920). If 5. 05 mmol/L was taken as the cutoff value, the sensitivity and specificity was 54. 5% and 83. 2%, respectively. There was significant relationship between the two values (r=0. 432, P=0. 000). (3) There were no relationship between early pregnancy FPG and the blood glucose value of 1, 2 and 3 h in 75 g OGTT (r=0. 093, 0. 036 and 0. 107, P=0.122, 0. 549 and 0. 074 respectively). OGTT 0 h value was positively related to OGTT 1, 2 and3 h glucose level (r=0.493, 0.421 and 0.368, P=0.000, respectively). (4) All early pregnant FPG values in this study were under 6.1 mmol/L. Twenty-two GDM and 27 GIGT patients were diagnosed in this study. Early pregnancy FPG did not relate to the GDM and GIGT diagnosis.Conclusions Early pregnancy FPG could not replace 50 g GCT as an early screening for glucose metabolic abnormality in pregnancy, but FPG during early pregnancy is necessary.
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Objective:To investigate the hippocampus neuron injury,mitochondrial function and mitochondrial apoptosis related protein expression in kainic acid(KA) induced epilepsy rat,and to explore the role of mitochondrial pathways of apoptosis in the neuron injury.Methods:KA induced epilepsy model was produced by injection of KA into the hippocampus.Forty SD rats were randomly divided into five groups: control and KA group(6 h,1 d,3 d and 7 d),n=32.The concentration of Glu in hippocampus CA3 area was detected by HPLC.The apoptosis of hippocampus neurons and the concentration of free calcium ion were assayed by flow cytometry.The expression of cytochrome C and caspase-9 in hippocampus CA3 area was determined by Western blot.Results: ①The concentration of Glu in hippocampus CA3 area was increased in the fourth day after KA injection.②The concentration of free calcium ion,mitochondrial membrane potential,and the number of apoptosis neurons was significantly changed after 6 h of KA injection.Seven days after KA injection,these changes were more significant.③The hippocampus neuron expressed low levels of cytochrome C and caspase-9,and the expression of cytochrome C and caspase-9 was dramatically increased in a time dependent manner which increased by 4.37and 3.20 fold 7 d after KA injection.Conclusion:Mitochondrial pathways of apoptosis involve in hippocampal neuron apoptosis in KA induced epilepsy rat.
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Objective:To analyze OLFM1 by bioinformatics and prepare its polyclonal antibody.Methods:According to the bioinformatics analysis and prediction of the possible high structure,hydrophobicity and antigenicity of OLFM1 and the principal of antibody project,a partial peptide of OLFM1 with 20-amino acid residues with was synthesized after homology search.The synthesized peptide was then used to immunize rabbit.The specificity and titer of polyclonal antibody against OLFM1 were identified via ELISA and Western blot.Results:Polyclonal antibody against OLFM1 was proved to recognize OLFM1 protein specifically,and its titers reached 1?32 000.Conclusion:By the bioinformatics analysis and prediction,the hydrophilicity and antigenicity of OLFM1 are analyzed.The polyclonal antibody against OLFM1 is successfully obtained.