The prenatal weekly temperature exposure and neonatal congenital heart disease: a large population-based observational study in China.

We aim to explore the link between maternal weekly temperature exposure and CHD in offspring and identify the relative contributions from heat and cold and from moderate and extreme atmospheric temperature. From January 2019 to December 2020, newborns who were diagnosed with CHD by echocardiography in the Network Platform for Congenital Heart Disease (NPCHD) from 11 cities in eastern China were enrolled in the present study. We appraised the exposure lag response relationship between temperature and CHDs in the distributed lag nonlinear model and further probed the pooled estimates by multivariate meta-analysis. We further performed the exposure-response curves in extreme temperature (5th percentile for cold and 95th for hot events). We also delve into the cumulative risk ratios (CRRs) of temperature on CHDs in general and subgroups. In this study, 5904 of 983, 523 infants were diagnosed with CHDs. The temperature-CHD combination performed positive significance in two exposure windows, gestational weeks 10-16 and 26-31, and reached the maximum effect in the 28th week. Compared with extreme cold (5th, 6.14℃), these effects were higher in extreme heat (95th, 29.26℃). The cumulative exposure-response curve showed a steep nonlinear rise in the hot tail but showed non-significance at low temperatures. In this range, the CRRs of temperature showed an increment to a ceiling of 3.781 (95% CI: 1.460-10.723). The temperature- CHD curves for both sex groups showed a general growth trend. No statistical significance was observed between these two groups (P = 0.106). The cumulative effect of the temperature related CHD was significant in regions with lower education levels (maximum CRR was 9.282 (3.019-28.535)). A degree centigrade increase in temperature exposure was associated with the increment of CHD risk in the first and second trimesters, especially in extreme heat. Neonates born in lower education regions were more vulnerable to temperature-related CHDs.

Prediction of congenital heart disease for newborns: comparative analysis of Holt-Winters exponential smoothing and autoregressive integrated moving average models.

OBJECTIVE: To describe the temporal trend of the number of new congenital heart disease (CHD) cases among newborns in Jinhua from 2019 to 2020 and explored an appropriate model to fit and forecast the tendency of CHD. METHODS: Data on CHD from 2019 to 2020 was collected from a health information system. We counted the number of newborns with CHD weekly and separately used the additive Holt-Winters ES method and ARIMA model to fit and predict the number of CHD for newborns in Jinhua. By comparing the mean square error, rooted mean square error and mean absolute percentage error of each approach, we evaluated the effects of different approaches for predicting the number of CHD in newborns. RESULTS: A total of 1135 newborns, including 601 baby girls and 534 baby boys, were admitted for CHD from HIS in Jinhua during the 2-year study period. The prevalence of CHD among newborns in Jinhua in 2019 was 0.96%. Atrial septal defect was diagnosed the most frequently among all newborns with CHD. The number of CHD cases among newborns remained stable in 2019 and 2020. There were fewer cases in spring and summer, while cases peaked in November and December. The ARIMA(2,1,1) model relatively offered advantages over the additive Holt-winters ES method in predicting the number of newborns with CHD, while the accuracy of ARIMA(2,1,1) was not very ideal. CONCLUSIONS: The diagnosis of CHD is related to many risk factors, therefore, when using temporal models to fit and predict the data, we must consider such factors' influence and try to incorporate them into the models.

Geographical and Socioeconomic Factors Influence the Birth Prevalence of Congenital Heart Disease: A Population-based Cross-sectional Study in Eastern China.

Neonatal congenital heart disease (CHD) is the most common congenital anomaly. As a practical matter of people's livelihood, cardiac ultrasonography was performed on potential CHD children in 11 cities eastern China. In this study, we aimed to document the birth prevalence of CHD and its socioeconomic and geographical distribution, as supported by this public health policy. In this study, the diagnosis of CHD was made based on echocardiography. Geographical and socioeconomic factors were determined by the Statistical Bulletin on National Economic and Social Development (SBNESD). 51857 newborns from the Network Platform for Congenital Heart Disease (NPCHD) from January to December 2019 in 11 cities eastern China were included. The total birth prevalence of CHD was 5.79 per 1000 births. The study on the low-income areas, mountainous areas, areas with low medical institution bed level, and with high qualification of medical personnel reported a signifcantly higher birth prevalence of CHD compared with high-income cities, flat areas, areas with high medical institution bed level, and with low qualification of medical personnel. ASD, VSD, PDA, PS, TOF, atrioventricular septal defect, coarctation of the aorta, TAPVD, TGA and pulmonary atresia are the most frequent subtypes. ASD, VSD, PDA, PS, atrioventricular septal defect, coarctation of the aorta and pulmonary atresia showed a female preponderance, while TOF, TGA and TAPVD showed a male preponderance. Our study gives a relatively realistic prevalence of CHD after cardiac ultrasound examination of newborns suspected positive with CHD. Significant differences across geographical regions, income levels, and health service access were observed. In the future, population-wide cardiac ultrasound screening, prospective birth defect registries, and systematic medical follow-up programs covering the entire eastern or even China are needed to determine the exact birth prevalence.

Maternal air pollution exposure and neonatal congenital heart disease: A multi-city cross-sectional study in eastern China.

OBJECTIVE: To examine the association between air pollution and neonatal congenital heart disease (CHD), and evaluate the cumulative burden of CHD attributed to above certain level for ambient air pollution exposure. METHODS: We identified newborns who were diagnosed as CHD by echocardiography in Network Platform for Congenital Heart Disease (NPCHD) from January 2019 to December 2020 in 11 cities eastern China. The exposure lag response relationship between air pollutants (PM2.5, PM10, SO2, NO2, CO, and O3) concentration and CHDs was calculated by the distributed lag nonlinear model (DLNM). We further calculated the cumulative risk ratios (CRRs) of each air pollutant above reference concentrations on CHDs. RESULTS: A total of 5904 CHDs from 983, 523 newborns were enrolled in this study. A 10 µg/m3 increase in PM2.5, PM10, SO2, NO2, CO and O3 exposure was associated with an increased risk of higher CHD incident RR = 1.025, 95% CI: 1.016-1.038 for PM2.5 in the third trimester, RR = 1.001, 95% CI: 1.000-1.002 for PM10 in the third trimester, 1.020, 95%CI: 1.004-1.036 for NO2 in the third trimester, RR = 1.001, 95%CI: 1.000-1.002 for O3 in the first trimester, all P value < 0.05). Cumulative effect curves of PM2.5, PM10, SO2, NO2, CO, and O3 were observed as sub-linear with a maximum of 1.876 (95%CI:1.220-2.886), 1.973 (95%CI:1.477,2.637), 2.169 (95%CI:1.347-3.493), 2.902 (95%CI:1.859-4.530), 1.398 (95%CI:1.080-1.809), 2.691 (95%CI:1.705-4.248), respectively. Significant associations were observed for air pollutants and CHDs in cities with higher average education years and babies concepted in cold season. CONCLUSIONS: Our findings could provide growing evidence regarding the adverse health effects of air pollution on CHD, thereby strengthening the hypothesis that air pollutants have harmful impacts on cardiac development. Further studies are needed to verify the associations.

MiR-150 Inhibits Cell Growth In Vitro and In Vivo by Restraining the RAB11A/WNT/ß-Catenin Pathway in Thyroid Cancer.

BACKGROUND Emerging evidence has shown that downregulation or upregulation of microRNAs (miRNAs) plays an important role in the development and progression of thyroid cancer (TC). However, the potential role of miR-150 and its biological function in TC remains largely unclear. MATERIAL AND METHODS Real-time polymerase chain reaction (RT-qPCR) was employed to detect the expression level of miR-150 and RAB11A in human TC tissue and human normal thyroid tissue. MTT assay, colony formation assay, flow cytometry cell cycle, and apoptosis assay were used to investigate the role of miR-150 and RAB11A on the malignant phenotypes in vitro. Nude mouse xenograft assay and western blot assay was used to verify the function of miR-150 in vivo. Western blot assay and immunofluorescence assay were used to detect the activation of WNT/ß-catenin pathway mediated by miR-150 and RAB11A. EGFP reporter assay, RT-qPCR assay, and western blot assay were used to validate the regulation relationship. RESULTS This study demonstrated that miR-150 expression in human TC tissues was markedly downregulated. Moreover, overexpression of miR-150 markedly inhibited cell proliferation via inducing the cell cycle arrest and promoting cell apoptosis by directly targeting RAB11A in vitro and suppressing tumor growth in vivo. However, overexpression of RAB11A promoted cell malignant phenotypes. In addition, miR-150 restrained the RAB11A mediated WNT/ß-catenin activation in TC cells. CONCLUSIONS miR-150 may function as a suppressor gene in TC cells by inhibiting the RAB11A/WNT/ß-catenin pathway.

[Repair of acromioclavicular dislocation with clavicular hook plate internal fixation and coracoacromial ligament transposition].

OBJECTIVE: To explore the operative method and the clinical outcomes of repairing acromioclavicular dislocation by clavicular hook plate internal fixation and coracoacromial ligament transposition. METHODS: From August 2004 to December 2007, 12 cases of acromioclavicular dislocation were repaired with the internal fixation of clavicular hook plate and the transposition of coracoacromial ligament. There were 9 males and 3 females aged 22-56 years old (average 32 years old). Causes of injury: 6 cases from falling injury, 4 cases from crush injury and 2 cases from traffic accident. There were 5 cases of the left acromioclavicular dislocation, and 7 cases of the right. According to acromioclavicular dislocation classification set by WANG Yicong, 8 cases were graded as type III, 3 cases as type IV, and 1 case as type V. The time from injury to operation was 3-28 days (average 6 days). The injured arm was hung after operation, and the function training was started 3-5 days after operation. RESULTS: All wounds healed by first intention, and the X-ray films showed complete reposition of acromioclavicular joints was achieved in all cases 1 week after operation. Over the follow-up period of 12-30 months, no plate and screw loosening, hook break and acromion fracture occurred. At 2 months after operation, 2 patients had slight pain when moving the shoulder, and the symptom disappeared when removing the plate. No re-dislocation was observed in all cases after removing the plate at 6-10 months after operation. The function of shoulder joint was assessed by Karlsson evaluation standard 1 year after operation, 11 cases were graded as excellent and 1 case was good. CONCLUSION: For the repair of acromioclavicular dislocation, the method of combining clavicular hook plate internal fixation with coracoacromial ligament transposition has the advantages of minor wound, easy operation, little influence on the function of shoulder joints, and reliable restoration of the stability of shoulder joint.

[Treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy].

OBJECTIVE: To investigate the advantages and the clinical outcomes of the treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. METHODS: From June 2002 to December 2004, 12 cases of comminuted inferior femoral fractures were treated (9 males, 3 females). Of them, 5 cases were classified as type B and 7 cases as type C according to AO classification. All cases were treated with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. In 12 cases of one-stage bone grafting, there 5 of autologous cancellous bone grafting and 7 allo-freeze drying bone grafting. RESULTS: With a follow-up of 6 to 18 months, all fractures healed within 3 to 6 months. There were no infection and nonunion. The function of all the knees joint was excellent. According to Noye's criterion for knee scoring, the results were excellent in 9 cases and good in 3 cases; the excellent and good rate was 100%. CONCLUSION: It is a good method to treat comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. It has many advantages of less injury to knee joint, good anatomic reduction and reliable fixation.

[Reconstruction of wrist joint by transplanting fibular head pedicled with lateral inferior genicular artery].

OBJECTIVE: To investigate a new operative method to reconstruct wrist joint for treating the defect of the distal radius after excision of tumor. METHODS: From October 1999 to December 2001, 3 cases of giant cell tumor in the distal radius were resected and the wrist joint was reconstructed by transplanting the fibular head pedicled with the lateral inferior genicular artery. RESULTS: After followed up for 6 to 18 months, all patients achieved the bony healing within 4 months without tumor relapse and had good function of the wrist joint. CONCLUSION: This operation is simple and reliable. The fibular head can be cut according to the tumor size of the radius.