[Causal relationship between sleep and coronary artery disease: a Mendelian randomization study].

Objective: To understand the causal relationship between sleep and coronary artery disease (CAD). Methods: This study included six genome-wide association parts; five for sleep related traits[sleep duration (continuous variable), long sleep duration (binary variable), short sleep duration (binary variable), early-to-bed/up habit (known as 'morningness') and frequently insomnia] and one for CAD. Heterogeneity in dependent instrument approach was used to assess and to remove the pleiotropic instruments. Generalized summary data-based Mendelian randomization was performed to estimate the causal relationships between sleep related traits and CAD. And a conservative Bonferroni was used for statistical tests. Results: Sleep duration was putatively causal for CAD (OR=0.755, 95%CI: 0.658-0.867, P=6.68E-05). Our results also indicated significant causal effects between both short sleep duration and frequently insomnia on CAD, with ORs as 4.251 (95%CI: 2.396-7.541, P=7.51E-07) and 1.814 (95%CI: 1.346-2.446, P=9.25E-05), respectively. There was no convincing evidence of causality between long sleep duration or morningness with CAD. Conclusions: Our findings suggested that both sleep duration and frequently insomnia played causal roles on CAD, indicating that disease models should include sleep duration and insomnia as potential factors for CAD to develop effective interventions.

MiR-155 inhibits proliferation, invasion and migration of melanoma via targeting CBL.

OBJECTIVE: Malignant melanoma (MM), the deadliest form of skin malignancy, is a highly aggressive and malignant tumor with an increasing incidence rate in recent years. Increasing evidence suggested that dysfunctions of microRNAs (miRNAs) may play an important role in human tumors. However, the effect of miR-155 on malignant melanoma cell migration and invasion remains largely elusive. This research was designed to evaluate the potential function of miR-155 and CBL (Casitas B-lineage lymphoma) in malignant melanoma. PATIENTS AND METHODS: Quantitative Real-time polymerase chain reaction (qRT-PCR) was utilized to detect miR-155 and CBL expression in malignant melanoma tissues and cell lines. 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide (MTT) assay was performed to examine the regulation of miR-155 in melanoma proliferation. Transwell assay was carried out to detect the effect of miR-155 on the MM cell migration and invasion. Luciferase assay and biological analysis were used to predict and determine the target gene of miR-155. RESULTS: miR-155 was down-regulated in malignant melanoma tissues and cell lines. Ectopic expression of miR-155 could inhibit migration and invasion in malignant melanoma cells. What's more, we found that CBL was a new target of miR-155. Additionally, CBL was negatively associated with miR-155 in malignant melanoma and overexpression of CBL attenuated miR-155-mediated inhibition on MM cell migration and invasion. CONCLUSIONS: miR-155 inhibited malignant melanoma proliferation, migration and invasion. And high CBL expression was observed in MM tissues. This newly identified miR-155/CBL axis may provide new insight into the pathogenesis of malignant melanoma.

[Childhood obesity and coronary artery disease: a Mendelian randomization study].

Objective: To assess the casual effect of childhood obesity on adulthood coronary artery disease (CAD) using Mendelian randomization (MR) method. Methods: Data on BMI of children aged 2-10 years in 2015 were downloaded from Early Growth Genetics Consortium and Genetic Investigation of Anthropometric Traits Consortium. Twenty-seven genetic variants related to children's BMI were selected as instrumental variables (IVs), and the associations between IVs and CAD were extracted from a Meta-analysis of the genome-wide association study of CAD cases published in UK Biobank 2015. We used MR-Egger regression to test whether there was the pleiotropy of the selected SNPs. In the present MR methods, we conducted MR analyses by using mode-based estimate method as primary method for summary-level of associations to estimate the causal association between childhood obesity and CAD. Results: The intercept term estimated for CAD from MR-Egger method suggested that the selected SNPs don't exert pleiotropy with a 95%CI including the null (-0.008-0.018). In addition, we found evidence that support the effect of childhood obesity on CAD risk: a 1 s increase in children BMI (kg/m(2)), and the risk of suffering from CAD in adulthood increased by an average of 37% (OR=1.37, 95%CI: 1.09-1.72). Conclusion: This study provides a causal association between childhood obesity and CAD risk.

Transfusion-related acute lung injury in paediatric surgical patients: a retrospective study.

BACKGROUND: Little is known about the occurrence of transfusion-related acute lung injury(TRALI) in Chinese paediatric patients. As such, a retrospective review of medical records from January 2008 to December 2011 was undertaken. OBJECTIVE: To determine the incidence of TRALI and its risk factors in children (age <14 years). STUDY DESIGN AND METHODS: All medical records of Sheng Jing Hospital from January 2008 to December 2011 were reviewed retrospectively using the hospital's record system. Paediatric surgical patients who had been diagnosed clinically with acute lung injury were included. Transfusion data were collected, together with risk factors such as sepsis and aspiration. RESULTS: In total, 1495 patients were involved in the study. Thirty-five cases were analysed further as they had acute lung injury, pulmonary oedema and respiratory distress. TRALI was confirmed in two of these cases. The average duration of transfusion was found to be significantly longer in patients with TRALI compared with controls, and the percentage of female donors was significantly higher for patients with TRALI. CONCLUSION: The incidence of TRALI was found to be lower than reported previously, but TRALI is under-recognised, under-reported and undertreated.

The frequency and nature of drug administration error during anaesthesia in a Chinese hospital.

BACKGROUND: Throughout the world, drug administration error remains a known and significant threat to patients undergoing anaesthesia. Estimates of the extent of the problem vary, but few are based on large prospectively collected datasets. Furthermore, little is known about whether differences in work culture are important in error rates. METHODS: A prospective incident monitoring study was conducted at a large tertiary hospital in China to estimate the frequency of drug administration error during anaesthesia. Anaesthetists were asked to return a study form anonymously for every anaesthetic, indicating whether or not a drug administration error had occurred, including incident details if affirmative. RESULTS: From 24,380 anaesthetics, 16,496 study forms were returned (67.7% response rate), reporting 179 errors. The frequency (95% confidence interval) of drug administration error was 0.73% (0.63% to 0.85%) based on total study anaesthetics and 1.09% (0.93% to 1.26%) based on total forms returned. The largest categories of error were omissions (27%), incorrect doses (23%) and substitutions (20%). Errors resulted in prolonged stay in recovery for 21 patients, transfer to the ICU for five and one case each of haemorrhagic shock and asthmatic attack. More respondents who were not fully rested reported inattention as a contributing factor to error (21%) than those who were fully rested (7%, P = 0.04). CONCLUSION: Our results are comparable with other international prospective estimates indicating that drug administration error is of concern in China as elsewhere. These results will form a baseline from which to detect the effects of countermeasures.

The effect of remifentanil on the incidence of agitation on emergence from sevoflurane anaesthesia in children undergoing adenotonsillectomy.

The aim of the present study was to assess the effect of remifentanil on the incidence of emergence agitation in preschool-aged children undergoing adenotonsillectomy with sevoflurane anaesthesia. Sixty children, aged three to seven years, American Society of Anesthesiologists physical status I or II, were randomised into either group S (sevoflurane alone, n=30) or group R (sevoflurane plus remifentanil, n=30). Anaesthesia was induced with an intravenous bolus injection of fentanyl 3 microg/kg and propofol 2.5 mg/kg. Endotracheal intubation was facilitated by vecuronium 0.1 mg/kg. All patients were ventilated with 50% nitrous oxide and 1.5 to 2.5% sevoflurane in oxygen. End-tidal CO2 was maintained at 35 +/- 4 mmHg. Group S received no other medication while group R received remifentanil 1 microg/kg/minute intraoperatively. Mean blood pressure, heart rate, pulse oximetry, eye-opening time and extubation time were recorded in the operating room. In recovery, emergence agitation was assessed using the Pediatric Anesthesia Emergence Delirium scale with a score > or =10 taken as indicating agitation. Emergence agitation occurred in 20 of the 30 patients in group S and seven of the 30 patients in group R (P < 0.01). In preschool-aged children undergoing adenotonsillectomy with sevoflurane general anaesthesia, after propofol and fentanyl induction, intraoperative remifentanil decreased the incidence of emergence agitation.

Environmental effects of nationwide selenium fertilization in Finland.

To study the possible pollution of natural waters by selenium added to agricultural fertilizers, water selenium concentrations were determined in lakes and ground water pools during the year 1992, when the enrichment of fertilizers by selenium had continued for 8 yr. Water samples were preconcentrated by evaporating, and selenium concentrations were analyzed fluorometrically using the dye 2,3-diaminonaphthalene after wet digestion. In lake water samples from 13 lakes, no significant correlations were found between selenium and pH, chlorophyll A, total nitrogen, or phosphorus. Agriculturally affected and nonaffected lakes had no differences in their selenium concentrations. In the lakes that were surrounded by cultivated fields mean water selenium was 83.4 ng/L (range: 75.2-93.4 ng/L, n = 9). Correspondingly, in lakes situated in forests without agricultural surroundings, mean water selenium concentration was 76.5 ng/L (range: 51.2-110 ng/L, n = 3). Only one lake in the close vicinity of a coal power plant had a high water selenium concentration (mean 272 ng/L). In ground water samples, there was a big variation in selenium levels between different pools, the levels varying between 33 and 260 ng/L. This variation may partly be explained by different selenium concentrations of the bedrock and sediments. However, simultaneous increase of total nitrogen, phosphorus, and selenium levels in consecutive samples from some ground water pools indicates leaching of selenium from the fertilizers into the ground water in certain areas.