Estimates of the effects of physical activity on osteoporosis using multivariable Mendelian randomization analysis.

This study estimates causality of physical activity (PA) on bone mineral density (BMD) by conducting multivariable Mendelian randomization (MR). The findings suggest that habitual vigorous PA increases lumbar spine BMD, and higher overall acceleration average would improve forearm BMD. The results could promote PA intervention targeting individuals with optimized type. INTRODUCTION: Evidence from epidemiologic studies showed type, frequency, and duration of PA influenced BMD. However, these observational studies may be confounded by many factors, resulting in spurious associations. We aimed to conduct multivariable MR to estimate the causal effect of self-reported and device-measured PA on osteoporosis. METHODS: Three self-reported and two device-measured PA-related traits were selected as exposures. Outcomes were BMD at different skeletal sites: femoral neck BMD (FN BMD), lumbar spine BMD (LS BMD), and forearm BMD (FA BMD). Exposure datasets were obtained from UK Biobank with total 377,234 subjects. Outcome datasets were obtained from GEFOS consortium with 53,236 subjects. Standard MR analysis and multivariable MR were conducted to assess the total and direct causal effect of PA on BMD. RESULTS: For self-reported PA, inverse-normalized moderate-to-vigorous had a direct causal effect on FN BMD independently (ß = - 1.116 (95% confidence interval, 95%CI: - 2.210, - 0.023), P = 0.045); vigorous PA showed a direct effect (ß = 3.592 (95%CI: 0.310, 6.874), P = 0.032) on LS BMD independently. While overall acceleration average and fraction of accelerations both had a direct causal effect on FA BMD independently. CONCLUSIONS: Habitual vigorous PA could increase LS BMD. Individuals with higher overall acceleration average would have a higher FA BMD.

[Analysis of clinical characteristics and factors associated with short term outcomes in early term neonates].

Objective: To investigate the clinical characteristics of early term and full term neonates, and analyze the risk factors associated with short term outcomes in early term neonates. Method: Neonates with birth weight (BW) ≥2 500 g from year 2013 were analyzed retrospectively based on American Congress of Obstericians & Gynecologists (ACOG) latest definition of term infants. According to inclusion and exclusion criteria, early term (gestational age 37-38 weeks) and full term(gestational age 39-40 weeks) neonates were included, whose morbidity constituent proportion was analyzed by χ(2) test or Fisher accuracy test or t test or Wilcoxon test. Risk factors associated with short term outcomes in early term population were analyzed by Logistic regression analysis. Result: There were 3 002 discharged term infants being investigated, among whom 1 303 cases were included(768 males and 535 females), and 37, 38, 39 and 40 weeks' gestational age newborns were 160, 324, 450 and 369 respectively. Compared with full term neonates(n=819), early term neonates (n=484) had longer length of hospital stay (LOS)(6.0(5.0, 9.0) vs. 6.0(4.0, 8.0), Z=2.830, P=0.005), higher usage rate of intravenous antibiotics(86.4%(418/484) vs. 80.1%(656/819), χ(2)=8.009, P=0.005), higher assisted ventilation rate(9.5%(46/484) vs. 2.9%(24/819), χ(2)=25.528, P<0.01), higher pulmonary surfactant administration rate(4.3%(21/484) vs. 1.1%(9/819), χ(2)=14.006, P<0.01), as well as higher hypoglycemia incidence(3.9%(19/484) vs. 1.2%(10/819), χ(2)=10.226, P=0.001). There were no statistically significant differences in 1 min Apgar score (9(9, 10)vs. 9(9, 10), Z=0.860, P=0.390), 5 min Apgar score (10(9, 10) vs. 10(9, 10), Z=0.810, P=0.418), white blood cell count (15 (11, 21) ×10(9) /L vs.15 (11, 22) ×10(9) /L, Z=0.880, P=0.379), hemoglobin count(180 (159, 205) vs. 182 (160, 204) g/L, Z=0.560, P=0.576), or platelet count(303(234, 372) ×10(9)/L vs. 301(237, 391) ×10(9)/L, Z=0.550, P=0.584). BW between 2 500 g and 2 999 g(OR 1.69, 95% CI: 1.10-2.62, χ(2) =5.614, P=0.018), wet lung(OR=2.61, 95% CI: 1.61-4.24, χ(2)=15.023, P=0.000)and pneumonia(OR 1.88, 95% CI: 1.14-3.08, χ(2)=6.192, P=0.013) were risk factors in early term neonates' short term adverse outcomes. Conclusion: Early term newborns are still at their "immature" state, and respiratory disorders are major risk factors associated with short term outcomes. Hence, early delivery during 37-38 weeks should be avoided as possible as we can.

[Ultrastructure differences of in vitro cotton fiber and native cotton fiber].

Native cotton fiber and in vitro cotton fiber that was induced from cotton ovule callus by suspension culture were observed using transmission electron microscope and scanning electron microscope. The ovule surface on the first day preanthesis was quite smooth. On the anthesis, it had a lot of protuberances. Two kinds of callus, smooth and rough were found. The microfibrils of callus was vertical to the cell long axis and they changed their orientations with the development of the in vitro cotton fiber: from the vertical to shallow spiral and then to parallel to the cell long axis. So was the native cotton fiber. It suggests that in vitro cotton fiber and native cotton fiber have similar development process. Compared with the ovule surface cell, most callus cells had smaller nuclear. During the development of the fiber, the plasm of native cotton fiber was denser than that of in vitro fiber, and it has more cellular organ than in vitro fiber. The cell wall of native cotton fiber was thicker and denser than that of the in vitro cotton fiber too. It suggests that the physiological activity of in vitro cotton fiber was less active than native cotton fiber.

Comparison of continuous and split-course radiotherapy for nasopharyngeal carcinoma--an analysis of 1446 cases with squamous cell carcinoma grade 3.

PURPOSE: An analysis of 1446 cases with squamous cell nasopharyngeal carcinoma Grade 3 was made for the comparison of treatment results of continuous (CG) and split-course (SG) radiotherapy regimens. METHODS AND MATERIALS: The patients were given their first definitive radiotherapy at our department from July 1977 to December 1980, 1093 cases by continuous treatment regimen, and 353 cases by split-course regimen. The interval of the split was 10-45 days, mean 28.6 days. Trials were nonrandomized, but the treatment conditions for both groups were the same. RESULTS: The 5-year survival rate was 33.6% for CG, and 26.9% for SG. For Stage III and IV patients, the 5-year survival rate was 31% (290/933) for CG, and 21.5% (36/107) and 18.8% (17/90) for those with a split of 21-30 and 31-45 days, respectively (both p < 0.05); the 5-year local control rate was 27.4% (256/933) for CG, and 15.5% (26/167) (p < 0.01), and 15.5% (14/90) (p < 0.05) for those with a split of 21-30 and 31-45 days, respectively. The metastatic rate in 5-years was 21.59% vs. 27.48% for CG to SG (p < 0.01), but not different statistically for any subgroup. No relation was confirmed between local control rate and radiation dose. CONCLUSION: According to the data obtained in this series, we believe that the treatment results of CG were superior to those of SG, especially for Stage III and IV patients, and those with a split of 21 days or more.

Comparison of continuous and split-course radiotherapy for nasopharyngeal carcinoma.

From July 1977 through December 1980, a series of 1882 cases with nasopharyngeal carcinoma (NPC) had their first definitive radiotherapy course at our department, 1424 cases by continuous treatment regimen, and 458 cases by a split-course regimen. The interval of the split was 11-45 days, with an average of 28.6 days. Trials were non-randomized, but the treatment conditions for both groups were the same. The overall 5-year survival rate was 34.6%, 35.4% for the continuous group and 31.8% for the split-course group. The 5-year survival rate for Stage IV patients (squamous cell carcinoma Grade III) was 25.7% (69/268) for the continuous group and 14.1% (10/71) for the split-course group. Breaking down the cases by primary and cervical metastatic sites, for T3 cases, the 5-year local control rate for the primary site was 29.4% (133/451) for the continuous group, and 18.6% (22/118) for the split-course group. These differences are statistically significant (p less than 0.05). However, according to the data shown by this series, we can conclude that the split-course treatment regimen had no benefit over the continuous one when overall 5-year survival is considered.