Local transplantation of GMSC-derived exosomes to promote vascularized diabetic wound healing by regulating the Wnt/ß-catenin pathways.

With the increasing number of diabetic patients, chronic wound healing remains a great challenge in clinical medicine. As one of the main components secreted by stem cells, the exosome is considered to be a promising candidate for promoting chronic wound healing. Here, gingival mesenchymal stem cell (GMSC)-derived exosomes (GMSC-Exo) were isolated and demonstrated to promote the proliferation, migration, and tube formation of human umbilical vein endothelial cells (HUVECs) by regulating the Wnt/ß-catenin signaling pathway in a diabetic-mimicking high glucose environment. In order to deliver GMSCs-Exo to the target site and prolong their local retention, porous microspheres consisting of poly-lactic-co-glycolic acid (PLGA), amphiphilic block copolymer (PLLA-PEG-PLLA), nano-hydroxyapatite (nHAP), and poly-ε-l-lysine (EPL) coating were fabricated through a double emulsion method and following surface treatment, hereafter referred to as PHE microspheres. PHE microspheres loaded with GMSCs-Exo were implanted into the full-thickness skin wound of a diabetic mouse model, resulting in significant vascularized wound healing when compared to a control group only injected with GMSCs-Exo suspension or filled with PHE microspheres. These findings indicated that the GMSCs-Exo-loaded porous microspheres could efficiently treat diabetic wounds and have promising potential for future clinical translations.

Association of GCKR Gene Polymorphisms with Metabolic Syndrome in a Han Population from Northeast China.

BACKGROUND: As a serious public universal health issue, metabolic syndrome (MetS) has a high prevalence world-wide. Some studies illustrated that GCKR modulated insulin action and serum lipids are critical diagnostic criteria of MetS. The goal of this study is to investigate the association between GCKR polymorphisms with metabolic syndrome (MetS) in a Han population from northeast China. METHODS: Four single nucleotide polymorphisms (SNPs, rs1260326, rs8179206, rs780094, and rs2293571) were genotyped in 3,754 participants. MetS was defined according to International Diabetes Federation criteria (2009). Genotype and allele frequency distributions were compared between two groups by chi-squared test. The associations of the four SNPs under different genetic models with MetS were tested by multivariate logistic regression analysis adjusted for age, gender, location, education, occupation alcohol consumption, and smoking. p-values of no more than 0.003125 [0.05/(4 SNPs*4 different genetic models)] after Bonferroni correction were considered statistically significant. Linkage disequilibrium (LD) and haplotype analysis were evaluated by the Haploview software (version 4.2) and SNPStats program. RESULTS: Logistic regression analysis revealed that after Bonferroni correction, rs780094 was associated with MetS under the recessive model (p = 0.002). Weak LD was found for the four SNPs, and the CAGC haplotype appeared to be significantly decreased the risk of MetS (p = 0.026, OR = 0.88, 95% CI = 0.79 - 0.98). CONCLUSIONS: GCKR rs780094 was associated with MetS in northeast Han population, and haplotype CAGC generated by rs1260326, rs8179206, rs780094, and rs2293571 may decrease the risk of the disease.

Stepwise clustering future meteorological drought projection and multi-level factorial analysis under climate change: A case study of the Pearl River Basin, China.

Climate change has significant impacts on the Pearl River Basin, and the regional ecological environment and human production may face severe challenges in the future due to changes in temperature and precipitation, as well as their derivative disasters (e.g., drought). Therefore, a full understanding of the possible impacts of climate change on Pearl River Basin is desired. In this study, the potential changes in temperature, precipitation, and drought conditions were projected through a stepwise clustering projection (SCP) model driven by multiple GCMs under two different RCPs. The developed model could facilitate specifying the inherently complex relationship between predictors and predictands, and its performance was proven to be great by comparing the observations and model simulations. A multi-level factorial analysis was employed to explore the major contributing factors to the variations in projecting drought conditions. The results suggested that the Pearl River Basin would suffer significant increasing trends in Tmean (i.e., 0.25-0.34 °C per decade under RCP4.5 and 0.42-0.60 °C per decade under RCP8.5), and the annual mean precipitation would increase under both RCPs. The drought events lasting for 1-2 months would be decreased by 7.7%, lasting for 3-4 months would be increased by 4.3%, and lasting for more than five months would be increased by 3.4% under RCP4.5, respectively. While they changed to 6.1%, 1.4%, and 4.7% under RCP8.5, respectively. More medium and long-term drought events with higher drought severity would occur. GCM has dominant influences on four different responses of drought duration, accounting for 50.20%, 52.61%, 56.71%, and 56.24% of total variabilities, respectively. Meanwhile, the effects explained by GCM*RCP interactions cannot be neglected, with an average contribution rate of 44.37%, 37.86%, 37.66%, and 35.83%, respectively.

Prevalence and correlates of overweight and obesity among adolescents in northeastern China: a cross-sectional study.

OBJECTIVES: To estimate the prevalence of overweight/obesity among adolescents and evaluate the associated factors in this group in Changchun City in northeastern China. METHODS: A cross-sectional study of 1955 adolescents aged 11-18 years was conducted in Changchun City using stratified cluster sampling. Parents and caregivers of children completed the questionnaires as requested without objection. The questionnaire included demographic characteristics and anthropometric parameters. Univariate and multivariate logistic regression analyses were performed to analyse the relationship between overweight/obesity and related factors. RESULTS: In total, the prevalence of overweight was 12.7% (male 17.4%; female 10.1%) and of obesity was 4.9% (male 8.8%; female 3.1%) in Changchun, Jilin Province. The prevalence of overweight and obesity was higher in boys than in girls (p<0.001). Multivariate logistic regression showed that overweight and obesity were significantly associated with male sex (OR=1.91, 95% CI 1.48 to 2.47), eating fresh fruits more than 2 days per week (OR=1.41, 95% CI 1.09 to 1.84) and eating quickly (OR=1.37, 95% CI 1.06 to 1.78). Students who were not picky (OR=0.69, 95% CI 0.53 to 0.90) were less likely to be overweight, and adolescents whose father was overweight or obese (OR=0.67, 95% CI 0.52 to 0.86) or whose mother was overweight or obese (OR=0.72, 95% CI 0.52 to 0.99) were less likely to be overweight. CONCLUSION: The prevalence of overweight and obesity among adolescents in Changchun has been high in recent years, and the prevalence was higher among boys than among girls. Sex, dietary habits (weekly frequency of fruit consumption, picky eating and slowness in eating) and parental weight were important factors for overweight and obesity in adolescents. Further research should be conducted on the health of adolescents in China, and further intervention measures should be implemented to reduce the prevalence of overweight/obesity.

Prevalence and correlates of poor sleep quality among college students: a cross-sectional survey.

BACKGROUND: Sleep problems are widespread among college students around the globe, especially in China. This study was designed to investigate the prevalence of poor sleep quality and identify associated factors among college students in Jilin Province, China. METHODS: A total of 6284 participants were completely collected by stratified cluster sampling in 2016. Information on basic demographics, lifestyles, social and family support, and subjective sleep quality was collected by questionnaire. The Pittsburgh Sleep Quality Index (PSQI) is a self-administered questionnaire used to assess sleep for one month. RESULTS: 1951 (31.0%) participants were classified into poor sleep quality group, as defined by a PSQI score > 5. Males scored significantly higher than females on sleep duration and use of sleep medication, while females scored significantly higher than males on PSQI total and sleep disturbances. The results of the multivariate logistic regression show the following factors to be significant predictors of poor sleep quality: freshman (OR = 1.523, 95% CI: 1.168-1.987), alcohol use (OR = 1.634, 1.425-1.874), gambling behaviors (OR = 1.167, 95% CI: 1.005-1.356), exercised for more than 30 min a week on less than one day (OR = 1.234, 95% CI: 1.016-1.498), the feelings of satisfied with parental love (OR = 1.849, 95% CI: 1.244-2.749), and harmonious/neutral relationship with classmates (OR = 2.206, 95% CI: 1.312-3.708; OR = 1.700, 95% CI: 1.414-2.045),. No study pressure of this academic year (OR = 0.210, 95% CI: 0.159-0.276), no truancy in the past month (OR = 0.510, 95% CI: 0.354-0.735), never had self-injurious behaviors (OR = 0.413, 95% CI: 0.245-0.698), very harmonious family relationship (OR = 0.377, 95% CI: 0.219-0.650), frequent communication with parents (OR = 0.524, 95% CI: 0.312-0.880), the feelings of satisfied with maternal love (OR = 0.432, 95% CI: 0.257-0.725), and frequent excursions to gymnasium (OR = 0.770, 95% CI: 0.659-0.899) were the protective factors. CONCLUSIONS: The implication of the present study may be that college students must be made aware of the consequences of inadequate sleep quality and risk factors could be improved if students tried to change their behavior and subjective consciousness.

Association between ambient air pollution and pregnancy complications: A systematic review and meta-analysis of cohort studies.

BACKGROUND: Pregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have a great impact on public health. Exposure to ambient air pollution during pregnancy may cause pregnancy complications. The aim of our study is to explore the risk of trimester-specific maternal exposure to air pollutants on complications of pregnancy. METHODS: PubMed, EMBASE, Web of Science, and Cochrane were systematically searched for cohort studies published before October 27, 2019 which reported the association between ambient air pollutants (PM2.5, PM10, CO, NO, NO2, NOx, O3, and SO2) and pregnancy complications (GDM, HDP, preeclampsia, and gestational hypertension) during different exposure windows. A meta-analysis was applied to combine relative risks (RRs) and their confidence intervals (CIs) from eligible studies. Quality assessment was conducted and Egger test was used to evaluate the publication bias. All statistical analyses were performed by STATA software (Version 15, StataCorp, College Station, Texas, USA). RESULTS: This meta-analysis consisted of 33 cohort studies conducted on 22,253,277 pregnant women. Meta-analyses showed during the first trimester, there were significant associations of PM10 with gestational hypertension (RR = 1.07, 95% CI: 1.02-1.12 per 10 µg/m3, I2 = 0.0%), of SO2 with GDM (RR = 1.04, 95% CI: 1.00-1.08 per 1 ppb increment, I2 = 54.1%), of PM2.5 with preeclampsia (RR = 0.97, 95% CI: 0.95-1.00 per 5 µg/m3, I2 = 4.1%). During the entire pregnancy, PM2.5 significantly increased the risk of hypertensive disorders of pregnancy (RR = 1.18, 95% CI: 1.02-1.34 per 5 µg/m3, I2 = 85.1%). Egger test indicated that wide-scale publication bias was unlikely. CONCLUSION: Maternal exposure to ambient air pollutants is associated with pregnancy complications especially during the first trimester. Further large multicenter cohort studies considering different constituents of pollutants, levels of disease severity, sensitive populations, and various exposure windows are warranted in the future research.

Comparison of Wide Margin and Inadequate Margin for Recurrence in Sacral Chordoma: A Meta-Analysis.

STUDY DESIGN: .: A meta-analysis. OBJECTIVE: .: The goal of this study was to accurately evaluate the risk ratio (RR) of recurrence in chordoma patients with wide margin after removing the tumors using surgery, compared with inadequate margin (intralesional or marginal). SUMMARY OF BACKGROUND DATA: .: As a rare malignant bone cancer, the more effective treatment for sacral chordoma is still surgical resection. However, there is no convincing evidence and risk ratio about sacral chordoma patients would be benefit from which kind of surgical margin. METHODS: .: We searched the PubMed, Cochrane Library, Web of Science, and EMBASE from inception to December 2018. The heterogeneity analysis and calculation of the pooled risk ratio were performed using RevMan 5.3 software. The assessment of publication bias and sensitivity analysis was conducted using StataSE 15.1 software. The protocol for this meta-analysis was registered on International prospective register of systematic reviews (PROSPERO, CRD42019127441). RESULTS: .: Twelve studies with a total of 436 patients who met the inclusion criteria were included. The pooled results indicated that patients in the wide group had lower recurrence rate than those in the inadequate group (RR = 0.42, 95% confidence interval [CI] 0.31-0.57; P < 0.001). And patients in the wide group had lower mortality rate than those in the inadequate group (RR = 0.49, 95% CI 0.26-0.91; P = 0.02). No significant differences in the risk of mortality were found between relapsed patients in the two groups (RR = 0.64, 95% CI 0.35-1.15; P = 0.13). CONCLUSION: .: In sacral chordoma patients, wide margin is associated with low recurrence risk, when it is feasible, a wide excision should be considered appropriate for sacrum chordoma. LEVEL OF EVIDENCE: 2.

Association between RELN polymorphisms and schizophrenia in a Han population from Northeast China.

OBJECTIVE: To explore the association between the RELN gene and schizophrenia in the overall sample and samples stratified by sex in a northeastern Chinese population. METHODS: A total of 1536 participants from Jilin Province, China, were recruited in this case-control study. Four single nucleotide polymorphisms (rs1062831, rs3808039, rs362746, and rs736707) in the RELN gene were genotyped. Binary logistic regression analysis was applied to detect associations between the genotypes of each single nucleotide polymorphism and schizophrenia. P values of no more than 0.003125 [0.05/(4 SNPs*4 different genetic models)] after Bonferroni correction were considered statistically significant. RESULTS: All single-nucleotide polymorphisms conformed to Hardy-Weinberg equilibrium in the control group. Logistic regression analysis revealed that after Bonferroni correction, rs362746 was associated with schizophrenia under the recessive model (P = 0.001) and codominant model (P = 0.003) in the overall group. The association between schizophrenia and RELN single-nucleotide polymorphisms was not found in a sex-specific pattern after Bonferroni correction. CONCLUSION: Our study provides and supports the evidence that RELN is a candidate gene for schizophrenia. Replication studies conducted in different populations are required, and the sex-specific association of this gene with schizophrenia warrants further exploration.

Analysis of Factors Affecting the High Subjective Well-Being of Chinese Residents Based on the 2014 China Family Panel Study.

(1) Purpose: The purpose of our research is to understand the subjective well-being (SWB) of Chinese adult residents and its influencing factors and to identify the key groups and areas to provide a basis for the formulation of relevant policies to improve residents' happiness. (2) Methods: In this study, we analyzed the influencing factors of SWB of individuals older than 16 years of age, according to the 2014 China Family Panel Study (CFPS). We weighted 27,706 samples in the database to achieve the purpose of representing the whole country. Finally, descriptive statistics were used for the population distribution, chi-square tests were used for univariable analysis, and binary logistic models were used for multivariable analysis. (3) Results: The response rate of SWB was 74.58%. Of the respondents, 71.2% had high SWB (7-10), with a U-shaped distribution between age and SWB. Females are more likely than males to rate themselves as happy. There is a positive ratio between years of education and SWB. Residents who have better self-evaluated income, self-rated health (SRH), psychological well-being (PWB), Body Mass Index (BMI), social trust, social relationships, and physical exercise have higher SWB. (4) Conclusion: The results of the present study indicate that to improve residents' SWB, we should focus more attention on middle-aged and low-income groups, particularly men in agriculture. The promotion of SWB should be facilitated by improvements in residents' education, health status, and social support as well as by the promotion of smoking bans and physical exercise.

The diagnostic performance of PET/CT scans for the detection of para-aortic metastatic lymph nodes in patients with cervical cancer: A meta-analysis.

OBJECTIVE: We performed a meta-analysis to evaluate the diagnostic value of positron emission tomography/computed tomography (PET/CT) in the detection of para-aortic lymph node metastasis in cervical cancer. METHODS: We searched the PubMed, Embase, Web of Science, Cochrane Library, Chinese Biological Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang and VIP databases in all languages from their inception to September 2018. Stat15.0 software was used to obtain pooled estimates of sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) as well as a summary receiver operating characteristic (SROC) curves. Deek's funnel plot was used to assess publication bias. QUADAS-2 was used to evaluate the quality of the studies. The protocol for this meta-analysis is registered in PROSPERO (CRD42019115330). RESULTS: We obtained 14 studies, and the pooled estimates for sensitivity and specificity of PET/CT were 0.71 (95% confidence interval (CI) = 0.54-0.83) and 0.97 (95% CI = 0.93-0.98), respectively. Pooled PLR and NLR were 21.53 and 0.30, respectively. The diagnostic odds ratio (DOR) was70.59, and the area under the curve (AUC) was 0.95. CONCLUSION: PET/CT is an effective and important imaging method for the diagnosis of para-aortic lymph node metastasis in early cervical cancer.

Decreased serum complement component 4 levels in patients with schizophrenia.

Dysregulation of the immune system in mental disease, particularly complement component 4 (C4), which may be associated with schizophrenia, has been repeatedly observed. This study investigated the association between the level of serum component 4 and schizophrenia. Data were derived from a case-control association study of 40 unrelated adult patients with schizophrenia and 40 matched healthy controls. The component 4 level in serum was measured for comparative analysis by a component 4 enzyme-linked immunosorbent assay kit. Our findings suggest that the serum component 4 level is lower in patients with schizophrenia than in the controls, and the results apply to both males and females. Our results will lay an important foundation for establishing diagnostic methods and provide feasible and reliable evidence for the clinical treatment of schizophrenia.