Health-related quality of life and influencing factors of patients with paroxysmal nocturnal hemoglobinuria in China.

BACKGROUND: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder, leading to various complications and impairments in patients' health-related quality of life (HRQOL). Limited research has been conducted to evaluate the HRQOL of Chinese patients with PNH. Understanding the HRQOL in this specific population is crucial for providing effective healthcare interventions and improving patient' health outcomes. This study aimed to assess HRQOL of Chinese patients with PNH, and identify key determinants. METHODS: A cross-sectional study was conducted during 2022 to recruit patients with PNH in China. The study population was recruited from PNH China, one of the largest public welfare PNH patient mutual aid organization in China. Data were collected via an online questionnaire including the EQ-5D-5L (5L), and social-demographic and clinical characteristics. Descriptive statistics were employed to summarize the characteristics of the participants and their HRQOL. Multiple linear and logistic regression analyses were adopted to explore key factors affecting HRQOL. RESULTS: A total of 329 valid questionnaires were collected. The mean (SD) age of the patients was 35.3 (10.0) years, with 52.3% of them being male. The patients reported more problems in Anxiety/Depression (81.5%) and Pain/Discomfort (69.9%) dimensions compared to the other three 5L dimensions. The mean (SD) of 5L health utility score (HUS) and EQ-VAS score were 0.76 (0.21) and 62.61 (19.20), respectively. According to multiple linear regression, initial symptoms (i.e., Anemia [fatigue, tachycardia, shortness of breath, headache] and back pain) and complication of thrombosis were significant influencing factors affecting 5L HUS. Total personal income of the past year, initial symptom of hemoglobinuria and complication of thrombosis were significantly influencing factors of VAS score. Social-demographic and clinical characteristics, such as gender, income, and thrombosis, were also found to be significantly related to certain 5L health problems as well. CONCLUSION: Our study manifested the HRQOL of PNH patients in China was markedly compromised, especially in two mental-health related dimensions, and revealed several socio-demographic and clinical factors of their HRQOL. These findings could be used as empirical evidence for enhancing the HRQOL of PNH patients in China.

Recurrence and malignant transformation of laryngeal leukoplakia treated with CO2 laser: A systematic review and meta-analysis.

BACKGROUND: Laryngeal leukoplakia (LL) is a white lesion with high potential of recurrence and malignant transformation. Currently, CO2 laser has become the primary surgical treatment for LL, and the recurrence and malignant transformation rates after treatment vary widely. OBJECTIVE: We performed a systematic review and meta-analysis dedicated to evaluating the rates of recurrence and malignant transformation of LL lesions treated with CO2 laser and exploring relevant risk factors for recurrence or malignant transformation. METHODS: Literature searches were conducted on ProQuest, PubMed, Web of Science, Ovid Medline, Embase, and Cochrane databases. Some articles identified through hand searching were included. RESULTS: A total of 14 articles and 1462 patients were included in this review. Pooled results showed that the overall recurrence rate was 15%, and the malignant transformation rate was 3%. Subgroup analysis showed that the dysplasia grade was not a significant risk factor for the recurrence and malignant transformation of LL (P > .05). CONCLUSIONS: The results of this systematic review and meta-analysis suggest that the CO2 laser is a safe and effective surgical instrument for the excision of LL, which yields low rates of recurrence and malignant transformation. The risk factors relevant to recurrence or malignant transformation remain unclear and require further investigation.

The role of HPV11 E7 in modulating STING-dependent interferon ß response in recurrent respiratory papillomatosis.

Recurrent respiratory papillomatosis (RRP) is a rare benign tumor caused mainly by the infection of the respiratory tract epithelial cells by the human papillomavirus (HPV) type 6/11. However, the specific mechanisms underlying the inhibition of the host's innate immune response by HPV remain unclear. For this purpose, we employed single-cell RNA sequencing to analyze the states of various immune cells in RRP samples post-HPV infection and utilized a cellular model of HPV infection to elucidate the mechanisms by which HPV evades the innate immune system in RRP. The results revealed distinct immune cell heterogeneity in RRP and demonstrated that HPV11 E7 can inhibit the phosphorylation of the stimulator of interferon genes protein, thereby circumventing the body's antiviral response. In vitro co-culture experiments demonstrated that stimulation of macrophages to produce interferon-beta induced the death of HPV-infected epithelial cells, also reducing HPV viral levels. In summary, our study preliminarily identifies the potential mechanisms by which HPV evades the host's antiviral immune response, as well as the latent antiviral functions exhibited by activated macrophages. This research serves as an initial exploration of antiviral immune evasion in RRP, laying a solid foundation for investigating immunotherapeutic approaches for the disease.IMPORTANCESurgical tumor reduction is the most common treatment for recurrent respiratory papillomatosis (RRP). One of the characteristics of RRP is its persistent recurrence, and multiple surgeries are usually required to control the symptoms. Recently, some adjuvant therapies have shown effectiveness, but none of them can completely clear human papillomavirus (HPV) infection, and thus, a localized antiviral immune response is significant for disease control; after all, HPV infection is limited to the epithelium. Inhibition of interferon-beta (IFN-ß) secretion by HPV11 E7 viral proteins in epithelial cells by affecting stimulator of interferon genes phosphorylation may account for the persistence of low-risk HPV replication in the RRP. Moreover, suppression of the IFN-I pathway in RRP cell types might provide clues regarding the hyporeactive function of local immune cells. However, activation of macrophage groups to produce IFN-ß can still destroy HPV-infected cells.

Enhanced Photostability of Lead Halide Perovskite Nanocrystals with Mn3+ Incorporation.

Recently, lead halide perovskite nanocrystals (NCs) have shown great potential and have been widely studied in lighting and optoelectronic fields. However, the long-term stability of perovskite NCs under irradiation is an important challenge for their application in practice. Mn2+ dopants are mostly proposed as substitutes for the Pb site in perovskite NCs synthesized through the hot-injection method, with the aim of improving both photo- and thermal stability. In this work, we employed a facile ligand-assisted reprecipitate strategy to introduce Mn ions into perovskite lattice, and the results showed that Mn3+ instead of Mn2+, even with a very low level of incorporation of 0.18 mol % as interstitial dopant, can enhance the photostability of perovskite binder film under the ambient conditions without emission change, and the photoluminescent efficiency can retain 70% and be stable under intensive irradiation for 12 h. Besides, Mn3+ incorporation could prolong the photoluminescent decay time by passivating trap defects and modifying the distortion of the lattice, which underscores the significant potential for application as light emitters.

Comparing urine point-of-care tests to screen preeclampsia: Congo-red dot paper test versus dipstick urinalysis.

To compare the urine Congo-red dot paper test (CRD) with dipstick urinalysis to screen preeclampsia (PE). A total of 409 paired spot urine samples were obtained prospectively from women with suspected pre-eclampsia attending for routine hospital visits. Congo-red dot paper test and dipstick urinalysis were examined and compared to screen pre-eclampsia. The agreement between the two urinary test is modest (kappa coefficient = 0.28, 95% CI 0.14-0.42). The specificity of CRD was higher than urinalysis (97.4% vs. 90.4%, p < .001). Urinalysis performed better in sensitivity (77.3% vs. 40.9%, p = .04) and the area under the receiver operating characteristic curves (AUC) (0.84 [95% CI 0.74-0.94] vs. 0.69 [95% CI 0.55-0.83], p = .04) than CRD, respectively. The sensitivity, specificity, AUC of the parallel test of them is 86.4% (64.0%-96.4%), 89.1% (85.5%-92.0%), and 0.88 (95% CI 0.79-0.96). And the serial test is 31.8% (14.7%-54.9%), 98.7% (96.8%-99.5%), 0.65 (95% CI 0.51-0.79), accordingly. The urinalysis is a better diagnosing test for preeclampsia. CRD could aid in the diagnosis of patients with preeclampsia. Combined the two tests in suspected patients may further improve the performance in the diagnosis of preeclampsia. Further study need to be made for its potential clinical practice.

Trans-cinnamaldehyde fumigation inhibits Escherichia coli by affecting the mechanism of intracellular biological macromolecules.

This study aimed to determine the antibacterial mechanism of cinnamaldehyde fumigation in Escherichia coli (E. coli). Through vapour fumigation, cinnamaldehyde was confirmed to exhibit effective antibacterial activity against E. coli. The minimum inhibitory concentration (MIC) and minimum bacterial concentration (MBC) were 0.25 µL/mL and 0.5 µL/mL, respectively. Based on transmission electron microscopy, the wrinkled bacterial cells observed after fumigation could be related to the leakage of intracellular substances. Laser tweezers Raman spectroscopy revealed changes in the main chain of proteins, the hydrogen bond system and spatial structure, and single- and double-stranded DNA breaks. In addition, breakage of the fatty acyl chain backbone was found to affect the vertical order degree of the lipid bilayer and cell membrane fluidity, thereby inhibiting the growth of E. coli. Overall, our findings indicate that cinnamaldehyde fumigation inhibits E. coli growth by inducing changes in intracellular biological macromolecules.

A Novel Five-Step Reduction Technique of Arytenoid Dislocation.

The article reported a novel reduction device and standardized reduction technique for patients with arytenoid dislocation. The results showed that this reduction technique has been excellent in helping patients with arytenoid dislocation. Laryngoscope, 134:1744-1748, 2024.

Zbtb14 Promotes Non-Alcoholic Fatty Liver Disease-Associated Fibrosis in Gerbils via the ß-Catenin Pathway.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a popular chronic liver disorder with high morbidity and with no approved therapeutic drugs. Fibrosis is a crucial drug efficacy indicator for NAFLD. Thus, investigating the mechanisms of NAFLD-associated fibrosis and exploring effective therapeutic targets is imperative. METHODS: Gerbil NAFLD-associated fibrosis model was constructed by feeding a high-fat and high-cholesterol diet. The hematoxylin and eosin staining and the alanine transaminase (ALT) and aspartate transaminase (AST) assays were used to determine liver tissue injury. Masson staining and hydroxyproline (Hyp) level determination were used to assess liver fibrosis. High-throughput mRNA sequencing was used to screen differentially expressed genes in the NAFLD-associated fibrosis model. Cell Counting Kit-8 was utilized to test cell viability. RESULTS: Liver injury and fibrosis were observed in the gerbil NAFLD-associated fibrosis model with increased ALT, AST, and Hyp levels. The screened differentially expressed genes were mainly enriched in "negative regulation of hemopoiesis", "response to interleukin-1", and "granulocyte migration". Zinc Finger and BTB Domain Containing 14 (Zbtb14) was upregulated in liver tissues of the gerbil NAFLD-associated fibrosis model, patients with liver fibrosis, and hepatic stellate cells (HSCs). Additionally, Zbtb14 regulated primary HSCs activation via the ß-catenin pathway. CONCLUSIONS: Zbtb14 regulated NAFLD-associated fibrosis via the ß-catenin pathway, for the first time, and it serves as the probable target for NAFLD therapy.

AgIn5S8/ZnS Quantum Dots for Luminescent Down-Shifting and Antireflective Layer in Enhancing Photovoltaic Performance.

Colloidal AgIn5S8/ZnS quantum dots (QDs) have recently emerged as a promising, efficient, nontoxic, down-shifting material in optoelectronic devices. These QDs exhibit a high photoluminescent quantum yield and offer a range of potential applications, specifically in the field of photovoltaics (PVs) for light management. In this work, we report an eco-friendly method to synthesize AgIn5S8/ZnS QDs and deposit them on commercial silicon solar cells (with an active area of 7.5 cm2), with which the short-circuit current (JSC) enhanced by 1.44% and hence the power conversion efficiency by 2.51%. The enhancements in PV performance are mainly attributable to the improved external quantum efficiency in the ultraviolet region and reduced surface reflectance in the ultraviolet and near-infrared regions. We study the effect of QD concentration on the bifunctions of downshifting and antireflection. The optimal 15 mg/mL QDs blade-coated onto the Si solar cells realize maximum current generation as the reflectance loss in the visible wavelength is compensated by the minimized reflection in the near-infrared region.

Dysphagia Outcomes Before and After Adenotonsillectomy in Children With Obstructive Sleep Apnea: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Obstructive sleep apnea (OSA) and tonsil hypertrophy may be associated with dysphagia. However, randomized clinical trials assessing dysphagia outcomes in children randomized to adenotonsillectomy (AT) vs watchful waiting with supportive care (WWSC) are lacking. Objective: To assess dysphagia outcomes in children with OSA and tonsil hypertrophy managed with AT or WWSC. Design, Setting, and Participants: This secondary analysis of a multicenter randomized clinical trial, the Childhood Adenotonsillectomy Trial (CHAT), was conducted at tertiary children's hospitals from October 2007 to June 2012. Children aged 5.0 to 9.9 years with OSA were randomized to AT or WWSC and underwent polysomnography at baseline and 7 months. Caregivers completed the OSA-18 questionnaire, which includes an item on difficulty in swallowing at baseline and 7 months. The current secondary analysis was conducted from December 1, 2022, to January 10, 2023. Interventions: AT vs WWSC. Main Outcomes and Measures: Prevalence of dysphagia, based on parental responses to the difficulty in swallowing item on the OSA-18 questionnaire, was redefined as a binary outcome at baseline and 7-month follow-up. Results: In total, 386 children were included (199 female [51.6%]; median [IQR] age, 6.0 [5.0-8.0] years). Of the total, 207 children were Black (53.6%). At baseline, the number of children with dysphagia was similar (4.0%; 95% CI, -4.9% to 12.9%) between the AT group (56 [29.8%]) and the WWSC group (51 [25.8%]). Following AT, a decrease was observed (21.3%; 95% CI, 13.5%-28.9%) in the prevalence of dysphagia among the children. In contrast, the prevalence of dysphagia did not change significantly (1.0%; 95% CI, -7.6% to 9.6%) in the WWSC group. Children in the AT group were more likely to experience a resolution of dysphagia than those in the WWSC group (adjusted odds ratio, 4.84; 95% CI, 1.91-12.25). Higher baseline AHI was associated with a lower resolution of dysphagia (AOR, 0.91; 95% CI, 0.83-0.98). Conclusions and Relevance: This secondary analysis of the CHAT randomized clinical trial suggested that children with dysphagia and OSA undergoing AT may experience dysphagia improvement. A prospective randomized trial that uses a validated dysphagia survey is needed to verify the effectiveness of AT in treating dysphagia. Trial registration: ClinicalTrials.gov Identifier: NCT00560859.

Analysis of the anatomical distribution of HPV genotypes in head and neck squamous papillomas.

Squamous papillomas (SPs) of the head and neck are usually benign lesions associated with human papilloma virus (HPV) infection. However, the reported HPV detection rates vary widely, especially with respect to anatomical distribution. The etiology of SPs in the head and neck remains unclear; analyzing HPV genotypes of SPs based on anatomical sites could assist in clarifying the pathogenesis of SPs in the head and neck. Therefore, the aim of this study was to review the prevalence, subtypes, and anatomical distribution of HPV in head and neck SPs at a hospital in China; we also investigated whether p16, a marker of HPV infection in oropharyngeal carcinoma, could serve as a surrogate marker for HPV in head and neck SPs. The presence of HPV DNA of 23 types (5 low-risk HPV and 18 high-risk HPV types) was detected via real-time PCR. p16 immunohistochemistry was performed using SP sections. Age, sex, anatomical location, and HPV subtype were recorded for each case. In total, 105 SPs were identified, including 47 in the larynx, 42 in the pharynx, 6 in the external auditory canal (EAC), 5 in the oral cavity, and 5 in the nasal cavity. HPV was found in 57 (54.3%) cases, with the highest positivity rate in the larynx (46/47; 97.9%). Only 5/42 (11.9%) patients showed HPV positivity in the pharynx. HPV incidence was highly dependent on the anatomical site. SPs in the larynx and EAC were more likely to carry HPV than those in other anatomical sites. High-risk HPV infections were rarely associated with SPs in the head and neck region. The sensitivity and specificity of p16 immunohistochemistry for HPV infection were 88% and 96%, respectively. There may be an association between p16 and HPV infection in head and neck SPs, but further studies are needed to validate this assertion.

USP33 promotes nonalcoholic fatty acid disease-associated fibrosis in gerbils via the c-myc signaling.

Nonalcoholic fatty acid disease (NAFLD) is a common complication of obesity associated with liver fibrosis. The underlying molecular mechanisms involved in the progression from normal to fibrosis remain unclear. Liver tissues from the liver fibrosis model identified the USP33 gene as a key gene in NAFLD-associated fibrosis. USP33 knockdown inhibited hepatic stellate cell activation and glycolysis in gerbils with NAFLD-associated fibrosis. Conversely, overexpression of USP33 caused a contrast function on hepatic stellate cell activation and glycolysis activation, which was inhibited by c-Myc inhibitor 10058-F4. The copy number of short-chain fatty acids-producing bacterium Alistipes sp. AL-1, Mucispirillum schaedleri, Helicobacter hepaticus in the feces, and the total bile acid level in serum were higher in gerbils with NAFLD-associated fibrosis. Bile acid promoted USP33 expression and inhibiting its receptor reversed hepatic stellate cell activation in gerbils with NAFLD-associated fibrosis. These results suggest that the expression of USP33, an important deubiquitinating enzyme, is increased in NAFLD fibrosis. These data also point to hepatic stellate cells as a key cell type that may respond to liver fibrosis via USP33-induced cell activation and glycolysis.

Control mechanisms of water chemistry based on long-term analyses of the Yangtze River.

Long-term series data can provide a glimpse of the influence of natural and anthropogenic factors on water chemistry. However, few studies have been conducted to analyze the driving forces of the chemistry of large rivers based on long-term data. This study aimed to analyze the variations and driving mechanisms of riverine chemistry from 1999 to 2019. We compiled published data on major ions in the Yangtze River, one of the three largest rivers in the world. The results showed that Na+ and Cl- concentrations decreased with increasing discharge. Significant differences in riverine chemistry were found between the upper and middle-lower reaches. Major ion concentrations in the upper reaches were mainly controlled by evaporites, especially Na+ and Cl- ions. In contrast, major ion concentrations in the middle-lower reaches were mainly affected by silicate and carbonate weathering. Furthermore, human activities were the drivers of some major ions, notably SO42- ions associated with coal emissions. The increased major ions and total dissolved solids in the Yangtze River in the last 20 years were ascribed to the continuous acidification of the river and the construction of the Three Gorges Dam. Attention should be given to the impact of anthropogenic activities on the water quality of the Yangtze River.

GSI CTA evaluation of the vertebrobasilar artery in normal adults at high altitude.

Objective: Vascular geometry is influenced by several factors during its growth and development. Here, we compared the differences in vertebrobasilar geometry among residents of a plateau region at different altitudes and investigated the relationship between vascular geometry and altitude. Methods: Data of some adults in the plateau region who experienced vertigo and headache as the main symptoms but had no evident abnormalities found during imaging examination were collected. They were divided into three groups based on an altitude gradient: group A (1,800-2,500 masl), group B (2,500-3,500 masl), and group C (over 3,500 masl). They underwent head-neck energy-spectrum computed tomography angiography with a gemstone spectral imaging scanning protocol. The following indices were observed: (1) vertebrobasilar geometric configurations (walking, tuning fork, lambda, and no confluence), (2) vertebral artery (VA) hypoplasia, (3) the bending number of bilateral VA intracranial segment, (4) length and tortuosity of the basilar artery (BA), and (5) anteroposterior (AP)-mid-BA angle, BA-VA angle, lateral-mid-BA angle, and VA-VA angle. Results: Of the 222 subjects, 84 of them were included in group A, 76 in group B, and 62 in group C. The number of participants in walking, tuning fork, lambda, and no confluence geometries was 93, 71, 50, and 8, respectively. As altitude increased, the tortuosity of the BA also increased (1.05 ± 0.06 vs. 1.06 ± 0.08 vs. 1.10 ± 0.13, P = 0.005), as did the lateral-mid-BA angle (23.18° ± 9.53° vs. 26.05° ± 10.10° vs. 31.07° ± 15.12°, P = 0.007) and the BA-VA angle (32.98° ± 17.85° vs. 34.51° ± 17.96° vs. 41.51° ± 19.22°, P = 0.024). There was a relatively weak positive correlation between the altitude and the tortuosity of the BA (rs = 0.190, P = 0.005), the lateral-mid-BA angle (rs = 0.201, P = 0.003), and the BA-VA angle (rs = 0.183, P = 0.006) which showed a significant difference. Compared with groups A and B, there were more multibending groups and fewer oligo-bending groups in group C (P < 0.001). There was no difference found in the vertebral artery hypoplasia, actual length of the BA, VA-VA angle, and AP-mid-BA angle among the three groups. Conclusion: As the altitude increased, the tortuosity of the BA and the sagittal angle of the vertebrobasilar arterial system also increased. The increase in altitude can lead to changes in vertebrobasilar geometry.

Global trends and hotspots on childhood obstructive sleep apnea: a 10-year bibliometric analysis.

Background: Obstructive sleep apnea (OSA) is children's most common sleep-related breathing disorder. It may develop a wide range of severe complications if not diagnosed promptly and treated effectively. However, Childhood OSA has not specifically been analyzed using a bibliometric approach. Methods: We respectively collected the research results of childhood OSA from 2013 to 2022 through Web of Science and PubMed. Vosviewer, CiteSpace, and bibliometric online analysis platforms were used for visualizing and analyzing the literature. The MeSH terms were bi-clustered using the Bibliographic Item co-occurrence Matrix Builder (BICOMB) and graph clustering toolkit (gCLUTO) to identify the hotspots. Results: 4022 publications were finally identified on childhood OSA from 2013 to 2022. The United States has the largest number of publications (1902), accounting for 47.29%. University of Cincinnati is the most productive organization (196), followed by the University of Pennsylvania (151). The most prolific journal was the International Journal of Pediatric Otorhinolaryngology, with 311 documents published. In comparison, Pediatrics is the most cited journal (6936). Gozal D ranked highest among all authors in publication (192). Burst detection shows continuous positive airway pressure, Robin sequence, and nocturnal oximetry are recent keywords of great interest to researchers. Five hotspots were identified by co-word biclustering. Conclusion: Research over the past ten years has been fruitful, establishing the foundation for childhood OSA. Clusters (0-4) of high-frequency Major Mesh topics have attracted extensive attention. Evaluation and treatment methods of childhood OSA remain major focuses. We believe this article will provide other researchers with new directions and may contribute to a future breakthrough in this field.

Influence of arbuscular mycorrhizal fungi on bioaccumulation and bioavailability of As and Cd: A meta-analysis.

Increasing industrial activity has led to a growing risk of arsenic (As) and cadmium (Cd) accumulations and biomagnifications in plants and humans. Arbuscular mycorrhizal fungi (AMF) have been extensively studied as a soil amendment owing to their capability to reduce the accumulation of As and Cd in plant tissues. However, a quantitative and data-based consensus has yet to be reached on the effect of AMF on As and Cd bioaccumulation and bioavailability. Here, a meta-analysis was conducted to quantitatively evaluate the impact of AMF using 1430 individual observations from 194 articles. The results showed that AMF inoculation caused a decrease in shoot and root As and Cd accumulation compared to control, and the reduction rates were affected by experimental duration, P fertilizer, AMF species, plant family, plant lifecycle, and soil properties. Intermediate experimental duration (lasting 56-112 days) and no P fertilizer favored AMF to reduce the shoot As and root Cd accumulation. Compared to other plant families, the reduction in As and Cd accumulation in legumes was the greatest, following AMF inoculation. The soils with alkaline, high organic carbon (OC), and low available phosphorus (AP) appeared to be more favorable for AMF to reduce As accumulation in plant tissues, while soils with low AP were more conducive to reducing the Cd accumulation in plant tissues. In addition, AMF inoculation increased pH (1.92%), OC (6.27%), easily-extractable glomalin-related soil protein (EE-GRSP) (29.36%), and total glomalin-related soil protein (T-GRSP) (29.99%), and reduced bioavailable As (0.52%) and Cd (2.35%) in soils compared to control. Overall, the meta-analysis provides valuable guidelines for the optimal use of AMF in different plant-soil systems.

Genesis of high hexavalent chromium groundwater in deep aquifers from loess plateau of Northern Shaanxi, China.

Hexavalent chromium (Cr(VI)) groundwater usually exists in shallow aquifers related to ultramafic and serpentine formations, but knowledge of the genesis of dissolved Cr(VI) in deep sandstone aquifers is limited. Both groundwater and aquifer sediments were taken from the Jingbian County in the Loess Plateau of Northwestern Shaanxi to investigate distribution and genesis mechanism of high Cr(VI) groundwater in deep sandstone aquifers. Results showed that the Cr concentrations (median 142 µg/L) in groundwater from deep aquifers (>100 m) were relatively high, while the Cr concentrations in shallow groundwater were low (median 33.8 µg/L). Dissolved Cr mainly existed in the species of Cr(VI) (average, 90%). Deep groundwater with higher Cr(VI) concentrations generally had higher pH, Eh, and DO than shallow groundwater, indicating that the high Cr(VI) groundwater existed in relatively oxic environment. Cretaceous sandstones in deep aquifers had anomalously high contents of total Cr (average 115 mg/kg), where Cr was mainly present in silicates-bound form, and secondly in strongly adsorbed form. There were positive correlations between Mn and Cr in the unweathered silicate-bound form and adsorbed form, which were conducive to Cr(III) oxidation into Cr(VI) in an alkaline-oxic environment. The different ionic ratios (i.e. (Ca2+ + Mg2+)/(HCO3- + SO42-)) also supported silicate weathering as the dominant rock-water interactions in the deep groundwater, which enhanced the release of the unweathered silicate-bound Cr. Relatively high pH and ionic strength mobilized the adsorbed Cr(VI) into groundwater. This investigation emphasizes the geological origin of high Cr(VI) groundwater in deep sandstone aquifers containing Mn oxides, which deserves more concerns for the purpose of drinking water supply.

[Effect of Mobile Health for Standardized Management on Women with Gestational Diabetes Mellitus].

Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM). Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups. Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group [(67.22±22.76)% vs.(60.69±21.28)%,P=0.004].The incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit demonstrated no significant differences between groups(all P > 0.05). Conclusions Mobile health applied in standardized management is conducive to the glycemic control of GDM women,whereas it does not significantly improve the pregnancy outcomes.Due to the short time of intervention,the effects of mobile health on pregnancy outcomes need further study.