2013 Vol. 26, No. 6

Original Articles
Total Energy Expenditure of 16 Chinese Young Men Measured by the Doubly Labeled Water Method
ZHUO Qin, SUN Rui, GOU Ling Yan, PIAO Jian Hua, LIU Jian Min, TIAN Yuan, ZHANG Yu Hui, YANG Xiao Guang
2013, 26(6): 413-420. doi: 10.3967/0895-3988.2013.06.001

Objective Doubly labeled water (DLW) method is the gold standard for measuring total energy expenditure (TEE). We used this method to measure TEE in Chinese young men. Methods Sixteen healthy young men age 23±1 years with body mass index 22.0±1.4 kg/m2 were recruited. TEE was measured by the DLW method, and basal energy expenditure (BEE) was determined by indirect calorimetry. We also conducted 24-h activity, energy balance and factorial approach to estimate energy requirements of the subjects. Results TEE of subjects by DLW method was 9.45±0.57 MJ/day (2258±180 kcal/day). The 24-h activity was 10.80±0.33 MJ/day (2582±136 kcal/day). The energy requirement, derived from energy balance observations, was 9.93±1.32 MJ/day (2373±315 kcal/day). The BEE of 6.65±0.28 MJ/day (1589±67 kcal/day), calculated by the adjusted Schofield equation, was significantly higher (P<0.001) than that measured by indirect calorimetry, 5.99±0.66 MJ/day (1433±158 kcal/day). The TEE derived from the factorial approach was 10.31±0.43 MJ/day (2463±104 kcal/day). Conclusion The TEE of Chinese young men measured by the DLW method was about 10%lower than the current recommended nutrient intake (RNI), suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.

Dietary Exposure of the Chinese Population to Acrylamide
ZHOU Ping Ping, ZHAO Yun Feng, LIU Hua Liang, MA Yong Jian, LI Xiao Wei, YANG Xin, WU Yong Ning
2013, 26(6): 421-429. doi: 10.3967/0895-3988.2013.06.002

Objective To assess the current status of the acrylamide in the Chinese food supply, the dietary acrylamide exposure in the Chinese population and to estimate the public health risks of the current consumption. Methods The acrylamide content in the total diet study (TDS) food samples was analyzed using an LC-MS/MS method. Based on the analytical results, the dietary exposure calculations were performed using a deterministic method, combining mean acrylamide concentrations from the food group composite with their associated food consumptions. Results Acrylamide was detected in 43.7% of all samples collected and acrylamide concentration varied from ND to 526.6 μg/kg. The estimated dietary intakes of acrylamide among Chinese general population given as the mean and the 95th percentile (P95) were 0.286 and 0.490 μg·kg-1 bw·day-1, respectively. The margins of exposure (MOEs) for the population calculated using both benchmark dose lower confidence limit for a 10%extra risk of tumors in animals (BMDL10) 0.31 and 0.18 μg·kg-1 bw·day-1, were 1069 and 621 for the mean dietary exposure, and 633 and 367 for the high dietary exposure respectively. Conclusion These MOE values might indicate a human health concern on acrylamide for Chinese population. Efforts should continue to reduce acrylamide levels in food in order to reduce the dietary risks to the human health.

Characterization of Staphylococcus aureus Isolated from Clinical Specimens by Matrix Assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry
WANG Ye Ru, CHEN Qian, CUI Sheng Hui, LI Feng Qin
2013, 26(6): 430-436. doi: 10.3967/0895-3988.2013.06.003

Objective To develop a matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) approach to identify Staphylococcus aureus (S. aureus) and differentiate methicillin-resistant S. aureus (MRSA) from methicillin-sensitive S. aureus (MSSA). Methods A total of 100 S. aureus strains isolated from clinical specimens and farm workers were collected and analyzed by MALDI-TOF-MS. And data obtained were interpreted with biotyper software. Results Ninety-two strains were identified by MALDI-TOF-MS as S. aureus at a level of secure genus and probable species, and 4 strains were identified at probable genus after their cultivation, spectral collection and data preprocessing. One strain was identified as S. aureus with lower score. It was revealed that identification of S. aureus by MALDI-TOF-MS was highly correlated with typing by biochemical and serological methods with an accuracy as high as 97%. The biotyper cluster analysis showed that 100 isolates were divided into 2 types at the distance level of 400. Higher peak intensity in the mass of both 3784 Da and 5700 Da was observed in MRSA, whereas that was absent from MSSA. Conclusion MALDI-TOF-MS is considered as a simple, rapid and highly reproducible technique with high-throughput and accuracy for the identification of S. aureus and it can reliably differentiate MRSA from MSSA.

The Association of Overweight and Obesity with Blood Pressure among Chinese Children and Adolescents
DONG Bin, MA Jun, WANG Hai Jun, WANG Zhi Qiang
2013, 26(6): 437-444. doi: 10.3967/0895-3988.2013.06.004

Objective To examine the association between obesity and high blood pressure (BP) in Chinese children and adolescents. Methods Body mass index (BMI) and blood pressure measurements of 197 191 children aged 7-17 years were obtained from a Chinese national survey in 2010. Obesity and high BP were defined according to the reference values for Chinese children. Adjusted odds ratios (ORs) and 95%confidence intervals (CIs) of different BMI categories for high BP, as well as the population attributable risk percent (PAR%), were also calculated. Results The prevalence of high BP was 16.1% for boys and 12.9%for girls in 2010. Overweight and obese children had a significantly higher prevalence of high BP than non-overweight children in both boys and girls in each age group. ORs (95%CI) for high BP were 4.1 (3.9, 4.4) in obese boys and 4.0 (3.7, 4.3) in obese girls. The overall PAR%for high BP due to overweight and obesity was 14.4%. Conclusion Overweight and obese children have a significantly higher risk of high BP than non-overweight children. Eliminating overweight and obesity could reduce 14.4%of high BP cases.

Socio-economic and Psychosocial Determinants of Smoking and Passive Smoking in Older Adults
ZHANG Dong Mei, HU Zhi, ORTON Sophie, WANG Jia Ji, ZHENG Jian Zhong, QIN Xia, CHEN Ruo Ling
2013, 26(6): 453-467. doi: 10.3967/0895-3988.2013.06.006

Objective To determine the associations of socio-economic and psychosocial factors with active and passive smoking in older adults. Methods Using a standard interview method, we examined random samples of 6071 people aged≥60 years in 5 provinces of China during 2007-2009. Results World age-standardised prevalence for current and former smoking in men was 45.6% and 20.5%, and in women 11.1%and 4.5%. Current smoking reduced with older age but increased with men, low socioeconomic status (SES), alcohol drinking, being never-married, pessimistic and depressive syndromes. Former smoking was associated with men, secondary school education, a middle-high income, being a businessman, being widowed, less frequencies of visiting children/relatives and friends, and worrying about children. Among 3774 never-smokers, the prevalence of passive smoking was 31.5%, and the risk increased with women, low SES, alcohol drinking, being married, having a religious believe, and daily visiting children/relatives. There were sex differences in the associations, and an interaction effect of education and income on smoking and passive smoking. Conclusion Older Chinese had a higher level of smoking and passive smoking than those in high income countries, reflecting China’s failures in controlling smoking. The associations with low SES and different psychosocial aspects and sex differences suggest preventative strategies for active and passive smoking.

Effectiveness Analysis on the Physical Activity and the Health Benefit of a Community Population Based Program
JIANG Ying Ying, YANG Zheng Xiong, NI Rong, ZHU You Qun, LI Zhi Yu, YANG Li Chen, ZHAI Yi, ZHAO Wen Hua
2013, 26(6): 468-473. doi: 10.3967/0895-3988.2013.06.007

Objective To evaluate the community-based health promotion effect of physical activity. Methods The residents aged 18 and above from two communities in Gongshu District of Hangzhou City, Zhejiang province, were randomly selected and recruited for the multi-strategy and comprehensive physical activity intervention. Questionnaire survey, physical check up and blood biochemistry were conducted. Results After this two-year intervention, the time of the participant spent on weekly physical activity of moderate intensity increased from 464 min to 542 min (P<0.05), with an average increase of 78 min. Time spent in walking every week increased from 533 min to 678 min (P<0.05), with an average increase of 145 min. The body weight, waistline, blood pressure and heart rate all reduced significantly (P<0.05);the vital capacity increased significantly (P<0.05); and the related biochemical indicators were also improved. Conclusion Comprehensive and evidence-based physical activity interventions targeting community population can improve the levels of physical activity, related body measurement and biochemical indicators.

Effects of Environmental Lead Pollution on Blood Lead and Sex Hormone Levels among Occupationally Exposed Group in An E-waste Dismantling Area
YANG Yan, LU Xiao Song, LI Ding Long, YU Yun Jiang
2013, 26(6): 474-484. doi: 10.3967/0895-3988.2013.06.008

Objective To study the effects of environmental multi-media lead pollution on blood lead and sex hormone levels among lead exposed males engaged in E-waste dismantling, and the correlation between confounding factors and sex hormone levels. Methods An E-waste dismantling area in Taizhou of Zhejiang Province was selected as the research site. One hundred and fifty two samples were collected from the groundwater, soil, rice, corn, chicken, and pork in the dismantling area. The effects of the multi-media lead pollution on the male blood lead and sex hormone levels of FSH, LH, and T, as well as the correlation with confounding factors, were studied. Results The blood lead concentrations in the males aged under 31, from 31 to 45 and from 46 to 60 were 98.55, 100.23, and 101.45μg/L , respectively. Of all the environmental media lead exposures, the groundwater, rice and soil were main contributing factors to the lead accumulation in humans. FSH and LH levels increased with the age while the T levels decreased with the age instead. There was a significant correlation between the FSH and LH levels and wearing masks. Conclusion There was correlation between the FSH, LH, and T levels, and the mean values of lead concentrations in environmental media, and the sex hormone levels were correlated with the confounding factor of wearing masks.

BMI, WC, WHtR, VFI and BFI:Which Indictor is the Most Efficient Screening Index on Type 2 Diabetes in Chinese Community Population
MI Sheng Quan, YIN Peng, HU Nan, LI Jian Hong, CHEN Xiao Rong, CHEN Bo, YAN Liu Xia, ZHAO Wen Hua
2013, 26(6): 485-491. doi: 10.3967/0895-3988.2013.06.009

Objective Obesity is a major risk factor for type 2 diabetes, many indexes can be used to describes obesity and predict diabetes. This research attempts to identify the best indicator of obesity to screening diabetes in Chinese population. Methods A cross-sectional data of 8121 subjects aged 35-60 years were included in this research belongs to the Diabetes Appropriate Technology Intervention Study. Anthropometric indicators including body weight, height, waist circumferences (WC), body fat index (BFI) and visceral fat index (VFI) and blood biochemical indicators after an overnight fast [fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, and triacylglycerol] were measured. BMI (body mass index) and Weight to Height Ratio was calculated. Results Subjects with obesity had a higher risk of physician diagnosed diabetes (OR=2.50, 95% CI 1.83-3.43), new diagnosed diabetes (OR=4.23, 95% CI 2.91-6.15) and pre-diabetes (OR=1.75, 95% CI 1.31-2.34) compared to those with normal Body mass index (BMI). There was a significant trend of increased risk of all diabetes status with increased waist circumference (WC). The waist-to-height ratio (WHtR) yielded the most significant association with new diagnosed diabetes and physician diagnosed diabetes than other indices. Conclusion Central obesity is significantly correlated with diabetes. VFI was most correlated with pre-diabetes while WHtR is an efficient screening index than BMI and WC in Chinese community diabetes screening.

Age-related Infection with Cryptosporidium Species and Genotype in Pigs in China
YIN Jian Hai, YUAN Zhong Ying, CAI Hui Xia, SHEN Yu Juan, JIANG Yan Yan, ZHANG Jing, WANG Yan Juan, CAO Jian Ping
2013, 26(6): 492-495. doi: 10.3967/0895-3988.2013.06.010

Objective Pigs, as hosts of zoonotic Cryptosporidium species/genotypes, are domestic animals with public health significance. The present study was to characterize the infection rate and species/genotype of Cryptosporidium in pre-weaned and post-weaned pigs from Shanghai and Shaoxing, China. Methods A total of 208 fecal samples (42 from pre-weaned piglets, and 166 from post-weaned pigs) were examined by nested PCR of the 18S rRNA gene and analyzed by phylogenetic DNA fragment sequencing of secondary PCR products. Results Infection was detected in 79 samples (19/42 pre-weaned piglets, and 60/166 post-weaned pigs). C. suis (14/79) and Cryptosporidium pig genotype II (65/79) were identified; piglets were more susceptible to the former (13/14) and post-weaned pigs to the latter (59/65). Conclusion Infection of Cryptosporidium spp. in pigs was age-specific;piglets were more susceptible to C. suis while pigs were more susceptible to Cryptosporidium pig genotype II. These findings combined with the isolation of the two Cryptosporidium from water suggest that pigs may be a source of zoonotic Cryptosporidium water pollution. Improvements in pig feeding practices, sewage discharge, feces disposal and field worker protection are therefore important to prevent potential public health problems.

Impact of Sub-chronic Aluminium-maltolate Exposure on Catabolism of Amyloid Precursor Protein in Rats
LIANG Rui Feng, LI Wei Qing, WANG Hong, WANG Jun Xia, NIU Qiao
2013, 26(6): 445-452. doi: 10.3967/0895-3988.2013.06.005

Objective To investigate the impact of sub-chronic Aluminium-maltolate [Al(mal) 3 ] exposure on the catabolism of amyloid precursor protein (APP) in rats. Methods Forty adult male Sprague-Dawley (SD) rats were randomly divided into five groups: the control group, the maltolate group (7.56 mg/kg BW), and the Al(mal) 3 groups (0.27, 0.54, and 1.08 mg/kg BW, respectively). Control rats were administered with 0.9% normal saline through intraperitoneal (i.p.) injection. Maltolate and Al(mal) 3 were administered to the rats also through i.p. injections. Administration was conducted daily for two months. Rat neural behavior was examined using open field tests (OFT). And the protein expressions and their mRNAs transcription related with APP catabolism were studied using enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (RT-PCR). Results The expressions of APP, β-site APP cleaving enzyme 1 (BACE1) and presenilin-1 (PS1) proteins and their mRNAs transcription increased gradually with the increase of Al(mal) 3 doses (P<0.05). The enzyme activity of BACE1 in the 0.54 and 1.08 mg/kg Al(mal) 3 groups increased significantly (P<0.05). The expression of β-amyloid protein (Aβ) 1-40 gradually decreased while the protein expression of Aβ1-42 increased gradually with the increase of Al(mal) 3 doses (P<0.05). Conclusion Result from our study suggested that one of the possible mechanisms that Al(mal) 3 can cause neurotoxicity is that Al(mal) 3 can increase the generation of Aβ1-42 by facilitating the expressions of APP, β-, and γ-secretase.

Letters to the Editor
A Better Instrument for Screening Diabetes in Rural Areas of China:An Equation Developed from Multivariate Logistic Regression or a Simplified Scoring Form
ZHAO Xiao Long, HE Xiao Ye, ZHANG Heng Sheng, LU Bin, LI Jin Hui, LI Yi Ming, ZHOU Li Nuo, and HU Ren Ming
2013, 26(6): 496-499. doi: 10.3967/0895-3988.2013.06.011
Correlation of Inferior Vena Cava Respiratory Variability Index with Central Venous Pressure and Hemodynamic Parameters in Ventilated Pigs with Septic Shock
LIU Xiao Lei, TAO Yong Kang, YAN Sheng Tao, QI Zhi Wei, LU Hai Tao, WANG Hai Feng, GU Cheng Dong, ZHANG Guo Qiang
2013, 26(6): 500-503. doi: 10.3967/0895-3988.2013.06.012
Molecular Typing of Brucella Suis Collected from 1960s to 2010s in China by MLVA and PFGE
LI Zhen Jun, CUI Bu Yun, CHEN Hai, CHEN Jing Diao, ZHAO Hong Yan, PIAO Dong Ri, JIANG Hai, ZHANG Li, TANG Xu, KE Chang Wen, YAO zhen, TIAN Guo Zhong
2013, 26(6): 504-508. doi: 10.3967/0895-3988.2013.06.013
Analysis of Paraquat Intoxication Epidemic (2002-2011) within China
YIN Yu, GUO Xiang, ZHANG Shou Lin, SUN Cheng Ye
2013, 26(6): 509-512. doi: 10.3967/0895-3988.2013.06.014
Policy Forum
Establishment of Occupational Exposure Limit for Warfarin in China
XU Jian Ning, FU Zhao Hui, YU Wen Lan, WANG Quan Kai, TAN Feng
2013, 26(6): 513-516. doi: 10.3967/0895-3988.2013.06.015

This study aims to establish the occupational exposure limit (OEL) in the air for workplace of warfarin based on the available toxicological studies and field investigations by using questionnaire and air monitoring. The clinical therapeutic dose was used as lowest observed effect level (LOEL), and no observed effect level (NOEL) was achieved by using a safety factor. The highest concentration of warfarin monitored in the worksite of centrifuge washing, drying and packing were 0.029 mg/m3, 0.051 mg/m3 respectively, which did not exceed the OEL 0.1 mg/m3 recommended by NIOSH and ACGIH. Considering its feasibility for enforcement and protection for workers, we recommend OEL 0.1 mg/m3 of warfarin in China.